Study 4: Simulated Patient Consultations in a Second Language: The Role of Open Learning Tasks in Enhancing Competence and Intrinsic Motivation

<B>Summary of the Study:</B><BR><BR>
This study investigated whether <B>open learning tasks</B> (where students generate their own medical Dutch dialogue) or <B>closed learning tasks</B> (where students use pre-scripted sentences) are more effective for international medical students learning Dutch.<BR>
• <B>Design</B>: Mixed-methods, quasi-experimental, pre-post.<BR>
• <B>Participants</B>: 15 third-year international medical students (open task group: n=7; closed task group: n=8), all at <B>B2 Dutch CEFR level</B> and with prior English SPC experience .<BR>
• <B>Procedure</B>: Over six weeks, both groups engaged in <B>six simulated patient consultations (SPCs)</B> covering diabetes, autoimmune diseases, respiratory diseases, heart diseases, oncology, and neurology.<BR>
o <B>Open-task group</B>: Watched full expert consultations, created their own dialogues, used <B>rubrics</B> for peer/self-assessment.<BR>
o <B>Closed-task group</B>: Watched segmented didactic clips, reused model sentences, used <B>checklists</B> for peer/self-assessment .<BR>
• <B>Instruments</B>:<BR>
o Intrinsic Motivation to Experience Stimulation (IMES) scale<BR>
o Need for Competence Satisfaction (NCS) scale<BR>
o Self/peer assessment rubrics or checklists<BR>
o Semi-structured interviews (30–45 min, n=15)<BR>
<B>Key Findings</B>:<BR>
1. <B>Intrinsic Motivation</B>: Both groups showed high intrinsic motivation, with <B>no significant group differences</B> .<BR>
2. <B>Competence</B>:<BR>
o Open-task group reported <B>higher satisfaction of competence</B> (N-gain Mdn = .5 vs. 0, p=.02).<BR>
o Objective assessment scores: Open-task (self = 78%, peer = 84%) vs. Closed-task (self = 69%, peer = 80%).<BR>
3. <B>Qualitative Themes</B>:<BR>
o <I>Learning expectations</I>: Both groups valued Dutch fluency, vocabulary, and real-life practice .<BR>
o <I>Contentment with learning</I>: Both groups appreciated authenticity; open-task group emphasized <B>difficulty and enrichment</B> (desirable difficulties).<BR>
o <I>Perceived learning improvement:</I> Both groups felt progress, but open-task students reported <B>greater integration</B> of language with consultation skills .<BR>
4. <B>Overall Conclusion</B>: Open tasks did not further increase intrinsic motivation but created <B>desirable difficulties</B> that enhanced competence and integration. Closed tasks led to faster but shallower progress .<BR><BR>