Amsterdam UMC, Vrije Universiteit Amsterdam, Faculty of Medicine, Research in Education, Amsterdam, the Netherlands.
Department of Psychiatry, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands.
Int J Med Educ. 2020 Jun 19;11:111-119. doi: 10.5116/ijme.5e88.b9ff.
The aim was to investigate which factors influence the situational motivation of medical specialists and how situational and contextual motivation affect one another.
A qualitative design was used, and a constructivist approach was adopted with the Self-Determination Theory of motivation as a framework. Twenty-two medical specialists from three medical centers in the Netherlands were recruited through convenience, snowball and purposive sampling and observed for two days each. At the end of the second observation day, a semi-structured interview was conducted. Data were transcribed and coded in an open manner. Themes were finalized through discussion and consensus.
Two-hundred and fifty hours of observation data together with the interview data identified that medical specialists experience six main themes influencing their situational motivation during a workday. Technical issues are influencing motivation negatively factors. Working with colleagues can be both a motivating factor and influence motivation negatively, e.g., filling in for each other through feelings of relatedness was motivating. Being in control of one's own planning through feelings of autonomy was motivating. Patient care, especially in combination with teaching, stimulated specialists' motivation.
The results indicate that factors influencing motivation negatively are mainly tasks and organizational processes that distract from patient care or that compromise the quality of care. When optimizing the work environment of medical specialists, autonomous motivation and continuing professional development are stimulated. These, in turn, can improve the quality of patient care and wellbeing of specialists.
旨在探讨哪些因素影响医学专家的情境动机，以及情境动机和背景动机如何相互影响。
采用定性设计，采用建构主义方法，以动机的自我决定理论为框架。通过便利、滚雪球和目的性抽样，从荷兰的三个医疗中心招募了 22 名医学专家，每位专家观察两天。在第二次观察日结束时，进行了半结构化访谈。数据以开放的方式进行转录和编码。通过讨论和达成共识，最终确定了主题。
250 小时的观察数据和访谈数据确定，医学专家在工作日期间经历了六个主要主题，这些主题影响他们的情境动机。技术问题是影响动机的负面因素。与同事合作既可以是一个激励因素，也可以产生负面影响，例如，通过关联感来互相替代是激励因素。通过自主性来控制自己的计划是激励因素。患者护理，特别是与教学相结合，激发了专家的动机。
结果表明，影响动机的负面因素主要是任务和组织流程，这些任务和组织流程会分散对患者护理的注意力，或损害护理质量。在优化医学专家的工作环境时，应激发自主动机和持续的专业发展。这反过来又可以提高患者护理的质量和专家的幸福感。
