Achievement goal theory is consistently associated with specific cognitions, emotions, and behaviors that support learning in many domains, but has not been examined in postgraduate medical education.

Motivation is broadly defined as the process by which goal-directed behavior is initiated and sustained. Recently Cook and Artino1 argued the importance of “making the theoretical foundations of motivation accessible to medical educators” and they included achievement goal theory as one of five contemporary theories of motivation that may be highly relevant to medical education.

Medical education, including postgraduate residency programs, represents a competitive achievement context in which individuals exert effort to obtain desirable outcomes. Achievement goal theory uses the term “goal” to represent different aims a learner has in the achievement context.

Specifically, in the hierarchical model of achievement goals, goals are conceptualized as consisting of two dimensions. The first dimension is competence and represents the extent to which individuals strive to gain competence or demonstrate competence.

The former is labeled a mastery goal and the latter is labeled as a performance goal. The second dimension is valence and represents the extent to which individuals move toward or away from their goal (approach or avoidance goals, respectively).

Crossing competence and valence results in a 2 x 2 matrix with four types of goals: mastery-approach, mastery-avoidance, performance-approach, and performance-avoidance. Each goal is associated with a relatively unique pattern of cognitions, emotions, and behaviors that can support or impede student learning and success.

Implications for practice

As mentioned, 23% of the residents did not endorse mastery-approach goals and 14% endorsed performance-avoidance goals. If these numbers are similar in other residency programs we should consider encouraging mastery-approach goals in residency and minimizing performance-avoidance goals as much as possible.

There are two major approaches to supporting mastery-goals, one focuses on changing the environment and the other on changing learners’ personal achievement goals.

First, researchers have several recommendations for how to build a mastery-learning environment including allowing students to have the choice, minimizing normative comparisons, and providing adequate time to meet program outcomes.

Second, researchers have shown that brief psychosocial interventions such as attributional retraining can help students increase their endorsement of mastery-approach goals.

Attributional retraining involves helping students shift their cognitions from uncontrollable and stable explanations for outcomes such as the low ability to controllable and unstable explanations such as effort.

In combination, environmental and individual interventions could be used to leverage mastery goals not only for postgraduate medical education but undergraduate as well.