Tokumasu Kazuki, Obika Mikako, Obara Haruo, Kikukawa Makoto, Nishimura Yoshito, Otsuka Fumio
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Department of General Internal Medicine, Okinawa Chubu Hospital, Uruma, Japan.
Int J Med Educ. 2022 Apr 29;13:115-123. doi: 10.5116/ijme.6250.1017.
This study aimed to determine qualitatively how medical residents develop intrinsic motivation to learn and work in clinical training settings.
This study was a descriptive qualitative study, which is widely used in healthcare research. We conducted a semi-structured interview aimed to explore key participants' in-depth experiences and perspectives regarding intrinsic motivation. The authors interviewed seven postgraduate Japanese medical residents. The transcripts were analyzed using the sequential and thematic qualitative data analysis technique steps for coding and theorization, which entails coding steps from open to selective, writing a storyline using the final selective codes, and offering theories.
External stimulations (a self-handle environment and a near-peer role model) triggered the medical residents' cognitive process (gap recognition, awareness, and internalization) to intrinsic motivation. The residents' awareness of autonomy, responsibility, and independence played a vital role in this process. Furthermore, a psychological feeling of competence also reinforced their intrinsic motivation. Positive feedback and approval from attending physicians and patients' gratitude promoted residents' sense of competence.
We illustrated a process for increasing medical residents' intrinsic motivation. The intrinsic motivation was triggered by external stimulations (a self-handle environment and a near-peer role model), which caused the cognitive process: gap recognition, awareness of important attitudes as a doctor (autonomy, responsibility, and independence), and internalization. Since the first step of this process was an external factor, there are potential benefits of designing an appropriate training environment for increasing medical residents' intrinsic motivation.
本研究旨在定性地确定医学住院医师在临床培训环境中如何培养内在学习和工作动机。
本研究是一项描述性定性研究，广泛应用于医疗保健研究。我们进行了一项半结构化访谈，旨在探索关键参与者关于内在动机的深入经历和观点。作者采访了七名日本医学研究生住院医师。使用顺序和主题定性数据分析技术步骤对访谈记录进行编码和理论化分析，这包括从开放编码到选择性编码的步骤，使用最终的选择性编码编写故事情节，并提出理论。
外部刺激（自我掌控的环境和近邻榜样）触发了医学住院医师产生内在动机的认知过程（差距识别、意识和内化）。住院医师的自主性、责任感和独立性意识在这一过程中发挥了至关重要的作用。此外，一种胜任感的心理感受也增强了他们的内在动机。主治医师的积极反馈和认可以及患者的感激之情提升了住院医师的胜任感。
我们阐述了一个增强医学住院医师内在动机的过程。内在动机由外部刺激（自我掌控的环境和近邻榜样）触发，引发了认知过程：差距识别、作为医生的重要态度（自主性、责任感和独立性）的意识以及内化。由于这一过程的第一步是外部因素，因此设计一个合适的培训环境对于增强医学住院医师的内在动机具有潜在益处。
