Abstract
The COVID-19 pandemic has greatly changed medical education, and medical trainees’ self-regulation has become more emphasized. In Japan, the concept of self-regulated learning has not been fully applied in health profession education due to a lack of effective measurement tools. We aimed to validate the translated Japanese version of the Motivated Strategies for Learning Questionnaire in the context of Problem-Based Learning (J-MSLQ-PBL). The questionnaire employs a seven-point Likert-type scale with 81 items and is categorized into two sections: motivation and learning strategies. An exploratory factor analysis (EFA) was conducted by using Promax rotation to examine the factor structure of the scale, using the collected data from 112 Japanese medical students. Factor extraction was based on a scree plot investigation, and an item was accepted when the factor loading was ≥0.40. In the motivation section, the extracted factors from the EFA were well aligned with the subscales of the original MSLQ, including “Self-Efficacy for Learning and Performance”, “Task Value”, “Self-Efficacy for Learning and Performance”, “Test Anxiety”, “Extrinsic Goal Orientation”, and “Intrinsic Goal Orientation”. In the learning strategies, the extracted factors poorly matched the structure of the original subscales. This discrepancy could be explained by insufficient translation, the limited sample size from a single medical school, or cross-cultural differences in learning strategies between Western and Japanese medical students. Only the motivation part of the J-MSLQ-PBL should be implemented to measure the competency elements of self-regulated learning in Japan.
1. Introduction
COVID-19 has substantially changed medical education. Social distancing is strongly recommended during a pandemic, and in-person educational activities in medical schools and hospitals have been suspended; therefore, the modality of learning for medical students has changed to an online mode [1,2]. This results in fewer opportunities for trainees in medicine to meet their classmates and talk with the faculty and mentors at medical schools [2]. With the increased use of online learning during the pandemic, students spent less time in live learning opportunities and more time in self-directed learning activities.
Medical students’ autonomy and self-regulation should be more emphasized during and post-COVID-19 pandemic, as self-regulated learning is a fundamental process that allows students to adapt to the unusual situation (e.g., pandemic) and to develop planning, prevision, and monitoring of their learning activities and wellness [3].
Self-regulated learning, defined as learners’ active participation in the learning process from metacognitive, motivational, and behavioral perspectives, is becoming even more prominent in the new normal era [4,5,6,7]. Zimmerman’s self-regulated learning theory suggests how motivations work in a cyclic process in three phases: forethought, performance, and self-reflection [8]. In the first phase of forethought, learners set goals and choose strategies to achieve them by utilizing their motivational beliefs, such as self-efficacy, values, and interests. Next, learners observe and control themselves in the performance phase to attain their goals. In the last phase of self-reflection, individuals reflect on their previous performance to prepare for new goals for future learning (i.e., the new foresight phase) [9].
The Motivated Strategies for Learning Questionnaire (MSLQ) is one of the most widely used measurements designed to assess the competency elements in self-regulated learning in pedagogy. In addition, this measurement is widely used in health professions’ education research. Cook et al. aimed to validate the MSLQ in medical trainees and showed that several factors of their MSLQ data demonstrated a similar psychometric profile to that of original scales studied in educational psychology [10]. Another study investigated the medical students’ changes in the self-regulated learning process during the transition to clinical learning in the first clinical year in Australia [11].
However, in Japan, self-regulated learning has yet to be fully applied in medical education due to a lack of effective measurement tools [12]. Problem-based learning (PBL) is one of the ordinary teaching strategies that facilitates students’ self-regulated learning competencies in Japanese undergraduate medical education. This study, therefore, aimed to collect and examine validity evidence for the Japanese version of the MSLQ adapted to the PBL context.
2. Materials and Methods
2.1. Design and Participants
This was a secondary analysis study using a database, which was initially collected to examine the impact of self-regulated learning during the problem-based learning (PBL) course [11] at Jichi Medical University, Japan, on medical students’ professional identity formation. Of all 124 third-year medical students invited to participate in this study, 112 agreed.
2.2. Measurements
The MSLQ, which is a seven-point Likert-scale survey, includes two sections: motivation and learning strategies [12]. The motivation section includes 31 items assessing three domains: goal orientation, self-belief, and test anxiety. The learning-strategies section includes 50 items assessing three domains: the use of cognitive strategies, metacognitive strategies, and resource management. The principal investigator of the research project (Y.M.) and the supervisor (A.L.J.) created a Japanese version of the MSLQ by translating all 81 items into Japanese, with backtranslation [13]. In the translation process, we adapted the item descriptions to the context of PBL to make the MSLQ suitable for assessing the participants’ self-regulated learning competencies during the PBL course. We named this scale the J-MSLQ-PBL.
2.3. Context
The one-day PBL program for third-year medical students was divided into four segments: (1) an opening case discussion for the formulation of the self-study objectives, (2) a self-study period for objectives and preparation for subsequent group discussion, (3) a group discussion that included within-group information sharing, and (4) a 60 min wrap-up lecture from a specialist. This survey was conducted in the orientation phase of the PBL course.
2.4. The Theoretical Framework of Validation
According to Kane [14], the validation of a measurement method requires gathering evidence to examine the four key inferences: (1) the scoring of a single observation (scoring), (2) using the primary observation score to generate the whole test performance (generalization), (3) inferring the real-life performance from the test performance (extrapolation), and (4) interpreting this information to make a decision (implication). In addition, recent validation studies in health sciences education have commonly used Kane’s framework for translating psychomimetic tools in English into other languages [15,16].
2.5. Analysis
We conducted an exploratory factor analysis (EFA) with the maximum likelihood method and Promax rotation to examine the factor structure of the Motivation and Learning Strategies Scales of the J-MSLQ. Factor extraction was based on parallel analysis, and an item was accepted when the factor loading was ≥0.40. Due to the small sample size, a confirmatory factor analysis was not conducted. The Kaiser–Meyer–Olkin (KMO) test was used to test the suitability of the scale for the sampling adequacy. Cronbach’s alpha was calculated as a measure of internal reliability. All data analyses were conducted in R (Version 4.2.1) and R studio (2022.07.2 Build 576) with the packages psych (version 2.2.9) and GPArotation (version 2022.10-2).
2.6. Ethics
This study was approved by the Jichi Medical University Clinical Research Ethics Committee (reference number: 18–168). Informed consent was obtained from all participants.
3. Results
Table 1 and Table 2 show the mean score, standard deviation, median, and first and third quartiles in items of the J-MSLQ-PBL, respectively. Q5, Q6, Q15, and Q31, which were categorized as “Self-Efficacy for Learning and Performance”, tended to have low scores (less than three points). In contrast, Q4, Q17, and Q23, which were categorized as “Task Value”, tended to have high scores (more than five points). In the items of the Learning Strategies Scale, trends in scores were not observed.
Table 1.
Descriptive statistics of the Motivation Scale.
Table 2.
Descriptive statistics of the Learning Strategies Scale.
3.1. Factor Analysis
Because of the negative correlation with the total scale, Q3 of the Motivation Scale was excluded from the EFA. The KMO tests for the Motivation and Learning Strategies Scales were 0.788 and 0.754, respectively. Based on parallel analysis, the 30-item Motivation Scale and the 50-item Learning Strategies Scale suggested six and five factors, respectively. The factor loadings and proportions of variance explained by the factors are outlined in Table 3 and Table 4.
Table 3.
Factor loadings and variance explained from an exploratory factor analysis of the Motivation Scale.
Table 4.
Factor loadings and variance explained from an exploratory factor analysis of the Learning Strategies Scale.
In the Motivation Scale (Figure 1), the first factor, which explained 12.2% of the total variance in the data, was labeled “Self-Efficacy for Learning and Performance” based on the high loadings of Q6, Q15, Q20, and Q31. The second factor, which explained 9.9%, was labeled “Task Value” based on the high loadings of Q17, Q23, Q26, and Q27. The third factor, which explained 8.5%, was labeled “Control of Learning Beliefs and Self-Efficacy for Learning and Performance” based on the high loadings of Q2, Q5, Q18, Q21, and Q29. The fourth factor, which explained 8.0%, was labeled “Extrinsic Goal Orientation” based on the high loadings of Q7, Q11, Q13, Q22, and Q30. The fifth factor, which explained 7.1%, was labeled “Test Anxiety” based on the high loadings of Q8, Q14, Q19, and Q28. The last factor, which explained 6.7%, was labeled “Intrinsic Goal Orientation” based on the high loadings of Q1, Q10, Q24, and Q25. In total, 52.4% of the total variability in the data was explained by the factor structure.
Figure 1.
Factor analysis of the Motivation Scale.
In the Learning Strategies Scale (Figure 2), the first factor explained 10.9% of the total variance in the data. The second to fifth factors explained 8.9%, 8.5%, 6.4%, and 5.2%, respectively. In total, 39.9% of the total variability in the data was explained by the factor structure. There were no trends in the categories of items with high loadings in each factor; hence, labeling factors according to loadings was difficult.
Figure 2.
Factor analysis of the Learning Strategies Scale.
3.2. Internal Reliability of the Motivation Scale and Subscales
After excluding the items with a factor loading less than 0.40, the Cronbach’s alpha of the overall Motivation Scale was 0.87 (26 items). The six subscales were as follows: 0.88 (four items), 0.81 (four items), 0.80 (four items), 0.79 (five items), 0.72 (four items), and 0.64 (four items) for “Self-Efficacy for Learning and Performance”, “Task Value”, “Control of Learning Beliefs and Self-Efficacy for Learning and Performance”, “Extrinsic Goal Orientation”, “Test Anxiety”, and “Intrinsic Goal Orientation”, respectively (Table 3). The internal reliability of the Motivation Scale, as well as the subscales other than goal setting, was adequate (α > 0.70).
4. Discussion
This study aimed to collect and examine validity evidence for the Japanese version of the MSLQ adapted to the PBL context regarding Kane’s four steps of validity arguments [14,15]. In addition, we found that the internal structure of the motivation section of the J-MSLQ-PBL was consistent with the theory of self-regulated learning; however, the learning-strategies section did not align with the original structure of the MSLQ.
4.1. Scoring Inference
One of the potential reasons for the inconsistency of the learning-strategies section between the J-MSLQ-PBL and the original MSLQ could be the insufficient translation process for the J-MSLQ-PBL. While the J-MSLQ-PBL was developed using the backtranslation method, the method could be inappropriate for some translations whose topic is sensitive to sociocultural factors such as the learning culture, educational system, and differences in cultural backgrounds. This could be a barrier to correctly translating assessment tools in health-sciences education. The descriptions of the motivation-section items were concise because the section focuses on the planning of goal setting for learning at an individual level. However, the descriptions of the learning-strategies section were more complicated because these subscales refer to applying strategies, monitoring performance, and reflecting on performance in the self-regulated learning process [17]. In addition, the learners’ behavior related to the subscale on profound learning (e.g., critical and metacognitive thinking) and interpersonal learning (e.g., peer learning and help-seeking) could be susceptible to cultural influences. To deal with this issue, cross-cultural survey guidelines recommend using a team translation model that employs bilingual experts to ensure proper translation and cross-cultural and linguistic equivalences between the two language survey versions [18].
4.2. Generalization Inference
The internal structure of the motivation section was consistent with the original MSLQ. In addition, Cook et al. [10] reported that the motivation section of the MSLQ was well-validated in medical residents by performing a correlation, reliability, and factor analysis. Furthermore, Miyabe also conducted a validation study of the Japanese version of the MSLQ with first-year nursing students [19]. The current study furthermore examined the validity evidence of the J-MSLQ-PBL and demonstrated that the scale’s internal structure is consistent with the SRL theory. This indicates that the J-MSLQ-PBL for the PBL context can be generalizable to measure Japanese medical students’ SRL competency elements for learning in PBL. However, this study was conducted in a single private medical school in Japan; thus, further validation study in another type of institution is needed to expand the generalizability. Furthermore, a more robust statistical analysis, such as a structural equation model using a larger sample size, would improve the generalizability of the J-MSLQ-PBL.
4.3. Implication Inference
Our study also showed that the results of EFA for the learning-strategies section did not align with the SRL theory. There are several possible reasons. Most of Japan’s educational contents in preclinical medical education are didactic, even if PBL is partially included in the curriculum [20]. Thus, Japanese medical students have fewer opportunities to develop their skills in learning strategies than medical students in other countries [21]. In this sense, there was the possibility of a content validity issue; Japanese medical students perhaps could not understand the meaning of the descriptions in the learning-strategies sections because they are less experienced in using these skills. In addition, it has been reported that the group dynamics of Japanese medical students in PBL are inactive. Therefore, the students’ interactions during PBL may differ from those in other English-speaking countries [22]. This could influence the response to the items of the help-seeking and peer-learning subscales, as it is considered that there is a social-interaction pattern within the learning environment that is unique to Japanese medical trainees [18,23].
4.4. Extrapolation Inference
Due to its limited coherence with theory, the learning-strategies section is not applicable for usage, as the validity evidence in both the literature and the present study for the section was insufficient. On the contrary, the motivation section was well-validated from both perspectives.
There are limitations to arguing the implications of the J-MSLQ-PBL. First, as discussed, there would be an issue of face validity due to the insufficient translation procedure; thus, the team translation model needs to be applied to consider the cultural influence on the translation process. In addition, integrating qualitative evidence, such as in-depth interviews to explore the students’ perceptions of item descriptions, could help improve the face validity.
5. Conclusions
This study examined validity evidence for the Japanese version of the MSLQ adapted to the PBL context. The internal structure of the motivation section of the J-MSLQ-PBL was consistent with the theory of self-regulated learning; however, the learning-strategies section did not align with the original structure of the MSLQ. Thus, only the motivation section of the J-MSLQ-PBL can be implemented to measure competency elements in self-regulated learning in Japan. Additional work is needed to clarify the reason for the discrepancy in the learning-strategies section between the J-MSLQ-PBL and the MSLQ.
Author Contributions
O.N., conceptualization, methodology, investigation and writing—original draft; Y.S., validation, formal analysis, and writing—original draft; H.K., writing—review and editing; Y.M., investigation, writing—review and editing, supervision, project administration, and funding acquisition. All authors have read and agreed to the published version of the manuscript.
Funding
This research was funded by JSPS Kakenhi, grant numbers JP17K08924 and JP20K10384.
Institutional Review Board Statement
Not applicable.
Informed Consent Statement
Not applicable.
Data Availability Statement
Not applicable.
Acknowledgments
The authors would like to thank Motoyuki Nakaya, Jimmie Leppink, Cees van der Vleuten, Yoshikazu Asada, Adam Jon Lebowitz, Teppei Sasahara, Yu Yamamoto, Masami Matsumura, Akira Gomi, Shizukiyo Ishikawa, Hitoaki Okazaki, and Hiroyuki Hanada for their helpful assistance to complete this study. The authors also thank Ririka Saito for her editing of this manuscript.
Conflicts of Interest
The authors declare no conflict of interest.
References
- Hayashi, M.; Nishiya, K.; Kaneko, K. Transition from undergraduates to residents: A SWOT analysis of the expectations and concerns of Japanese medical graduates during the COVID-19 pandemic. PLoS ONE 2022, 17, e0266284. [Google Scholar] [CrossRef]
- Rose, S. Medical Student Education in the Time of COVID-19. JAMA 2020, 323, 2131–2132. [Google Scholar] [CrossRef]
- Jumreornvong, O.; Yang, E.; Race, J.; Appel, J. Telemedicine and Medical Education in the Age of COVID-19. Acad. Med. 2020, 95, 1838–1843. [Google Scholar] [CrossRef] [PubMed]
- Lajoie, S.P.; Gube, M. Adaptive expertise in medical education: Accelerating learning trajectories by fostering self-regulated learning. Med. Teach. 2018, 40, 809–812. [Google Scholar] [CrossRef]
- Zheng, J.; Li, S.; Lajoie, S.P. The Role of Achievement Goals and Self-regulated Learning Behaviors in Clinical Reasoning. Technol. Knowl. Learn. 2020, 25, 541–556. [Google Scholar] [CrossRef]
- Lajoie, S.P.; Zheng, J.; Li, S.; Jarrell, A.; Gube, M. Examining the interplay of affect and self regulation in the context of clinical reasoning. Learn. Instr. 2021, 72, 101219. [Google Scholar] [CrossRef]
- Azevedo, R.; Bouchet, F.; Duffy, M.; Harley, J.; Taub, M.; Trevors, G.; Cloude, E.; Dever, D.; Wiedbusch, M.; Wortha, F.; et al. Lessons Learned and Future Directions of MetaTutor: Leveraging Multichannel Data to Scaffold Self-Regulated Learning with an Intelligent Tutoring System. Front. Psychol. 2022, 13, 813632. [Google Scholar] [CrossRef]
- Zimmerman, B.J. Self-Regulated Learning and Academic Achievement: An Overview. Educ. Psychol. 1990, 25, 3–17. [Google Scholar] [CrossRef]
- Artino, A.R., Jr.; Jones, K.D. AM last page: Self-regulated learning—A dynamic, cyclical perspective. Acad. Med. 2013, 88, 1048. [Google Scholar] [CrossRef]
- Cook, D.A.; Thompson, W.G.; Thomas, K.G. The Motivated Strategies for Learning Questionnaire: Score validity among medicine residents. Med. Educ. 2011, 45, 1230–1240. [Google Scholar] [CrossRef]
- Cho, K.K.; Marjadi, B.; Langendyk, V.; Hu, W. Medical student changes in self-regulated learning during the transition to the clinical environment. BMC Med. Educ. 2017, 17, 59. [Google Scholar] [CrossRef]
- Pintrich, P.R.; Smith, D.A.F.; Duncan, T.; Mckeachie, W.J. A Manual for the Use of the Motivated Strategies for Learning Questionnaire (MSLQ). 1991. Available online: https://www.researchgate.net/publication/271429287_A_Manual_for_the_Use_of_the_Motivated_Strategies_for_Learning_Questionnaire_MSLQ (accessed on 1 December 2022). [CrossRef]
- Matsuyama, Y.; Nakaya, M.; Leppink, J.; van der Vleuten, C.; Asada, Y.; Lebowitz, A.J.; Sasahara, T.; Yamamoto, Y.; Matsumura, M.; Gomi, A.; et al. Limited effects from professional identity formation-oriented intervention on self-regulated learning in a preclinical setting: A randomized-controlled study in Japan. BMC Med. Educ. 2021, 21, 30. [Google Scholar] [CrossRef]
- Kane, M.T. Validating the Interpretations and Uses of Test Scores. J. Educ. Meas. 2013, 50, 1–73. [Google Scholar] [CrossRef]
- Cook, D.A.; Brydges, R.; Ginsburg, S.; Hatala, R. A contemporary approach to validity arguments: A practical guide to K ane’s framework. Med. Educ. 2015, 49, 560–575. [Google Scholar] [CrossRef]
- Nomura, O.; Itoh, T.; Mori, T.; Ihara, T.; Tsuji, S.; Inoue, N.; Carrière, B. Creating Clinical Reasoning Assessment Tools in Different Languages: Adaptation of the Pediatric Emergency Medicine Script Concordance Test to Japanese. Front. Med. 2021, 8, 765489. [Google Scholar] [CrossRef]
- Soemantri, D.; McColl, G.; Dodds, A. Measuring medical students’ reflection on their learning: Modification and validation of the motivated strategies for learning questionnaire (MSLQ). BMC Med. Educ. 2018, 18, 274. [Google Scholar] [CrossRef]
- Nomura, O.; Wiseman, J.; Sunohara, M.; Akatsu, H.; Lajoie, S.P. Japanese medical learners’ achievement emotions: Accounting for culture in translating Western medical educational theories and instruments into an asian context. Adv. Health Sci. Educ. Theory Pract. 2021, 26, 1255–1276. [Google Scholar] [CrossRef] [PubMed]
- Miyabe, A.; Togashi, C.; Sakuma, K.; Sato, C. Reliability and validity of a Japanese version of the Motivated Strategies for Learning Questionnaire for motivation scales. J. Jpn. Health Med. Assoc. 2016, 25, 276–286. [Google Scholar]
- Onishi, H.; Yoshida, I. Rapid change in Japanese medical education. Med. Teach. 2004, 26, 403–408. [Google Scholar] [CrossRef]
- Saiki, T.; Imafuku, R.; Suzuki, Y.; Ban, N. The truth lies somewhere in the middle: Swinging between globalization and regionalization of medical education in Japan. Med. Teach. 2017, 39, 1016–1022. [Google Scholar] [CrossRef]
- Niwa, M.; Saiki, T.; Fujisaki, K.; Suzuki, Y.; Evans, P. The Effects of Problem-Based-Learning on the Academic Achievements of Medical Students in One Japanese Medical School, Over a Twenty-Year Period. Health Prof. Educ. 2016, 2, 3–9. [Google Scholar] [CrossRef]
- Nakao, H.; Nomura, O.; Kubota, M.; Ishiguro, A. Long-term impact of overnight shiftwork implementation on pediatric residents’ mental wellness: A repeated cross-sectional survey. J. Occup. Health 2022, 64, 12349. [Google Scholar] [CrossRef]
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

