Wang Liwei, Ren Jiajia, Zhang Song, Sun Yu'e, Ding Yu, Yang Congxian, Zheng Chan, Shi Zhenduo, Zhu Yangzi
Department of Anesthesiology, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou Central Hospital, Xuzhou, China.
Department of Science and Education, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou Central Hospital, Xuzhou, China.
J Med Internet Res. 2025 Apr 22;27:e72633. doi: 10.2196/72633.
Recent decades have witnessed a concerning global trend of declining engagement among physician scientists, with participation rates falling from 4.7% in the 1980s to approximately 1.5% today in the United States. The research highlights the declining engagement of physician scientists and the challenges young physicians face in participating in clinical research.
This study aims to examine the intrinsic motivation, attitudes, and practices of young physicians toward scientific research and its clinical value and identify factors that influence their engagement in research activities.
We developed a comprehensive questionnaire measuring intrinsic motivation (27 items; score range 27-135), attitudes (8 items; score range 8-40), and practices (7 items; score range 7-35) related to scientific research among physicians. Cronbach α coefficients for the 3 dimensions were 0.967, 0.916, and 0.937, respectively. A cross-sectional survey was conducted on young physicians from 12 hospitals in eastern provinces of China between May 2024 and October 2024.
A total of 532 valid questionnaires were obtained. Among the respondents, 271 (50.9%) were female, and 317 (59.6%) had not led or been deeply involved in a research project. Most physicians (more than 80%) reported high intrinsic motivation and positive attitudes, but relatively fewer demonstrated active research practices. Key challenges identified included balancing research with clinical work (n=102, 19.2%) disagreed that research alleviates clinical monotony) and insufficient institutional support (n=329, 61.3%) reported inadequate research investment from their hospitals). The mean scores for intrinsic motivation, attitude, and practice were 108.79 (SD 11.91; possible range: 27-135), 32.23 (SD 4.27; possible range: 8-40), and 27.44 (SD 3.81; possible range: 7-35), respectively. Multivariate logistic regression showed that intrinsic motivation score (odds ratio [OR] 1.063, 95% CI 1.035-1.091), attitude score (OR 1.095, 95% CI 1.029-1.165), and good research atmosphere (OR 1.915, 95% CI 1.038-3.533) were independently associated with practice. Moreover, structural equation modeling analysis revealed that intrinsic motivation had a direct effect on attitude (β=0.854; P<.001), attitude directly affected practice (β=0.637; P<.001), and intrinsic motivation indirectly influenced practice through attitude (β=0.544; P<.001).
Despite high levels of intrinsic motivation and positive attitudes toward research, young physicians face significant barriers to active research engagement. Our findings suggest that fostering a supportive research environment is a critical factor that can help translate motivation into practice. Young physicians exhibited positive intrinsic motivation and attitudes but relatively inactive practices toward scientific research and its clinical application. Institutional initiatives should focus on providing protected research time, formal mentorship programs, and adequate research infrastructure to leverage young physicians' existing motivation. Addressing the gap between motivation and practice could significantly contribute to reversing the declining trend of physician scientists and enhancing evidence-based medicine implementation.
近几十年来，全球范围内医生科学家参与度下降的趋势令人担忧，在美国，参与率从20世纪80年代的4.7%降至如今的约1.5%。该研究凸显了医生科学家参与度的下降以及年轻医生在参与临床研究时面临的挑战。
本研究旨在探讨年轻医生对科研及其临床价值的内在动机、态度和实践，并确定影响他们参与研究活动的因素。
我们编制了一份综合问卷，用于测量医生与科研相关的内在动机（27项；得分范围27 - 135）、态度（8项；得分范围8 - 40）和实践（7项；得分范围7 - 35）。这3个维度的Cronbach α系数分别为0.967、0.916和0.937。于2024年5月至2024年10月对中国东部省份12家医院的年轻医生进行了横断面调查。
共获得532份有效问卷。在受访者中，271名（50.9%）为女性，317名（59.6%）未曾主导或深度参与过研究项目。大多数医生（超过80%）报告有较高的内在动机和积极态度，但积极参与研究实践的相对较少。确定的主要挑战包括平衡研究与临床工作（n = 102，19.2%，不同意研究能缓解临床单调）以及机构支持不足（n = 329，61.3%，报告所在医院研究投入不足）。内在动机、态度和实践的平均得分分别为108.79（标准差11.91；可能范围：27 - 135）、32.23（标准差4.27；可能范围：8 - 40）和27.44（标准差3.81；可能范围：7 - 35）。多因素逻辑回归显示，内在动机得分（优势比[OR] 1.063，95%置信区间1.035 - 1.091）、态度得分（OR 1.095，95%置信区间1.029 - 1.165）和良好的研究氛围（OR 1.915，95%置信区间1.038 - 3.533）与实践独立相关。此外，结构方程模型分析显示，内在动机对态度有直接影响（β = 0.854；P <.001），态度直接影响实践（β = 0.637；P <.001），内在动机通过态度间接影响实践（β = 0.544；P <.001）。
尽管年轻医生对研究有较高的内在动机和积极态度，但他们在积极参与研究方面面临重大障碍。我们的研究结果表明，营造一个支持性的研究环境是帮助将动机转化为实践的关键因素。年轻医生对科研及其临床应用表现出积极的内在动机和态度，但实践相对不活跃。机构举措应侧重于提供受保护的研究时间、正式的导师计划和充足的研究基础设施，以利用年轻医生现有的动机。弥合动机与实践之间的差距可能会显著有助于扭转医生科学家数量下降的趋势并加强循证医学的实施。
