Benefits of gamification in medical education

Intrinsic and extrinsic types of motivation have been widely studied, and the distinction between them has shed important light on both developmental and educational practices. In this review we revisit the classic definitions of intrinsic and extrinsic motivation in light of contemporary research and theory. Intrinsic motivation remains an important construct, reflecting the natural human propensity to learn and assimilate. However, extrinsic motivation is argued to vary considerably in its relative autonomy and thus can either reflect external control or true self-regulation. The relations of both classes of motives to basic human needs for autonomy, competence and relatedness are discussed. Copyright 2000 Academic Press.

More than 4 decades of research and 9 meta-analyses have focused on the undermining effect: namely, the debate over whether the provision of extrinsic incentives erodes intrinsic motivation. This review and meta-analysis builds on such previous reviews by focusing on the interrelationship among intrinsic motivation, extrinsic incentives, and performance, with reference to 2 moderators: performance type (quality vs. quantity) and incentive contingency (directly performance-salient vs. indirectly performance-salient), which have not been systematically reviewed to date. Based on random-effects meta-analytic methods, findings from school, work, and physical domains (k = 183, N = 212,468) indicate that intrinsic motivation is a medium to strong predictor of performance (ρ = .21-45). The importance of intrinsic motivation to performance remained in place whether incentives were presented. In addition, incentive salience influenced the predictive validity of intrinsic motivation for performance: In a "crowding out" fashion, intrinsic motivation was less important to performance when incentives were directly tied to performance and was more important when incentives were indirectly tied to performance. Considered simultaneously through meta-analytic regression, intrinsic motivation predicted more unique variance in quality of performance, whereas incentives were a better predictor of quantity of performance. With respect to performance, incentives and intrinsic motivation are not necessarily antagonistic and are best considered simultaneously. Future research should consider using nonperformance criteria (e.g., well-being, job satisfaction) as well as applying the percent-of-maximum-possible (POMP) method in meta-analyses.