van der Burgt Stéphanie M E, Kusurkar Rashmi A, Croiset Gerda, Peerdeman Saskia M
VUmc School of Medical Sciences, Research in Education, Amsterdam, the Netherlands.
Int J Med Educ. 2018 Feb 26;9:57-63. doi: 10.5116/ijme.5a83.6025.
The aim was to obtain insight into the factors in the work environment that motivate or demotivate a medical specialist during his/her working day.
A qualitative ethnographic design was used, and a constructivist approach was adopted with the Self-Determination theory of motivation as a framework. Six medical specialists from VU University Medical Center in the Netherlands, recruited through convenience, snowball, and purposive sampling, were shadowed for one day each. Data were transcribed and open-coded. Themes were finalized through discussion and consensus.
Sixty hours of observation data identified motivating and demotivating factors categorized into four themes that are important for specialists' motivation. Informational technology issues are demotivating factors. Working with colleagues can be both a motivating and demotivating factor, e.g., filling in for each other through feelings of relatedness was motivating. Being in control of one's planning through feelings of autonomy was motivating. Furthermore, patient care and teaching, especially in combination, stimulated specialists' motivation. Regarding the design of the study, we found that situational motivation is indeed observable.
The basic psychological needs autonomy, competence, and relatedness are important for specialists' motivation. Investing in a more motivating, open, transparent, and basic-needs- supportive work environment for medical specialists is necessary. Keywords: Continuing professional development, motivation, medical specialists, self-determination theory, qualitative research.
旨在深入了解工作环境中促使或抑制医学专家工作日工作积极性的因素。
采用定性人种学设计，并采用建构主义方法，以自我决定动机理论为框架。通过便利抽样、滚雪球抽样和目的抽样，招募了荷兰阿姆斯特丹自由大学医学中心的六位医学专家，每人被跟踪观察一天。数据被转录并进行开放式编码。通过讨论和达成共识确定主题。
60小时的观察数据确定了促使和抑制积极性的因素，分为对专家积极性很重要的四个主题。信息技术问题是抑制积极性的因素。与同事合作既可能是促使积极性的因素，也可能是抑制积极性的因素，例如，通过关联感互相帮忙是有激励作用的。通过自主感掌控自己的计划是有激励作用的。此外，患者护理和教学，特别是两者结合，能激发专家的积极性。关于研究设计，我们发现情境动机确实是可观察到的。
自主、能力和关联等基本心理需求对专家的积极性很重要。有必要为医学专家营造一个更具激励性、开放、透明且支持基本需求的工作环境。关键词：持续专业发展、动机、医学专家、自我决定理论、定性研究。
