How basic psychological needs and motivation affect vitality and lifelong learning adaptability of pharmacists: a structural equation model

The effects of job characteristics on physicians' orientation toward lifelong learning

With the rapidly growing body of medical knowledge, physicians must engage in lifelong learning. Physicians' orientation toward lifelong learning is of crucial importance. This study aimed to explore the effects of job characteristics on physicians' lifelong learning. A multicenter study collecting data from physicians from three medical centers in Taiwan was performed. A total of 321 physicians were surveyed with the Chinese version of the Job Content Questionnaire (C-JCQ) and the revised Jefferson Scale of Physician Lifelong Learning (JeffSPLL) to assess their job characteristics (i.e., job demands, job control, social support) and orientation toward lifelong learning. Exploratory factor analysis was employed to validate both questionnaires. Hierarchical regression was utilized to explore the relationship of job characteristics and predictors with physicians' lifelong learning. The results revealed that job demands (β = 0.10), job control (β = 0.19), social support from supervisors (β = 0.16), the interaction of job demands × job control (β =  - 0.11) and the interaction of job demands × social support from colleagues (β = 0.13) were significantly (p < .05, p < .001) related to lifelong learning. Moreover, physicians in the active group (high demand, high control) possessed a stronger orientation toward lifelong learning (mean = 3.57) than those in the low-strain group (mean = 3.42), high-strain group (mean = 3.39) and passive group (mean = 3.20). In conclusion, examining physicians' job demands, job control and social support helps us to understand their orientation toward lifelong learning and may provide insight to improve educational strategies.

"Why is this relevant for me?": increasing content relevance enhances student motivation and vitality

The notion that motivation is imperative for students' psychological well-being and academic functioning is central to Self-Determination Theory (SDT). According to SDT, different types of motivations can co-occur to a various degree with separate outcomes, depending on the extent of experienced degree of autonomy. In the current study, we investigate how making a learning exercise more relevant for higher education STEM students can affect aspects of student functioning mediated through motivation. In a randomized experiment, results indicate that the students who received a more "relevant" assignment (experimental group) experienced more autonomous forms of motivation relative to the students who received a "generic" or "traditional" exercise (control group). Further, the experimental group reported higher levels of vitality and effort relative to the control group. Using a pre- and post-test design measuring changes in emotional affect during the learning activity, we found that the control group reported an increase in negative affect and a decrease in positive affect. Finally, path analysis showed significant relationships between the type of assignment provided and motivation and student functioning.

Relationship between psychological adaptability and work engagement of college teachers within smart teaching environments: the mediating role of digital information literacy self-efficacy

Introduction

Integrating the Internet and traditional teaching has enriched teaching resources and methods and introduced many advanced digital media. The smart teaching process is influenced by teachers' psychological adaptability, which can be affected by teachers' work engagement. However, the relationship between the two has not received sufficient attention in the literature. This study aims to analyze the relationship between college teachers' psychological adaptability and work engagement in a smart teaching environment.

Methods

Applying structural equation modeling (SEM) to a sample of 373 front-line teachers, this study focuses on the mediating effect of digital information literacy self-efficacy on the relationship between teachers' psychological adaptability and work engagement.

Results

The results show that the four dimensions of college teachers' psychological adaptability strongly influence work engagement and digital information literacy self-efficacy. In particular, teachers' psychological adaptability and work engagement are positively correlated; teachers' self-efficacy can positively affect the three dimensions of their work engagement, and teachers' psychological adaptability can positively affect their digital information literacy self-efficacy.

Conclusion

The above results can serve as a basis for the development and improvement of the training of college teachers and the implementation of smart teaching. The study findings highlight the importance of training teachers on information technology teaching and implementing measures to enhance teachers' digital information literacy self-efficacy. Training should focus on the knowledge and skills of teachers using information technology teaching and increase the practical links of teachers using information technology teaching.

Course Transformation to Enhance Student Learning in Undergraduate Nursing Course: From a Self-Determination Theory Perspective

AIM

The purpose of the study was to investigate whether course transformation teaching strategies using repetitive quizzing and peer-tutor supplemental instruction help enhance students' learning experiences and learning outcomes based on self-determination theory.

BACKGROUND

Undergraduate baccalaureate pharmacology and pathophysiology courses were redesigned as part of a campus-wide course transformation program to promote students' perceptions of learning and academic achievement.

METHOD

Students in the nursing pathopharmacology course participated in the two-time online perception survey (pretest and posttest) and knowledge-based exams.

RESULTS

Results revealed that the course transformation implemented to support students' basic psychological needs was significantly associated with both learning outcomes and students' feelings of competence while also decreasing attrition rates.

CONCLUSION

Considering the depth and breadth of pathopharmacology content, the teaching intervention using repetitive quizzing and peer-tutor supplemental instruction may contribute to improving students' understanding of the course content while promoting their competence.

Mediation role of work motivation and job satisfaction between work-related basic need satisfaction and work engagement among doctors in China: a cross-sectional study

OBJECTIVES

This study aims to examine the association of work-related basic need satisfaction (W-BNS) with doctors' work engagement and explore the mediating role of work motivation and job satisfaction between the two variables.

DESIGN

This was a cross-sectional study.

SETTING

The study was conducted in four public grade A tertiary hospitals in China.

PARTICIPANTS

A total of 1000 doctors were invited to participate; 849 doctors completed questionnaires validly.

PRIMARY AND SECONDARY OUTCOME MEASURES

Questionnaires were administered online and offline to collect data, consisting of six parts: social demographic characteristics, work-related characteristics, and scales related to W-BNS, work motivation, job satisfaction and work engagement. One-way analysis of variance, Pearson correlation analysis were performed using SPSS, and mediation analysis was carried out via PROCESS macro.

RESULTS

Our research showed that W-BNS, work motivation, job satisfaction and work engagement were positively correlated. Work engagement was significantly predicted by W-BNS (β＝0.15, p<0.001) through motivation at work (β＝0.23, p<0.001) and job satisfaction (β＝0.44, p<0.001), respectively. Compared with work motivation, the mediating effect of job satisfaction was stronger (95% CI -0.22 to -0.06).

CONCLUSION

The findings suggest that job satisfaction and work motivation may be important pathways through which doctors' W-BNS may influence their work engagement. In order to maintain and promote doctors' work engagement, hospital administrators should consider strengthening the internal motivation of doctors and improving their job satisfaction.

Education as drug policy: A realist synthesis of continuing professional development for opioid agonist therapy

BACKGROUND

Continuing professional development (CPD) for opioid agonist therapy (OAT) has been identified as a key health policy strategy to improve care for people living with opioid use disorder (OUD) and to address rising opioid-related harms. To design and deliver effective CPD programs, there is a need to clarify how they work within complex health system and policy contexts. This review synthesizes the literature on OAT CPD programs and educational theory to clarify which interventions work, for whom, and in what contexts.

METHODS

A systematic review and realist synthesis of evaluations of CPD programs focused on OAT was conducted. This included record identification and screening, theory familiarization, data collection, analysis, expert consultation, and iterative context-intervention-mechanism-outcome (CIMO) configuration development.

RESULTS

Twenty-four reports comprising 21 evaluation studies from 5 countries for 3373 providers were reviewed. Through iterative testing of included studies with relevant theory, five CIMO configurations were developed. The programs were categorized by who drove the learning outcomes (i.e., system/policy, instructor, learner) and their spheres of influence (i.e., micro, meso, macro). There was a predominance of instructor-driven programs driving change at the micro level, with few policy-driven macro-influential programs, inconsistent with the promotion of CPD as a clear opioid crisis policy-level intervention.

CONCLUSION

OAT CPD is challenged by mismatches in program justifications, objectives, activities, and outcomes. Depending on how these program factors interact, OAT CPD can operate as a barrier or facilitator to OUD care. With more deliberate planning and consideration of program theory, programs more directly addressing diverse learner and system needs may be developed and delivered. OAT CPD as drug policy does not operate in isolation; programs may feed into each other and intercalate with other policy initiatives to have micro, meso, and macro impacts on educational and population health outcomes.

Taxonomy of Factors Involved in Decision-Making to Sustain Organization Members’ Creativity

Creativity is highly valued in all areas of life, and it must be supported in the academic environment for the future prosperity of all organizations. This is the primary source of creativity for practice. The research presented is based on answering the following questions: Are an organization’s members willing to increase their motivation if the organization’s motivational efforts improve? What elements in decision-making are used to support the creativity and motivation of the organization’s members? The paper proposes a novel taxonomy of decision-making factors influencing organizations’ sustainable creativity based on linking the findings from the authors’ surveys. Its application will lead to an improvement in the organizations’ processes, especially in the process of education and knowledge generation. The sociological inquiry was used as the main data collection method. Other methods applied included content analysis, practical cases analysis, and comparison. Methods of mathematical-statistical analysis and deductive-inductive approach were used in the evaluation. This resulted in the confirmation of the impact of creative decision-making approaches by employees and managers on sustainable motivation and creativity in the organization. The taxonomy of decision-making factors for the support of sustainable creativity reflects the results of this original research combined with the findings summarized in the discussion.

Exploring Factors Associated With the Motivation of Clinical Pharmacists: A Focus on the South African Context

Introduction: Pharmacy practice in many middle to low-income countries has slowly transitioned from being product-focused to a more patient-focused clinical practice. Lack of motivation is one of the factors contributing to the scarcity of pharmacists in the wards. As little is known about motivation in clinical pharmacists, this study aimed to obtain insight into the quantity and quality of their work motivation and factors associated with it.

Methods: Self-determination Theory, used as the framework, describes autonomous motivation as being generated from within or through personal endorsement and controlled motivation as originating from external factors. An online questionnaire including the Academic Motivation Scale to measure autonomous motivation, controlled motivation and amotivation, was sent to clinical pharmacy graduates from 2000 to 2020 across South Africa, followed by interviews to explain some results. Independent t-test was used to analyze differences in motivation of clinical pharmacists to perform clinical services based on personal and environmental factors. Interview data were transcribed and analyzed to explain significant quantitative findings.

Results: Higher amotivation was found in graduates who are currently not practicing in dedicated clinical pharmacist positions, as well as in graduates who do not receive additional financial benefits for clinical services. We found no significant differences in the work motivation of clinical pharmacists based on their gender, age, current practice setting, work experience and additional training received. The interviews revealed that relatedness and autonomy are the most important factors for clinical pharmacists' work motivation.

Discussion: Overall participants had a high mean autonomous motivation, a high mean controlled motivation and low mean amotivation. In line with Self-determination Theory literature, considering the basic psychological needs for relatedness and autonomy could assist with designing interventions, like creating a supportive work environment, to optimize motivation. This could improve professional wellbeing, service implementation and prevent possible adverse events. Future research is necessary to understand barriers and facilitators of clinical pharmacists' work motivation.

Assessment of pharmacists' perception toward continuing education

Continuing education (CE) is a structured educational activity. Pharmacists must actively participate in CE and is an important part of developing the professional competency of pharmacists. This research focuses on measuring Saudi pharmacists' perception in CE, its impact on professional performance, and the barriers in CE. This was a cross-sectional study, conducted in 2020, using random sample of Saudi pharmacists working in all workplaces from different cities in Saudi Arabia using a questionnaire. The questionnaire consists of 15 questions that assess the perception of Saudi pharmacists toward CE and barriers that prevent them from CE. A total of 409 pharmacists participated in the study. Majority of pharmacists were working in government hospitals (48.4%) and have <2 years of practice experience (44.5%). More than 70% of respondents acknowledged that CE helps to increase their knowledge. The pharmacists mentioned that getting a certificate (23.37%) was the major reason for attending a CE event. The reasons that prevent respondents from attending live CE were cost and work responsibilities (23.59% and 24.57%, respectively). This study reported a subjective assessment of pharmacists' perception toward CE, their lifelong learning experience. Saudi pharmacists showed a great desire for CE because they believed that it greatly affects their professional performance.

The Association Among Achievement Goal Orientations, Academic Performance, and Academic Well-Being Among Chinese Medical Students: A Cross-Sectional Study

Learning motivation is a significant factor that ensures quality in medical education, and might affect the academic performance and well-being of medical students. This study aimed to explore the status of achievement goal orientations among medical students in China and to further identify the association among academic performance, academic well-being, and achievement goal orientations. Data were collected through a cross-sectional, anonymous survey conducted with 3,511 respondents (effective response rate = 81.7%), from four medical universities in China, and demographic factors, achievement goal orientations, academic performance, and academic well-being were assessed. The average score of achievement goal orientations of Chinese medical students suggested a difference in demographic factors, including sex, year of study, experience of leadership cadre, and family income. Both mastery and performance-avoidance goals were associated with academic performance, subjective academic stress, subjective learning adaptability, subjective sleep quality, and subjective well-being. Performance-approach goals were related to academic performance, subjective academic stress, and subjective learning adaptability. The achievement goal orientations of the medical students in this study were at a middle level. The findings emphasize the importance of mastery goals for promoting the academic performance and well-being of medical students. More care and attention toward achievement goal orientations can be beneficial for the improvement of the academic performance and well-being among medical students.

Structure-based virtual screening of bioactive compounds from Indonesian medical plants against severe acute respiratory syndrome coronavirus-2

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a virus that causes the infectious disease coronavirus disease-2019. Currently, there is no effective drug for the prevention and treatment of this virus. This study aimed to identify secondary metabolites that potentially inhibit the key proteins of SARS-CoV-2. This was an in silico molecular docking study of several secondary metabolites of Indonesian herbal plant compounds and other metabolites with antiviral testing history. Virtual screening using AutoDock Vina of 216 Lipinski rule-compliant plant metabolites was performed on 3C-like protease (3CL^pro), RNA-dependent RNA polymerase (RdRp), and spike glycoprotein. Ligand preparation was performed using JChem and Schrödinger's software, and virtual protein elucidation was performed using AutoDockTools version 1.5.6. Virtual screening identified several RdRp, spike, and 3CL^pro inhibitors. Justicidin D had binding affinities of −8.7, −8.1, and −7.6 kcal mol⁻¹ on RdRp, 3CL^pro, and spike, respectively. 10-methoxycamptothecin had binding affinities of −8.5 and −8.2 kcal mol⁻¹ on RdRp and spike, respectively. Inoxanthone had binding affinities of −8.3 and −8.1 kcal mol⁻¹ on RdRp and spike, respectively, while binding affinities of caribine were −9.0 and −7.5 mol⁻¹ on 3CL^pro and spike, respectively. Secondary metabolites of compounds from several plants were identified as potential agents for SARS-CoV-2 therapy.

Burnout and engagement among PhD students in medicine: the BEeP study

INTRODUCTION

Using a self-determination theory framework, we investigated burnout and engagement among PhD students in medicine, and their association with motivation, work-life balance and satisfaction or frustration of their basic psychological needs.

METHOD

This cross-sectional study was conducted among PhD students at a university medical centre (n = 990) using an electronic survey on background characteristics and validated burnout, engagement, motivation and basic psychological needs questionnaires. Cluster analysis was performed on the burnout subscale scores to find subgroups within the sample which had similar profiles on burnout. Structural equation modelling was conducted on a hypothesized model of frustration of basic psychological needs and burnout.

RESULTS

The response rate was 47% (n = 464). We found three clusters/subgroups which were composed of PhD students with similar burnout profiles within the cluster and different profiles between the clusters. Cluster 1 (n = 199, 47%) had low scores on burnout. Clusters 2 (n = 168, 40%) and 3 (n = 55, 13%) had moderate and high burnout scores, respectively, and were associated with low engagement scores. Cluster 3, with the highest burnout scores, was associated with the lowest motivational, engagement, needs satisfaction and work-life balance scores. We found a good fit for the "basic psychological needs frustration associated with burnout" model.

DISCUSSION

The most important variables for burnout among PhD students in medicine were lack of sleep and frustration of the basic psychological needs of autonomy, competence and relatedness. These add to the factors found in the literature.

Factors impeding the supply of over-the-counter medications according to evidence-based practice: A mixed-methods study

OBJECTIVE

Despite the positive attitudes pharmacists have toward evidence-based practices (EBPs), its application in community pharmacies in Saudi Arabia is lacking. Therefore, this study aimed to explore and assess EBPs by community pharmacists in Saudi Arabia when they dispense over-the-counter (OTC) medications for three minor ailments: diarrhea, cough, and the common cold.

RESEARCH DESIGN AND METHODS

We used a mixed-methods approach consisting of two study parts. The first was a quantitative investigation that used mystery shoppers. Four researchers, posing as mystery shoppers, visited 214 randomly selected pharmacies in the Riyadh region of Saudi Arabia. They used 14 questions from a standardized checklist to examine EBPs by community pharmacists. The qualitative part of the study entailed three focus-group discussions with 13 pharmacists from different community practice settings and explored factors that affected the application of EBPs when supplying OTC medications from the pharmacists' point of view.

RESULTS

The analysis indicated that 40% of pharmacists dispensed OTC medications according to EBPs. Logistic regression analysis showed that one question, "Describe your symptoms", predicted the correct supply of OTC medications (p = 0.021). The qualitative section of the study identified nine factors that affected EBP. Some of these factors facilitated EBP, such as established patient-pharmacist relationships, some acted as barriers such as conflicts between available evidence, while other factors could either facilitate or hinder EBPs, such as the health literacy of the patient.

CONCLUSION

Given that dispensing OTC medication is a core function of pharmacists, this study uncovered low adherence to EBPs by community pharmacists in Saudi Arabia when dispensing OTC medication for three minor ailments: diarrhea, cough, and the common cold. Furthermore, this study identified a number of explanatory factors for this low adherence. Targeting these factors could help change the behavior of pharmacists and decrease undesirable outcomes.

Satisfaction and needs of pharmacists in prescription-checking training: a cross-sectional survey

OBJECTIVE

Prescription checking is becoming increasingly prevalent in medical institutions. However, the prescription-checking ability of pharmacists requires improvement. The study aim was to explore the main aspects of prescription-checking training and provide an empirical reference for the training of pharmacists in medical institutions.

METHODS

Participants were pharmacists willing to complete a Likert questionnaire. Descriptive statistics were used to examine percentages and composition ratios. The chi-square test and exploratory factor analysis were used for inferential analysis.

RESULTS

The questionnaire showed good internal consistency reliability and validity. A total of 90% of participants were satisfied with the training. Exploratory factor analysis extracted three satisfaction dimensions: training organization, teaching method, and knowledge consolidation and assessment. The average examination score for the 20 courses was 89.21/100. Regarding trainee needs, 94.66% preferred face-to-face lectures, 89.33% expected high professional skills of the lecturers and 62.67% believed that clinical expertise was highly desirable.

CONCLUSIONS

There was a high demand for prescription-checking training among pharmacists. Trainees in this study showed high satisfaction. The most important aspects of prescription-checking training were training organization and knowledge consolidation and assessment. It is recommended that training should be stratified. Pharmacists preferred face-to-face and interactive lectures as a supplement to clinical knowledge.

Effectiveness of a professional development training program in increasing knowledge of mental health clinicians specializing in early psychosis

AIM

For early psychosis services to be effective, it is essential to have staff that are trained in evidence-based interventions in this area. In this paper, we report on research undertaken by The Early Psychosis Prevention and Intervention Centre's Statewide Services (ESW) team. The focus was on assessing knowledge acquisition in early psychosis clinicians that had attended ESW's specialist training.

METHODS

Between October 2012 and October 2017, data were collected from a large cohort of clinicians that had attended 46 ESW workshops covering topics identified in international guidelines as key components of early psychosis service provision. Participants were asked to complete between 3 and 11 pre- and post-workshop short answer and/or multiple choice questions that related to learning outcomes for the workshop. The percentage of correct responses before and after the workshop was compared for each participant, with a cumulative measure taken to provide information regarding knowledge acquisition across each workshop.

RESULTS

Participant compliance was high (89.7%) with 962 completed questionnaires being collected from 1073 attendees across the workshops. Results showed that the ESW training led to a statistically significant increase in clinician knowledge from pre-training scores of 47.2% correct, to 83.5% correct answers at the conclusion of training (pre M = 47.2%, SD = 28.8; post M = 83.5%, SD = 23.7; t[890] = -35.66, P < 0.001).

CONCLUSIONS

Training that utilized adult learning principles had a strong focus on evidence-based interventions, and used clinical examples to embed core principles, led to a statistically significant increase in early intervention clinician knowledge.

The role of empathy and psychological need satisfaction in pharmacy students' burnout and well-being

BACKGROUND

The purpose of this study was to examine the relationship between Korean pharmacy students' empathy and psychological need satisfaction and their levels of burnout and psychological well-being, using structural equation modeling.

METHODS

The participants were 452 pharmacy students from five South Korean universities. The Jefferson Scale of Empathy (Health Professions Students version), the Activity-Feeling States Scale, and the Maslach Burnout Inventory-Student Survey were used to assess empathy, psychological need satisfaction, and burnout, respectively. Psychological well-being was measured with the Mood Rating Scale, Self-Esteem Scale, and Satisfaction With Life Scale. The fits of the measurement and structural regression (SR) models with data on the four variables were evaluated using the Tucker-Lewis index (TLI), incremental fit index (IFI), comparative fit index (CFI), and root mean-square error of approximation (RMSEA) using AMOS 18.0.

RESULTS

A total of 447 students (98.9%) completed the survey. The measurement model showed adequate fit indices; all hypothesized factor loadings were significant. The proposed SR model also showed an acceptable fit (TLI = 0.92, IFI = 0.94, CFI = 0.94, RMSEA = 0.072); each path was supported except the path from empathy to burnout (β = 0.005). Empathy was positively associated with psychological well-being (β = 0.18). Perceived satisfaction of psychological needs was positively related to psychological well-being (β = 0.59), but strongly and negatively related to burnout (β = - 0.71). The model explained 50 and 44% of variances in burnout and psychological well-being, respectively.

CONCLUSIONS

Pharmacy students' empathy and psychological needs should be considered in pharmacy education systems to promote psychological adjustment.

Examining Associations Between Physician Data Utilization for Practice Improvement and Lifelong Learning

INTRODUCTION

Practice data can inform the selection of educational strategies; however, it is not widely used, even when available. This study's purpose was to determine factors that influence physician engagement with practice data to advance competence and drive practice change.

METHODS

A practice-based, pan-Canadian survey was administered to three physician subspecialties: psychiatrists (Psy), radiation oncologists (RO), and general surgeons (GS). The survey was distributed through national specialty society membership lists. The survey assessed factors that influence the use of data for practice improvement and orientation to lifelong learning, using the Jefferson Scale of Physician Lifelong Learning (JeffSPLL). Linear regression was used to model the relationship between the outcome variable frequency of data use and independent predictors of continuous learning to improving practice.

RESULTS

A total of 305 practicing physicians (Psy = 203, RO = 53, GS = 49) participated in this study. Most respondents used data for practice improvement (n = 177, 61.7%; Psy = 115, 40.1%; RO = 35; 12.2%; GS = 27, 9.4%) and had high orientation to lifelong learning (JeffSPLL mean scores: Psy = 47.4; RO = 43.5; GS = 45.1; Max = 56). Linear regression analysis identified significant predictors of data use in practice being: frequency of assessing learning needs, helpfulness of data to improve practice, and frequency to develop learning plans. Together, these predictors explained 42.9% of the variance in physicians' orientation toward integrating accessible data into practice (R = 0.426, P < .001).

DISCUSSION

This study demonstrates an association between practice data use and perceived data utility, reflection on learning needs and learning plan development. Implications for this work include process development for data-informed action planning for practice improvement for physicians.

Physicians as Teachers and Lifelong Learners

INTRODUCTION

Lifelong learning requires sustained motivation for learning. Employing a motivational theory framework, we investigated the relationships of psychological need satisfaction, clinical teaching involvement, and lifelong learning of physicians at different career stages and in various medical specialties. We also examined the associations of physician lifelong learning with stress, burnout, teaching enjoyment, and life satisfaction, all of which are essential for physician well-being and, ultimately, for the provision of quality patient care.

METHODS

This was a cross-sectional study. Using survey methodology, quantitative data were collected from 202 practicing physicians in Canada. The questionnaire contained validated scales of physician lifelong learning and psychological need satisfaction, measures of clinical teaching (involvement and enjoyment), stress level, burnout frequency, and life satisfaction. Analysis of covariance and correlational analysis were performed.

RESULTS

On average, participants reported moderate to moderately high levels of lifelong learning, psychological need satisfaction, teaching enjoyment, and life satisfaction. Irrespective of career stage and specialty, physicians' psychological need satisfaction and involvement in clinical teaching were significant in relation to lifelong learning. That is, physicians who experienced greater psychological need satisfaction at work and those who were involved in clinical teaching had, on average, higher lifelong learning scores. Physician lifelong learning had significant associations with life satisfaction and teaching enjoyment but not with stress level and burnout frequency.

DISCUSSION

Fulfilling physicians' basic psychological needs at work and supporting them in their teaching roles is likely to enhance physician lifelong learning and, ultimately, quality of patient care.

Determining the motivations of family members to undertake cardiopulmonary resuscitation training through grounded theory

AIMS

To explore the motivation of family members of patients at high risk for sudden cardiac death for undertaking cardiopulmonary resuscitation (CPR) training.

BACKGROUND

Home cardiac arrests are associated with poor outcomes because few family members learn CPR. Little is known about factors that motivate family members to participate in CPR training.

DESIGN

We used grounded theory to establish a theoretical framework to explore the motivational factors for learning CPR among family members.

METHODS

Twelve participant observations and 42 semi-structured interviews with family members of different behaviours towards CPR training were conducted from December 2013 - November 2016. Data were analysed using constant-comparisons, situational analysis, and encoding.

FINDINGS

A motivation-behaviour theoretical framework for learning CPR was constructed. We identified meeting inner needs as the core category to demonstrate motivation. Security motivation and responsibility motivation emerged as main categories, which demonstrate that seeking a sense of security and shouldering family responsibility were important considerations for family members to learn CPR. These two motivations produced high-engagement behaviours of family members to learn CPR.

CONCLUSIONS

The motivations we identified-deriving from a sense of security and family responsibility-are the main reasons family members would learn CPR and, therefore, should be understood by medical professionals. Understanding these motivations may help in the formulation of customized CPR training that further meets the needs of family members. For example, motivational interventions that are integrated with a family-based CPR course can be designed to improve the participation of family members and the sustainability of the course.