Intrinsic Motivation Inventory Research Articles

Gamified Networked Learning Environments in Higher Education: A Study on Student Engagement and Value Creation in Computer Science

In the rapidly evolving domain of computer science education, fostering deep engagement and sustained motivation among students remains a challenge. This study introduces the Answers platform, a pioneering online learning environment developed at TU Delft. This research aims to reimagine the learning experience for Bachelor and Master of Science Students in computer science by integrating gamification elements grounded in Wenger's value creation framework. Our paper explores two critical research questions: the perception of learners towards gamified learning experiences and the impact of the Answers' system on value creation and motivation. We incorporated points, badges, and leaderboards in a semester-long intervention to enrich the learning landscape. The Value Creation Questionnaire (VCQ) results indicated that the platform effectively created potential and applied value, significantly enhancing students' learning practices and motivation. However, its impact on fostering social connections could have been more pronounced. The platform also moderately influenced students' ability to impact their world and shift perspectives. The Intrinsic Motivation Inventory (IMI) revealed that students generally enjoyed using the platform but felt it did not significantly enhance feelings of connectedness. This paper contributes to the body of knowledge by demonstrating the efficacy of gamification in computer science education and offering insights into the design of engaging online learning platforms. By bridging theoretical frameworks with practical application, the Answers platform exemplifies the potential of gamified environments to revolutionize educational practices in the digital age.

Peer feedback in higher education: How students’ roles affect providing and receiving feedback

In this study, we aimed to explore the impact of different roles of feedback providers on their experience of providing feedback, as well as their influence on the feedback receivers’ responses to feedback. The students who performed the assignment (creating learning material) assumed the role of peer experts (N=22) in providing feedback. The other students (N=22) took on the role of peer users as they used the developed learning materials. The data on the students’ experiences were collected using the Intrinsic Motivation Inventory. The response to feedback was explored via interviews with the peer experts. Findings indicate that the peer experts exhibited a higher sense of competence than the peer users. Their feedback was perceived as more clear, specific, and useful than that provided by the peer users. According to the Self-Determination Theory, we highlight the importance of different task design features for students’ sense of competence, relatedness, and autonomy.

Effect of Outdoor Cycling, Virtual and Enhanced Reality Indoor Cycling on Heart Rate, Motivation, Enjoyment and Intention to Perform Green Exercise in Healthy Adults.

Background: Despite the benefits of physical activity (PA), Italy ranks low in leisure-time PA among European countries. Integrating virtual (VR)/enhanced (ER) reality with exercise equipment could boost PA engagement. Limited studies have explored how VR/ER-integrated cycling activity, compared to outdoor settings, influences PA among university students. Therefore, this study aimed to evaluate the acute effects of a brief cycling session outdoors and indoors on psychological and physiological outcomes, and secondly, investigate the potential of VR/ER-mediated nature experiences as a tool to promote green exercise. Methods: In February 2024, thirty-one subjects (20 M and 11 F; age 24.3 ± 3.2 years; BMI 23.5 ± 3.6 kg/m2) were involved in this randomized crossover-controlled trial, where they were assigned to three different conditions: ER cycling (ERC), VR cycling (VRC), and outdoor cycling (OUTC). Heart rate (HR), Physical Activity Enjoyment (PACE), Intrinsic Motivation Inventory (IMI), and Intention to Perform Green Exercise (INT-GE) were assessed at the end of each condition. Results: The OUTC condition showed significantly greater PACE, IMI, and INT-GE than ERC/VRC (p < 0.001), lower HRmean than ERC/VRC (p < 0.001 and p < 0.05, respectively), and lower HRmax than ERC (p < 0.05). Conclusions: VRC and ERC enhanced engagement and physiological responses during indoor cycling, but outdoor cycling offered superior benefits in motivation, enjoyment, and future engagement intentions. No significant differences were found between VRC and ERC in promoting intentions for outdoor activities, suggesting both technologies could be equally effective.

The effect of different visual feedback interfaces of music training games on speech rehabilitation in hearing-impaired children: An fNIRS study

Singing plays a critical role in enhancing musicality, sound discrimination, and attention, and proves advantageous for speech rehabilitation in children with hearing impairments. Computer-based training games are well-suited to the learning behaviors of children, with substantial evidence suggesting that music training augments speech training capabilities in this demographic. Despite this, there is a lack of detailed exploration into the design of interactive online music training interfaces tailored for these needs. This study investigates brain activation changes using two visual feedback singing games, analyzed through functional near-infrared spectroscopy: a serious game (SG) and an entertainment game (EG) with visually enhanced feedback. It also assesses the efficacy of home-based music training software for speech rehabilitation.Methods involved recording oxygenated hemoglobin concentration (Delta [HbO]) signals from the prefrontal cortex, motor cortex, occipital lobe, and temporal lobe in 21 children (average age: 9.3 ± 1.9 years) during two singing interface experiments. Subjects also completed the Intrinsic Motivation Inventory (IMI) questionnaire post-experiment.Main results showed that brain regions, particularly the temporal lobe, exhibited stronger and more pronounced activation signals with the SG interface compared to the EG, suggesting that SG is more effective for speech system rehabilitation. The Intrinsic Motivation Scale results revealed higher acceptability for SG than for EG. This study provides insights into designing online speech rehabilitation products for children with hearing impairment, advocating for better interactive training methods from a neuroscience perspective.

Impact of Motivational Speech on Psychological Need Satisfaction and Intrinsic Motivation of Young Adults

This study aimed to investigate the impact of motivational speeches on psychological need satisfaction and intrinsic motivation of young adults utilizing a pretest-posttest quasi experiment method. A total of 25 students was selected via non-probability purposive sampling. The study utilized the Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS; Chen et al., 2015) and the Intrinsic Motivation Inventory (IMI; Ryan &amp; Deci, 2000). Pretest measurements were taken from participants three weeks before and after viewing the motivational video “Formula for Success”. Post-test data was collected to evaluate the impact of the video. The results indicated a significant increase in psychological need satisfaction after the speech and a positive correlation between psychological need satisfaction and intrinsic motivation. No significant differences were found across gender, educational institutions and area of living. This study highlights the importance of motivational speech in increasing intrinsic motivation and psychological wellbeing offering a basis for future educational and motivational research. This study is likely to provide ground work for future studies.

Effect of simulating training of the fundamentals of laparoscopic surgery on the attitude of operating room nurses students: an intervention study

Abstract Objective Clinical education plays a key role in preparing students for patient care. Laparoscopy is one of the most important minimally invasive surgeries (MISs) wherein surgical technologists are responsible for camera navigation and assistant surgeons are responsible for peg transfer. Therefore, it is necessary to improve the attitude of the operating room students toward these skills during their study period. The present study was conducted to determine the effect of simulating training in the fundamentals of laparoscopic surgery (FLS) on the attitude of the operating room students. Methods This interventional study was conducted on 28 operating room students of Iran University of Medical Sciences in 2019. The census sampling method was used. The data-collection tool included the “Intrinsic motivation inventory (IMI) questionnaire.” The educational intervention was carried out in theoretical (booklet design) and practical (simulation) sections. Data analysis was carried out using descriptive and inferential analyses including the paired t-test, Mann–Whitney U test, and independent t-test. The collected data were analyzed using R and SPSS software. P-value &lt;0.05 was considered as the significant level. Results The mean ± SD of the participants’ age was 22.93 ± 2.14 years, and the majority of them were women (67.9%). There was a significant difference in the mean scores of students’ attitudes toward the FLS before and after the educational intervention (P &lt; 0.001) in all dimensions (interest, perceived competence, perceived choice, and tension). There was also a significant correlation between gender and interest dimension (P = 0.005). Conclusions The results of the present study showed that simulating the training FLS curriculum positively affects students’ attitudes. Therefore, the researchers suggest that for creating a positive attitude, increasing students’ interest in laparoscopic surgery, and ensuring a more effective presence in the operating room, this training should be considered in the operating room curriculum.

Learning effect of online versus onsite education in health and medical scholarship – protocol for a cluster randomized trial

BackgroundThe disruption of health and medical education by the COVID-19 pandemic made educators question the effect of online setting on students’ learning, motivation, self-efficacy and preference. In light of the health care staff shortage online scalable education seemed relevant. Reviews on the effect of online medical education called for high quality RCTs, which are increasingly relevant with rapid technological development and widespread adaption of online learning in universities. The objective of this trial is to compare standardized and feasible outcomes of an online and an onsite setting of a research course regarding the efficacy for PhD students within health and medical sciences: Primarily on learning of research methodology and secondly on preference, motivation, self-efficacy on short term and academic achievements on long term. Based on the authors experience with conducting courses during the pandemic, the hypothesis is that student preferred onsite setting is different to online setting.MethodsCluster randomized trial with two parallel groups. Two PhD research training courses at the University of Copenhagen are randomized to online (Zoom) or onsite (The Parker Institute, Denmark) setting. Enrolled students are invited to participate in the study. Primary outcome is short term learning. Secondary outcomes are short term preference, motivation, self-efficacy, and long-term academic achievements. Standardized, reproducible and feasible outcomes will be measured by tailor made multiple choice questionnaires, evaluation survey, frequently used Intrinsic Motivation Inventory, Single Item Self-Efficacy Question, and Google Scholar publication data. Sample size is calculated to 20 clusters and courses are randomized by a computer random number generator. Statistical analyses will be performed blinded by an external statistical expert.DiscussionPrimary outcome and secondary significant outcomes will be compared and contrasted with relevant literature. Limitations include geographical setting; bias include lack of blinding and strengths are robust assessment methods in a well-established conceptual framework. Generalizability to PhD education in other disciplines is high. Results of this study will both have implications for students and educators involved in research training courses in health and medical education and for the patients who ultimately benefits from this training.Trial registrationRetrospectively registered at ClinicalTrials.gov: NCT05736627. SPIRIT guidelines are followed.

Motivation Unraveled: Giving Choice to Football Players to Improve Anterior Cruciate Ligament Injury Prevention.

Benjaminse, A, Nijmeijer, EM, Gokeler, A, Broekhaar, DC, and Cortes, N. Motivation unraveled: giving choice to football players to improve anterior cruciate ligament injury prevention. J Strength Cond Res XX(X): 000-000, 2024-Providing athletes some control over a training session facilitates motor skill acquisition. This is a promising concept to use in anterior cruciate ligament (ACL) injury prevention, as the key for risk reduction is to improve quality of movement. The goal of this study was to better understand why improved motor learning occurred when football players had the opportunity to choose when to receive feedback when practicing sidestep cutting (SSC) movements. Healthy male recreational football players (n = 22, 22.9 ± 1.7 years, 185.5 ± 7.2 cm, 79.3 ± 9.2 kg) were included and assigned to the self-control (SC) or the yoked (YK) group. The players performed anticipated and unanticipated SSC. They received video instructions and were instructed to "copy the movement of the model to the best of their ability." During the training blocks, the SC group could ask for feedback, whereas the YK group could not. Cutting movement assessment scores (CMAS) were measured to test quality of movement and the Intrinsic Motivation Inventory was administered to measure constructs of motivation. In the anticipated condition, SC group showed better scores in immediate post and the retention test compared with pretest (p < 0.001), whereas the YK group showed worse scores in the retention test compared with immediate posttest (p = 0.001). Perceived competence (p = 0.017) and self-efficacy (p = 0.032) were consistent factors that correlated with improved CMAS in the SC group. This has given us innovative insights into underlying mechanisms optimizing the quality of movement, necessary to improve current ACL injury prevention approaches.

Feasibility of a co-designed online nutrition education program for people with multiple sclerosis

ObjectiveDiet quality is important for people with multiple sclerosis (MS), but conflicting online information causes them confusion. People with MS want evidence-based MS-specific information to help them make healthy dietary changes, and we co-designed an asynchronous, online nutrition education program (Eating Well with MS) with the MS community. Our aim was to determine the feasibility of Eating Well with MS. MethodsWe used a single-arm pre-post design. The feasibility trial was a nine-week intervention with adults with confirmed MS. Feasibility outcomes: 1) demand (recruitment); 2) practicality (completion); 3) acceptability (Intrinsic Motivation Inventory: interest/enjoyment and value/usefulness subscales); and 4) limited efficacy testing (Diet Habits Questionnaire (DHQ); Critical Nutrition Literacy Tool (CNLT); Food Literacy Behaviour Checklist (FLBC), using intention-to-treat analysis). ResultsRecruitment (n = 70) exceeded the target (n = 48) within six weeks. Of the 70 enrolled, 84 % completed at least one module and 54 % completed the full program (five modules). The median interest/enjoyment rating was 5 out of 7 and median value/usefulness rating was 6 out of 7 (where 7 = ‘very true’). Compared to pre-intervention, DHQ, CNLT, and FLBC scores all statistically significantly improved post-intervention. ConclusionEating Well with MS was well received by the MS community and improved their dietary behaviours; demonstrating feasibility. Our findings support the use of co-design methods when developing resources to improve dietary behaviours.

Does Dyadic Practice Interfere with the Type of Motor Learning Promoted by Analogy Instructions?

We investigated whether allowing individuals to exchange verbal information during dyadic practice changed the effect of analogy instructions intended to strengthen explicit motor learning by an implicit means. Forty-three right-handed college students performed golf putting, aiming at a target three meters away. Participants were assigned to one of two groups: Dyadic Practice Analogy Instruction or Individual Practice Analogy Instruction. Participants in the Dyadic Practice group were allowed to communicate with one another about the task during their practice. Before practice, participants performed a working memory capacity test. Both groups performed 180 trials of golf distributed across three days. On each day, there were four blocks of 15 trials. On the third day, participants reported the explicit rules they used to learn the task and they completed the Intrinsic Motivation Inventory. On the fourth day, they took three learning tests: retention, dual-task transfer, and social pressure transfer tests. Results of the retention test indicated that both groups learned the task comparably. Similarly, there were no significant group differences between the participants' number of explicit rules learned and their motivation levels on either of the transfer tests. Finally, only the participants in the Dyadic Practice Analogy Group showed a significant correlation between their performance on the dual-task transfer test and their working memory capacity. Overall, we found that dyadic practice did not interfere with the implicit type of motor learning promoted by analogy instruction (i.e., implicit learning).

Stress and value: the student perspective on utilizing real vs. actor patients in objective structured clinical examinations

BackgroundStudies have shown objective structured clinical examinations (OSCEs) to be one of the most reliable tools in assessing clinical performance; however in Pediatrics they primarily use manikins, simulators or parent actors which limits the comprehensiveness of the assessment. In our Pediatric Clerkship, medical students are evaluated using a standardized rubric during a clinical evaluation exercise (CEX) with real patients. This study assessed medical students’ perceived stress levels and the educational value of the CEX compared an OSCE. We hypothesized there would be equal stress and value for students with the CEX experience compared to the OSCE.MethodsThird year students anonymously completed questionnaires after required Pediatric CEX and Internal Medicine OSCE evaluations from July 2016-June 2017. The questionnaire included questions from the Intrinsic Motivation Inventory, a validated tool used to assess feelings of stress and perceived value of an exercise.ResultsA total of 147 and 145 questionnaires were completed after the CEX and OSCE. There were no differences between groups regarding levels of “nervousness” (p = 0.543) and “relaxation” (p = 0.055); students felt more “at ease” (p = 0.002) and less “pressure” (p < 0.001) during the CEX. Students perceived the CEX to be more useful and important to improve skills compared to the OSCE for the history taking, physical exam and interpersonal skills.ConclusionsOur results indicate that the CEX was associated with lower stress levels and had higher perceived value when compared to the OSCE. This study supports the usefulness of incorporating real patients into the clinical evaluation of medical students.

Effect of Computer-Assisted Cognitive Remediation Therapy on Cognition among Patients with Schizophrenia: A Pilot Randomized Controlled Trial.

In schizophrenia, cognition is closely linked to social competence and influences long-term prognosis. Thus, treatment should target cognitive improvement to enhance the patient's societal adaptation. This study evaluated the effects of computer-assisted cognitive remediation therapy (CR) using RehaCom® on cognition in patients with schizophrenia. Thirty patients were randomized, with 15 assigned to the CR and treatment as usual (TAU) group and 15 to the TAU-alone group. Over 12 weeks, patients received CR twice weekly, including two computer sessions and one verbal session. The outcomes measured were cognition using the Brief Assessment of Cognition in Schizophrenia and Schizophrenia Cognition Rating Scale, intrinsic motivation using the Quality of Life Scale and Intrinsic Motivation Inventory, psychiatric symptoms using the Positive and Negative Syndrome Scale, negative symptoms using the Scale for the Assessment of Negative Symptoms, and functional level using the modified Global Assessment of Functioning scale for Functioning. The CR + TAU group demonstrated considerable improvements in cognition, intrinsic motivation, and functional level compared to the TAU-alone group. These findings indicate that the CR using RehaCom® enhances cognition and other outcomes in schizophrenia.

Intrinsic motivation and perceived competence among junior doctors in managing ophthalmic disease

Introduction: Perceived competence among junior medical officers (JMOs) in managing ophthalmic disease remains low, and attempts to address this in ophthalmology education often neglect student motivation. This study aims to investigate whether JMOs’ perceived competence in managing ophthalmic patients could be predicted by their levels of motivation while studying ophthalmology as medical students. Methods: Seventy-one JMOs completed a 7-point Likert scale 34-item questionnaire. Intrinsic motivation as a medical student was measured using the Intrinsic Motivation Inventory (IMI), which included autonomy, competence, relatedness, interest and pressure subscales. Perceived competence in managing ophthalmic disease was measured using the Perceived Competence Scale (PCS). Linear regression analysis was used to determine if intrinsic motivation during medical school predicted perceived competence as JMOs. Results: Mean IMI scores and PCS scores were low, at 59 (out of 133) and 14 (out of 28), respectively. PCS scores were positively correlated with IMI scores (r = 0.61, p &lt; 0.001), competence (r = 0.59, p &lt; 0.001), relatedness (r = 0.49, p &lt; 0001) and interest (r = 0.61, p &lt; 0.001) and negatively correlated with pressure (r = -0.31, p = 0.009) and female gender (r = -0.30, p = 0.011). Linear regression analysis showed that IMI scores (β = 0.79, p &lt; 0.001) significantly predicted PCS scores. Subscale analysis showed that there was significant predictive value in competence (β = 0.32, p = 0.009) and interest (β = 0.39, p = 0.035) for PCS scores. Conclusion: This study shows that intrinsic motivation of medical students studying ophthalmology is significantly predictive of their perceived competence as JMOs managing ophthalmic disease. These results point to the importance of fostering medical student intrinsic motivation in an effort to improve perceived competence in JMOs.

Partnered dance evokes greater intrinsic motivation than home exercise as therapeutic activity for chemotherapy-induced deficits: secondary results of a randomized, controlled clinical trial.

Dance has been proposed to support superior intrinsic motivation over non-dance forms of therapeutic physical activity. However, this hypothesis has yet to be evaluated empirically, particularly among populations living with neuropathology such as survivors of cancer with neurologic complications from chemotherapy treatment. Questions about motivation are relevant to clinical outcomes because motivation mediates neuroplasticity. We conducted this secondary analysis of a randomized-controlled study to begin to investigate the relationships between personal motivation and neurophysiologic effects of dance-based intervention for healthy aging among populations with neurologic complications of cancer. We measured motivation using the Intrinsic Motivation Inventory, a validated patient-reported outcome from the psychological approach of Self Determination Theory. We assessed intrinsic motivation, extrinsic motivation, and satisfaction with intervention within a randomized controlled trial of dance versus exercise designed to alleviate symptoms of chemotherapy-induced impairment. Fifty-two survivors of breast cancer with chemotherapy-induced neuropathy diagnosis and associated sensorimotor functional deficits were randomized (1:1) to 8 weeks of partnered dance or home exercise, performed biweekly (NCT05114005; R21-AG068831). While satisfaction did not differ between interventions, intrinsic motivation was higher among participants randomized to dance than those randomized to exercise (p < 0.0001 at all timepoints: 2 weeks, 4 weeks, 6 weeks, and 8 weeks of intervention), as was extrinsic motivation at 2 weeks (p = 0.04) and 8 weeks (p = 0.01). These data provide evidence that social dance is more motivating than the type of home exercise generally recommended as therapeutic physical activity. The results inform directions for future study of the effect of dance-based therapeutics on embodied agency, neuroplastic changes, and clinically-relevant neuropathic improvement.

Effectiveness of the HEAR-Aware App for Adults Not Ready for Hearing Aids, but Open to Self-Management Support: Results of a Randomized Controlled Trial.

Recently, the HEAR-aware app was developed to support adults who are eligible for hearing aids (HAs) but not yet ready to use them. The app serves as a self-management tool, offering assistance for a range of target behaviors (TBs), such as communication strategies and emotional coping. Using ecological momentary assessment and intervention, the app prompts users to complete brief surveys regarding challenging listening situations they encounter in their daily lives (ecological momentary assessment). In response, users receive educational content in the form of "snippets" (videos, texts, web links) on the TBs, some of which are customized based on the reported acoustic environmental characteristics (ecological momentary intervention). The primary objective of this study was to assess the effectiveness of the HEAR-aware app in enhancing readiness to take action on various TBs and evaluate its impact on secondary outcomes. The secondary objective was to examine the app's usability, usefulness, and user satisfaction. A randomized controlled trial design with two arms was used. Participants with hearing loss aged 50 years and over were recruited via an HA retailer and randomly assigned to the intervention group (n = 42, mean age = 65 years [SD = 9.1]) or the control group (n = 45, mean age = 68 years [SD 8.7]). The intervention group used the app during 4 weeks. The control group received no intervention. All participants completed online questionnaires at baseline (T0), after 4 weeks (T1), and again 4 weeks later (T2). Participants' readiness to take action on five TBs was measured with The Line Composite. A list of secondary outcomes was used. Intention-to-treat analyses were performed using Linear Mixed effect Models including group (intervention/control), time (T0/T1/T2), and Group × Time Interactions. In addition, a per protocol analysis was carried out to explore whether effects depended on app usage. For the secondary aim the System Usability Scale (SUS), the Intrinsic Motivation Inventory, item 4 of the International Outcome Inventory-Alternative Intervention (IOI-AI), and a recommendation item were used (intervention group only at T1). For objective 1, there was no significant group difference for The Line Composite over the course of T0, T1, and T2. However, a significant (p = 0.033) Group × Time Interaction was found for The Line Emotional coping, with higher increase in readiness to take action on emotional coping in the intervention group than in the control group. The intention-to-treat analyses revealed no other significant group differences, but the per protocol analyses showed that participants in the intervention group were significantly more ready to take up Assistive Listening Devices (The Line Assistive Listening Devices) and less ready to take up HAs (Staging Algorithm HAs) than the control group (p = 0.049). Results for objective 2 showed that on average, participants rated the app as moderately useful (mean Intrinsic Motivation Inventory score 5 out of 7) and its usability as "marginal" (mean SUS score 68 out of 100) with about half of the participants rating the app as "good" (SUS score >70) and a minority rating is as "unacceptable" (SUS score ≤50). This study underscores the potential of self-management support tools like the HEAR-aware app in the rehabilitation of adults with hearing loss who are not yet ready for HAs. The range in usability scores suggest that it may not be a suitable intervention for everyone.

The Impact of Gamification Depth on Higher Educational Students’ Intrinsic Motivation and Performance Levels

Most studies on gamified learning have neglected gamification depth, which has motivated the current study to identify the impact of gamified depth on students’ intrinsic motivation and performance levels. A quasi-experimental approach was employed, which involved a total of 117 undergraduate students divided into control ( n = 57) and experimental ( n = 60) groups. The students were exposed to two gamified platforms, namely Kahoot! for shallow gamification and Classcraft for deep gamification, over four weeks. The Intrinsic Motivation Inventory (IMI) served to measure changes that occurred in students’ intrinsic motivation levels and the achievement test in the final lesson. Paired t-tests, an independent t-test and regression analysis were conducted to test the study hypothesis. Deep gamification significantly increased learners’ intrinsic motivation level (+0.1845), while shallow gamification decreased it (−0.6439). Contrarily, students in the shallow gamified learning environment achieved a higher performance with a mean value of 73.42 compared to the counterparts in a deep gamified environment (50.83). Students’ language mastery, interest, attitude and familiarity with technology were postulated to impact the study outcomes. Distinct subjects, age groups and a suitable experiment period are recommended for future studies to develop a proper gamified depth framework in the educational sector.

Feasibility of Computerized Visuomotor Integration System for Visual Field Defects and Spatial Neglect in Poststroke Patients.

To develop a computerized visuomotor integration system for assessment and training of visual perception impairments and evaluate its safety and feasibility in patients with a stroke. Visual field defects and spatial neglect lead to substantial poststroke impairment. Most diagnostic assessments are anchored in traditional methods, and clinical effects of rehabilitation treatments are limited. The CoTras Vision system included two evaluations and four training modules. The evaluation modules were based on the Albert's test and Star cancellation test, and training modules were based on visual tracking, central-peripheral integration, and visuomotor perception techniques. Bland-Altman plots for agreement with the traditional paper-and-pencil test were performed, and the modified Intrinsic Motivation Inventory, Patient Satisfaction Questionnaire, and Simulator Sickness Questionnaire were conducted. Ten patients with acute stroke completed the study. Bland-Altman plots revealed good agreements for Albert's test (mean difference, -0.3±4.5) and Star cancellation test (mean difference, 0.3±0.7). The mean±standard deviation scores of the modified Intrinsic Motivation Inventory, Patient Satisfaction Survey, and Simulator Sickness Questionnaire were 84.7±30.6, 40.5±7.9, and 34.0±34.5 respectively. The CoTras Vision system is feasible and safe in patients with stroke. Most patients had a high degree of motivation to use the system and did not experience severe adverse events. Further studies are needed to confirm its usefulness in stroke patients with visual field defects and hemineglect symptoms. Furthermore, a large, well-designed, randomized controlled trial will be needed to confirm the treatment effect of the CoTras Vision system.

Focused attention and intrinsic motivation using animations for instruction of fundamental motor skills in children with Down syndrome.

Children with Down syndrome (DS) demonstrate poorer performance in locomotor and ball skills than children with typical development. During motor assessment, keeping children's attention and motivation is challenging, especially for children with DS, which may affect the test outcomes. This study aimed first to examine the impact of examiner and App-animation demonstrations during the assessment on the performance of fundamental motor skills, focus of attention and intrinsic motivation for children with DS and neurotypical development (NTD). The secondary aim was to examine the differences in those outcomes between children with DS and neurotypical development. A sample of 24 children (10 with DS and 14 with NTD) aged between 3 and 10years were subjected to two motor performance assessment protocols: a traditional protocol using the Gross Motor Development Test-3 (TGMD-3) and a protocol using animations from an application as support for TGMD-3 (AppP). The focus of attention was obtained from video recordings during protocol instruction (number of eye shifts, eye shift time, instruction focus time, number of instructions required and total instruction time). Intrinsic motivation was assessed by the Intrinsic Motivation Inventory (IMI) at the end of each protocol. The results showed no significant differences between the protocols for locomotor skills, ball skills and gross motor index. However, children with NTD outperformed those with DS in these skills. When analysing the focus of attention, children with DS showed greater ocular deviations and longer instruction time requested in the traditional protocol compared with AppP, even when compared with NDT children. When comparing protocols in both groups, AppP demonstrated fewer ocular deviations and shorter ocular deviation times. Regarding intrinsic motivation, children with DS in the traditional protocol had lower motivation scores than those with NTD. Regarding the purchase of protocols, in both groups, the AppP presented higher scores for interest/pleasure, perceived competence and general motivation, with lower pressure/tension. The animated application (AppP) proved effective as a visual support during the TGMD-3 assessment, particularly benefiting children with DS by enhancing motivation and attention.

A Convergent Mixed Methods Design to Assess the Use of the Home Virtual Rehabilitation System By Persons with Chronic Stroke.

Purpose: Patients poststroke utilized the Home Virtual Rehabilitation System (HoVRS) to perform home-based, gamified upper extremity rehabilitation over 12 weeks. Outcomes related to adherence and clinical improvement were collected, and semistructured interviews were conducted to assess intrinsic and extrinsic motivators that impacted engagement with the system. Methods: Subjects performed between 299 and 2020 minutes of self-scheduled, sparsely supervised hand rehabilitation activities in their homes. Results: As a group, the subjects demonstrated statistically significant improvements at the structure/function, activity, and activities of daily living levels of function. Qualitative analysis generated seven themes that both positively and negatively influenced each subject's experience with HoVRS, including challenge as a primary intrinsic motivator and pursuing additional therapy and/or a return to higher functional status as a key extrinsic motivator. Subjects' ratings of the system using the Intrinsic Motivation Inventory before and after treatment were uniformly positive, but interview-based feedback was more balanced between positive and negative.

The DiSCoVeR trial – Mid-study look at post-training patient motivation for an innovative treatment approach

IntroductionThe DiSCoVeR Project: ‘Examining the synergistic effects of a cognitive control videogame and a self-administered non-invasive brain stimulation on alleviating depression’ is a double-blind, sham controlled, randomized controlled trial investigating the feasibility and efficacy of an innovative, self-applied treatment approach for patients diagnosed with major depressive disorder. The trial is conducted at three clinical trial sites (Hadassah, Israel; Riga Stradiņš University, Latvia; Ludwig-Maximilian-University, Germany). The treatment approach combines prefrontal transcranial direct current stimulation with a videogame designed to enhance cognitive and emotional control. This treatment is self-applied at home and remotely monitored. At the beginning of the intervention the patients are randomized in an active group receiving both active stimulation and videogame and the other group receiving sham stimulation and visually similar but not active videogame.ObjectivesThe present interims analysis after half of the patients included examines patients’ intrinsic motivation after completing the first five sessions (of 30) of the treatment. We also examine patients’ interest/enjoyment, perceived competence, effort, felt pressure/tension, and perceived choice following the first week of treatment. Intrinsic motivation has been associated with enhanced learning and performance, so it can be used as one of the predictors for patient compliance.MethodsAt the end of the 5th session, the patients filled in the Intrinsic Motivation Inventory (IMI) including the following subscales: interest/enjoyment, perceived choice, perceived competence, effort/importance and felt pressure/tension (scored on a 7-point Likert scale, ranging from 1 “not at all true” to 7 “very true”).ResultsThis report includes the first 55 patients randomized (27 patients in the active group and 28 patients in placebo group) for the DiSCoVeR trial. Patients rated their overall interest/enjoyment at 4.50 out of 7 (SD±0.17 95% CI 4.16 to 4.84), their perceived choice at 5.55 (SD±0.16; 95% CI 5.23 to 5.87), their perceived competence at 4.52 (SD±0.15; 95%CI 4.22 to 4.82), their effort/importance at 5.07 (SD±0.16; 95%CI 4.74 to 5.40) and their pressure/tension at 3.00 (SD±0.13; 95% CI 2.73 to 3.26).ConclusionsWe conclude that overall patients were quite interested in the treatment and had inherent pleasure while doing the sessions, felt that it was their choice to do them, felt that they performed the task quite effectively, were invested in doing the sessions and the experienced pressure and tension were low. The perceived choice and competence are positive predictors of intrinsic motivation. This aligns with the previous published data of a smaller patient subset (L. Konosonoka et al Medicina (Kaunas) 2022;58(Supplement 1):72) with the standard deviations being smaller in our larger patient sample.Disclosure of InterestNone Declared