Background: Healthcare professionals’ (HCPs) interactions with care recipients influence care recipients’ self-management skills. Since HCPs cultivate these skills during education, enhancing interaction styles in healthcare education is crucial. Therefore, the primary aim of this study is to evaluate the effects of a Self-Determination Theory (SDT)-based course module on physiotherapy students’ (de)motivating interaction styles. The secondary aim is to assess its impact on students’ SDT-based beliefs and self-management support competencies.
Methods: A nonequivalent pre-test post-test control group design was employed with students from the Master of Science in Rehabilitation Sciences and Physiotherapy at two universities: one was the intervention group (n = 148), the other the control group (n = 108). The intervention was an SDT-based module embedded in the curriculum with a theoretical and a practical part. The theoretical part was delivered during classes, and the practical part was implemented during internships. When internships were not possible (e.g. lack of consent from care recipients or no internship placement), students completed role-play simulations instead. During that practical part, they observed and reflected on a personal video-recorded treatment session. Students in both the intervention and control group reported twice on their (de)motivating interaction styles (autonomy-support, structure, control, chaos), SDT-beliefs (effectiveness and feasibility beliefs) and self-management support competencies (self-efficacy and performance subscales) via validated questionnaires. Interaction-effects (Group*Time) were analyzed using general linear mixed models.
Results: For the primary aim, the intervention group showed a significantly larger increase in autonomy-support (mean difference = 0.28, p = .002, 95%CI=[0.11, 0.45]) and a significantly larger decrease in both chaos (mean difference=-0.84, p < .001, 95%CI=[-1.10, -0.58]) and control (mean difference=-0.98, p < .001, 95%CI=[-1.23, -0.72]), compared to the control group. Regarding the secondary aim, SDT-effectiveness belief (mean difference = 0.31, p < .001, 95%CI=[0.18, 0.44]) and the six subscales of self-efficacy in self-management support (mean differences = between 0.27 and 0.37, p < .012, 95%CI=[0.09, 0.58]) increased significantly more in the intervention group compared to the control group.
Conclusions: The integration of an SDT-based course module in physiotherapy education may enhance physiotherapy students’ (de)motivating interaction skills, SDT-effectiveness beliefs, and self-efficacy in self-management support.
Supplementary Information: The online version contains supplementary material available at 10.1186/s12909-025-07805-4.
Keywords: (de)motivating interaction styles; Chronic disease; Healthcare education; Physiotherapists in training; Self-management support.