Self-Efficacy, Academic Motivation, and Self-Regulation: How Do They Predict Academic Achievement for Medical Students?

Purpose: Self-efficacy, academic motivation, and self-regulation have been identified as important factors contributing to students’ learning success in general education. In the field of medical education, however, few studies have examined these variables or their interrelationships as predictors of undergraduate medical students’ learning outcomes, especially in the context of flipped learning. Methods: Using structural equation modeling (SEM), this study explored the impact of self-efficacy on 146 first- and second-year medical students’ academic achievement in a flipped-learning environment, and whether such impact (if any) was mediated by academic motivation and self-regulated learning (SRL) strategies. Results: On average, students scored highest on self-efficacy (mean = 5 out of a possible 7), followed by intrinsic motivation (mean = 4.59), resource-management strategies (mean = 4.48), metacognitive strategies (mean = 4.46), extrinsic motivation (mean = 4.24), and cognitive strategies (mean = 4.17). Our SEM results suggest that, while there was a direct effect of self-efficacy on learning outcomes, academic motivation and SRL strategies did not mediate it. Conclusions: By unpacking the structural relationships among self-efficacy, academic motivation, SRL strategies, and learning outcomes, this study provides evidence-based support for the importance of promoting students’ self-efficacy in undergraduate medical flipped-learning environments. Strategies for increasing students’ self-efficacy are also discussed.