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

Summary of the Study: This study investigated whether open learning tasks (where students generate their own medical Dutch dialogue) or closed learning tasks (where students use pre-scripted sentences) are more effective for international medical students learning Dutch. • Design: Mixed-methods, quasi-experimental, pre-post. • Participants: 15 third-year international medical students (open task group: n=7; closed task group: n=8), all at B2 Dutch CEFR level and with prior English SPC experience . • Procedure: Over six weeks, both groups engaged in six simulated patient consultations (SPCs) covering diabetes, autoimmune diseases, respiratory diseases, heart diseases, oncology, and neurology. o Open-task group: Watched full expert consultations, created their own dialogues, used rubrics for peer/self-assessment. o Closed-task group: Watched segmented didactic clips, reused model sentences, used checklists for peer/self-assessment . • Instruments: o Intrinsic Motivation to Experience Stimulation (IMES) scale o Need for Competence Satisfaction (NCS) scale o Self/peer assessment rubrics or checklists o Semi-structured interviews (30–45 min, n=15) Key Findings: 1.

Intrinsic Motivation: Both groups showed high intrinsic motivation, with no significant group differences . 2. Competence: o Open-task group reported higher satisfaction of competence (N-gain Mdn = .5 vs. 0, p=.02). o Objective assessment scores: Open-task (self = 78%, peer = 84%) vs. Closed-task (self = 69%, peer = 80%). 3. Qualitative Themes: o Learning expectations: Both groups valued Dutch fluency, vocabulary, and real-life practice . o Contentment with learning: Both groups appreciated authenticity; open-task group emphasized difficulty and enrichment (desirable difficulties). o Perceived learning improvement: Both groups felt progress, but open-task students reported greater integration of language with consultation skills . 4.