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Fostering intrinsic motivation in remote undergraduate histopathology education
  1. Hussein Uraiby1,2,
  2. Ciaran Grafton-Clarke1,2,
  3. Morris Gordon3,
  4. Marco Sereno4,
  5. Barbara Powell2,
  6. Mark McCarthy1,2
  1. 1 Department of Clinical Education, University Hospitals of Leicester NHS Trust, Leicester, UK
  2. 2 Leicester Medical School, University of Leicester, Leicester, UK
  3. 3 School of Medicine, University of Central Lancashire, Preston, UK
  4. 4 Department of Respiratory Sciences, University of Leicester, Leicester, UK
  1. Correspondence to Dr Hussein Uraiby, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, UK; hussein_uraiby{at}


Aims The levels of abstraction, vast vocabulary and high cognitive load present significant challenges in undergraduate histopathology education. Self-determination theory describes three psychological needs which promote intrinsic motivation. This paper describes, evaluates and justifies a remotely conducted, post-COVID-19 histopathology placement designed to foster intrinsic motivation.

Methods 90 fourth-year medical students took part in combined synchronous and asynchronous remote placements integrating virtual microscopy into complete patient narratives through Google Classroom, culminating in remote, simulated multidisciplinary team meeting sessions allowing participants to vote on ‘red flag’ signs and symptoms, investigations, histological diagnoses, staging and management of simulated virtual patients. The placement was designed to foster autonomy, competence and relatedness, generating authenticity, transdisciplinary integration and clinical relevance. A postpositivistic evaluation was undertaken with a validated preplacement and postplacement questionnaire capturing quantitative and qualitative data.

Results There was a significant (p<0.001) improvement in interest, confidence and competence in histopathology. Clinical integration and relevance, access to interactive resources and collaborative learning promoted engagement and sustainability post-COVID-19. Barriers to online engagement included participant lack of confidence and self-awareness in front of peers.

Conclusions Fostering autonomy, competence and relatedness in post-COVID-19, remote educational designs can promote intrinsic motivation and authentic educational experiences. Ensuring transdisciplinary clinical integration, the appropriate use of novel technology and a focus on patient narratives can underpin the relevance of undergraduate histopathology education. The presentation of normal and diseased tissue in this way can serve as an important mode for the acquisition and application of clinically relevant knowledge expected of graduates.

  • medical informatics computing
  • education
  • medical
  • telepathology

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Data are available in a public, open access repository. Full learning resources and evaluative tools have been published, and freely available for reuse from the Harvard Dataverse.

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Data availability statement

Data are available in a public, open access repository. Full learning resources and evaluative tools have been published, and freely available for reuse from the Harvard Dataverse.

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  • Handling editor Dhirendra Govender.

  • Contributors HU lead the conception, design, implementation, evaluation, analysis, write-up and revision of this work. CG-C contributed to additional write-up, data analysis, review and revision of this work. MG contributed to review of pedagogical underpinning, additional write-up, revision and supervision of this work. MS contributed to data analysis, additional write-up and review of this work. BP contributed to implementation and review of this work. MM contributed to supervision and review of this work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.