Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
BMC Med Educ. 2023 Oct 19;23(1):779. doi: 10.1186/s12909-023-04679-2.
Residents completing competency-based medical education for postgraduate training face many challenging situations that may compromise their well-being or result in exhaustion or burnout. Factors described in self-determination theory and grit are important for residents' achievement of learning outcomes and well-being. This study explored the relationships among internal motivation, grit, well-being, and related factors among non-Western Asian residents.
We conducted an explanatory sequential mixed-methods survey-based study to explore correlations among satisfaction with basic psychological needs, grit, and well-being from September to November 2021 among residents at Ramathibodi Hospital, Mahidol University, Thailand. Data were collected with the Basic Psychological Needs Scale, Short Grit Scale, and World Health Organization-Five Well-Being Index. Next, participants with the highest and lowest scores for each scale were purposively invited to participate in semi-structured interviews. Interview data underwent thematic analysis and data collection continued until saturation was reached.
In total, 245 residents (51% major ward, 65% female) completed the survey. There were strong associations between internal motivation, grit, and well-being (r = 0.46-0.90). Female residents had higher autonomy and relatedness scores than males (p = 0.04 and p = 0.01, respectively), and residents with less family responsibility had higher relatedness scores than other residents (p = 0.01). Residents who got more sleep had higher autonomy, relatedness, and well-being scores than those that slept less (p < 0.05). Residents who exercised > 5 times/week had higher well-being scores than other residents (p < 0.01). Thirty residents completed interviews. The thematic analysis revealed internal motivation, grit, and well-being were promoted by a supportive learning environment, a well-designed curriculum, actions and personalities of faculty members, and good personal factors.
Internal motivation is significantly correlated with residents' grit, well-being, gender, family burdens, exercise, and sleep hours. Priority should be given to promoting internal motivation, grit, and well-being among residents by enhancing a positive learning environment, creating well-designed curricula, fostering good characteristics and actions among faculty members, and supporting residents' personal lives.
完成研究生医学教育培训的住院医师面临许多挑战，这些挑战可能会影响他们的幸福感，或导致他们精疲力尽或倦怠。自我决定理论和坚毅所描述的因素对住院医师的学习成果和幸福感很重要。本研究探讨了非亚裔住院医师内在动机、坚毅、幸福感和相关因素之间的关系。
我们进行了一项解释性顺序混合方法的基于调查的研究，以探讨 2021 年 9 月至 11 月期间，泰国玛希隆大学 Ramathibodi 医院住院医师的基本心理需求满意度、坚毅和幸福感之间的相关性。使用基本心理需求量表、短坚韧量表和世界卫生组织-五维健康指数收集数据。然后，根据每个量表的最高分和最低分有针对性地邀请参与者参加半结构化访谈。访谈数据进行主题分析，数据收集持续到达到饱和。
共有 245 名住院医师（51%为主要病房，65%为女性）完成了调查。内在动机、坚毅和幸福感之间存在强烈关联（r=0.46-0.90）。女性住院医师的自主性和关联性得分高于男性（p=0.04 和 p=0.01），家庭责任较小的住院医师的关联性得分高于其他住院医师（p=0.01）。睡眠较多的住院医师的自主性、关联性和幸福感得分高于睡眠较少的住院医师（p<0.05）。每周锻炼>5 次的住院医师的幸福感得分高于其他住院医师（p<0.01）。30 名住院医师完成了访谈。主题分析显示，内在动机、坚毅和幸福感受到支持性学习环境、精心设计的课程、教师的行为和个性以及良好的个人因素的促进。
内在动机与住院医师的坚毅、幸福感、性别、家庭负担、锻炼和睡眠时间显著相关。应优先通过增强积极的学习环境、创建精心设计的课程、培养教师的良好特质和行为以及支持住院医师的个人生活来促进住院医师的内在动机、坚毅和幸福感。
