Epistemic Emotions in Medical Education

• In Event: Emotions in Medical Education: Causes and Effects

Abstract

Rationale. Since medical students are often confronted with contradicting symptoms or medical opinions when learning how to diagnose patients, they probably experience a variety of epistemic emotions, such as surprise, curiosity, and confusion, during their studies. Because these emotions can influence students’ learning and academic accomplishments, it is important to acquire knowledge about their origins and effects.

Epistemic emotions relate to the knowledge-generating qualities of cognitive tasks and activities (Pekrun & Stephens, 2012). They typically arise when cognitive incongruity is experienced due to unexpected or conflicting information: this can induce surprise and curiosity, confusion when the incongruity cannot be resolved, anxiety due to severe incongruity, enjoyment when the problem gets solved, and frustration or boredom when resolution cannot be achieved.

In line with appraisal theories of emotions (e.g., Ellsworth & Scherer, 2003; Pekrun, 2006), perceived control and value have been proposed as antecedents of epistemic emotions, in addition to cognitive incongruity (Muis, Psaradellis, Lajoie, Di Leo, & Chevrier, 2015). Interestingly, both positive activating (e.g., curiosity) and negative activating epistemic emotions (e.g., confusion) have been associated with beneficial effects for learning (e.g., D’Mello, Lehman, Pekrun, & Graesser, 2014). By contrast, the negative deactivating emotion boredom has been found to be detrimental (Tze, Daniels, & Klassen, 2015).

Method. In our study, we investigated control and value appraisals as antecedents of epistemic emotions when studying a medical topic and explored the relationships of epistemic emotions with learning outcomes. 176 undergraduate students (74.4% female, mean age = 22.08, SD = 3.05) collaborated in a computer based learning environment to correctly diagnose patients with gastro-intestinal diseases. Thereby, they were confronted with contradicting diagnoses of fictitious learning partners triggering epistemic emotions. Control and value appraisals as well as epistemic emotions were measured by self-report. Learning outcomes were assessed with a multiple choice test.

Results. Preliminary findings of linear regression analyses indicate that control and value appraisals served as antecedents to students’ epistemic emotions. As hypothesized, task value positively predicted curiosity (β = .59, p < .001) and enjoyment (β = .31, p < .001) but negatively predicted boredom (β = -.34, p < .001). In addition, task value positively predicted surprise (β = .17, p < .05). Perceived control negatively predicted confusion (β = -.37, p < .001). Curiosity correlated positively with the learning outcome (r = .22, p < .01). In contrast to previous findings, negative emotions correlated uniformly negative with the learning outcome (confusion: r = -.17, p < .05; anxiety: r = -.17, p < .05; frustration: r = -.19, p < .05; boredom: r = -.22, p < .01).

Significance. In sum, these results provide support for the proposition that control and value appraisals function as antecedents of epistemic emotions in medical education. Furthermore, the findings suggest that positive activating emotions are positively associated, and negative emotions negatively associated with medical students’ learning outcomes. Implications for theories of epistemic emotions and practices in medical education will be discussed.

Authors

• Elisabeth Vogl, University of Munich

• Karsten Stegmann, University of Munich

• Reinhard Pekrun, University of Munich