Williams G C, Saizow R, Ross L, Deci E L
Department of Psychology, University of Rochester, NY 14627, USA.
Soc Sci Med. 1997 Dec;45(11):1705-13. doi: 10.1016/s0277-9536(97)00103-2.
Self-determination theory (Deci and Ryan, 1985) was used to predict medical students' career choices for internal medicine or surgery based on their experiences of the autonomy support provided by the instructors in the two corresponding third-year clerkships. Fourth-year medical students (n = 210) at three medical schools completed questionnaires that assessed (1) retrospective prior likelihood (as of the end of second year) of their going into internal medicine and surgery, (2) their perceived competence with respect to these two medical specialties, (3) their interest in the problems treated in each specialty, (4) the autonomy support of the instructors on the two corresponding rotations, (5) the current likelihood (late in the fourth year) of going into each of the two specialties, and (6) their actual residency choices. For a subset (n = 64), actual prior likelihoods of going into the two careers had also been assessed at the end of their second year. Structural equation modeling confirmed, as hypothesized, (a) that perceived autonomy support of the corresponding clerkship would predict students' choices of internal medicine or surgery, even after the effects of retrospective (and actual) prior likelihood had been removed, and (b) that this relationship between perceived autonomy support and career choice was mediated by perceived competence and interest. The present study suggests that students' experiences on clerkships do affect the likelihood that they will select particular specialties, and that students' interest in the areas are good indicators of the selections they will make.
自我决定理论（德西和瑞安，1985年）被用于根据医学生在相应的三年级实习中所体验到的教师自主支持，来预测他们选择内科或外科作为职业的情况。三所医学院的四年级医学生（n = 210）完成了问卷调查，这些问卷评估了：（1）回顾性的（截至二年级末）进入内科和外科的先前可能性；（2）他们对这两个医学专业的感知能力；（3）他们对每个专业所治疗问题的兴趣；（4）教师在相应的两轮实习中的自主支持；（5）（四年级后期）进入这两个专业中每个专业的当前可能性；以及（6）他们实际的住院医师选择。对于一个子集（n = 64），在他们二年级末也评估了进入这两个职业的实际先前可能性。结构方程模型如假设的那样证实了：（a）即使在去除回顾性（和实际）先前可能性的影响之后，相应实习的感知自主支持仍能预测学生对内科或外科的选择；（b）感知自主支持与职业选择之间的这种关系是由感知能力和兴趣介导的。本研究表明，学生在实习中的经历确实会影响他们选择特定专业的可能性，并且学生对这些领域的兴趣是他们将做出的选择的良好指标。
