Fostering the physician-scientist workforce: a prospective cohort study to investigate the effect of undergraduate medical students' motivation for research on actual research involvement

Perspectives on diagnostic radiographers' motivation for becoming researchers: A qualitative focus group study

INTRODUCTION

This paper presents motivational factors to engage, start a research project and pursue a research career. The study aimed to investigate radiographer's motivation for engaging in research.

METHODS

Eight radiographers from Denmark with experience in research were interviewed in a 2-h focus group interview in October 2023. This qualitative approach was selected to allow the participants to discuss their opinions and values. The discussions were audio recorded and transcribed before the thematic analysis was performed.

RESULTS

The analysis revealed six main themes: the importance of radiographic research, the importance of radiographers' participation in research, research radiographers' motivation, funding and participation in research projects, demotivation and difficulties, and facilitating radiographic research in the future.

CONCLUSION

The participants were motivated by different factors. The participants found both research in radiography and radiographers' participation in research-related activities important, although they found lack of support from managers, funding, and time to be demotivational factors.

IMPLICATION FOR PRACTICE

This study contributes to the limited literature on motivational factors for becoming a researcher within radiography.

Beyond the curriculum: unveiling medical students' drivers and barriers to research participation at Alfaisal University

Medical education continually adapts to the needs of future health care professionals, with student motivation in research being a pivotal aspect. This study at Alfaisal University aimed to explore the motivations, benefits, and challenges faced by medical students in extracurricular research activities. Using a mixed-method approach, we combined quantitative surveys with qualitative group interviews. Findings revealed that both extrinsic (e.g., enhancing postgraduate training prospects) and intrinsic (e.g., personal interest and skill refinement) factors significantly motivate students to be involved in research activities. Participants unanimously acknowledged skill enhancement, particularly in literature comprehension, creative ideation, and networking. However, challenges such as conflicts with course scheduling, lack of hands-on experiences, and mentorship issues were identified as potential barriers to research participation. Addressing these barriers and understanding motivations can inform the design of research programs, enhancing the overall student research experience. This study underscores the importance of research in medical education, emphasizing the need for institutions to prioritize addressing challenges and leveraging benefits to prepare medical students for a research-integrated clinical future.NEW & NOTEWORTHY This article examines the motivating factors and obstacles of extracurricular research in Alfaisal University, Saudi Arabia. The study utilizes a mixed methodology of online surveys and in-person group interviews to gain insights from the medical students of the university. We revealed several extrinsic and intrinsic motivators that drove the students; however, there remain several challenges to students during their research journey. Addressing these challenges will help the students obtain a more fruitful, educational research experience.

Exploring the motivation of health professionals to engage with research at various career stages

BACKGROUND

Research is crucial for improved healthcare and better patient outcomes, but there is a current shortage of clinician-researchers who can connect research and practice in the health professions field. This study aimed to investigate the effect of career stage, previous training and involvement in research on health professionals' (HPs) motivations to engage in research while in public hospital clinical roles. HPs' perceived motivation concerning the importance, value, and barriers attributed to research during different career stages were examined.

METHODS

A mixed methods study design was adopted for this research. An online survey developed based on the Expectancy-Value-Cost (EVC) theory was distributed to HPs (doctors, nurses, midwives, and allied health professionals) in three North Queensland Public Hospitals. Data analysis included descriptive and inferential statistics for the quantitative data and content analysis for the qualitative text responses.

RESULTS

Three hundred and fifty-five responses were received. Prior research training and involvement in research influenced respondents' perceptions about the importance, attitude, motivators, and barriers to research. Attainment value was the overarching motivation for involvement in research and research training for all career stages and all professional HP groups. Positive attitude to research was significantly higher (P = 0.003) for the allied health group (27.45 ± 4.05), followed by the medical (26.30 ± 4.12) and then the nursing and midwifery group (25.62 ± 4.21). Perceived importance and attitude attributed to research were significantly higher (P < 0.05) for those who had research training (26.66 ± 3.26 and 28.21 ± 3.73) compared to those who did not have research training (25.77 ± 3.77 and 23.97 ± 3.53). Significantly higher (P < 0.05) perceptions of organisational and individual barriers were reported among early career (50.52 ± 7.30) respondents compared to their mid-career (48.49 ± 8.14) and late career (47.71 ± 8.36) counterparts.

CONCLUSION

The findings from this study provide valuable insights into the factors that influence HPs' motivation for research. The results underscore the importance of professional group, involvement in research, exposure to research training, career stage, gender, and organisational support in shaping HPs' attitudes, values, and perceived barriers to research. Understanding these factors can inform the development of targeted strategies to enhance research engagement among HPs and promote evidence-based practice in healthcare.

Assessment of early scientific research skills training for medical undergraduates in China

The medical field is facing a physician-scientist shortage, threatening future medical research and development. Medical institutions can contribute to developing physician-scientists by stimulating students' involvement in research. In this study, a medical undergraduate teaching module to develop research skills and encourage interest in research was held in Chongqing, China. Undergraduate medical students at Chongqing Medical University completed research skills training. Before and after the training, an online, anonymous, self-reported questionnaire was administered. The self-reported questionnaire investigated students' demographic characteristics, students' perception of attitudes toward conducting research, research skills (e.g., identifying and utilizing information, critical appraisal of literature, paper writing, and understanding of research), and feedback on scientific research training. The module was implemented with 25 students from July 2019 to October 2019, and 96.0% (N = 24) of participants responded to the questionnaire both prior to and after the training. In the evaluation of research skills, results showed that use of appropriate tools for research (Z = -3.340, p < 0.01), students' ability to undertake a focused literature search (Z = -3.40, p < 0.01), identifying and utilizing information (Z = -3.34, p < 0.01), and paper-writing skills (Z = -3.49, p < 0.01) were significantly improved after the undergraduates participated in the scientific research training. A qualitative analysis of the feedback showed that students found that the training helped to enhance their knowledge, improve their study scores, and motivate them to conduct research in the future. Early scientific research ability training strengthened the research skills of medical undergraduates and motivated them to pursue research.

Establishment of the Clinician-Scientist Investigator Opportunity Network to Develop Military Medical Research Leaders

INTRODUCTION

The ability of military clinicians to conduct military medical research is often limited because of competing priorities and a lack of research mentorship. The Clinician-Scientist Investigator Opportunity Network (CSION) was developed with the intent of training clinicians how to engage in requirements-driven research within the DoD.

MATERIALS AND METHODS

Three to five academic medical faculties were selected from a pool of applicants each year to participate in a 2-year research fellowship. To be eligible for the CSION program, applicants had to meet the following criteria: (1) Completed residency graduate medical education training, (2) not be currently enrolled as a graduate medical education trainee, and (3) obtained permission from their department leadership to focus 25% of their duty hours on CSION participation to include didactic and research efforts. The remaining 75% of fellows' time was dedicated to clinical duties. Monthly didactics, intensive mentorship, and consistent support were offered to each fellow by the CSION leadership team. Metrics were recorded to include both research and clinical productivity.

RESULTS

Between January 2019 and December 2022, 12 CSION fellows graduated from the program (four in the class of 2020, three in 2021, and five in 2022). From 2019 to 2021, the 12 CSION fellows initiated 204 research protocols, generated 489 publications/presentations, and secured 33 research grants. All graduates of the program remain active in clinical research with multiple graduates currently assigned to research positions.

CONCLUSIONS

The CSION research education program is a 2-year additional duty research fellowship producing clinician-scientists conducting military-relevant medical research and publications and may be considered a low-cost/highly efficient alternative to achieve the reported benefits of the MD-PhD tract. The expansion of the CSION program may improve the quality of military medical research and health care.

Impacts of a University Research Assistant Program: The First Decade

Purpose

There is a declining number of physician-scientists. Little is published about the potential for university student experiences to contribute to the pipeline of future researchers. The purpose of this study was to describe a unique university research program and report the outcomes of the first 10 years.

Method

The University Research Assistant Program (URAP) was described including course content, research experiences, and student composition. Outcomes of URAP student contributions to the literature and research presentations was reported. URAP students were also surveyed to assess their perspectives on the impact of the URAP program on career choices after graduation.

Results

URAP began as an independent study course and grew into for-credit university courses. A total of 212 students have taken at least one semester and 88 responded to the survey. All students who participated in URAP have graduated, and 77% (n = 68) reported the URAP program prepared them to reach their career goals. Most graduates pursued health care careers including medical school (55%), Master's programs in health care (29%), or PhD in health care (5%). URAP students participated in research involving 11 different pediatric subspecialties. Many attained co-authorship of abstracts and publications, 53 first-authored an abstract presentation and 7 manuscripts.

Conclusions

URAP significantly influenced university students who overwhelmingly entered health care fields. While difficult to assess if these early experiences will influence participation as future physician -scientists, these students made meaningful research contributions while enrolled in these courses.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01852-6.

Publication rate and factors associated with publication of research projects by obstetrics residents in an academic department over 10 years

OBJECTIVES

To determine the publication rate of mandatory research projects conducted by obstetrics residents and to evaluate the publication-associated factors and reported obstacles.

STUDY DESIGN

This retrospective cohort study included all consecutive residents in an academic obstetrics-gynecology department in Paris, France, between 2010 and 2020. All residents were required to conduct a research project. Information about publication was collected by searching PubMed. A closed-ended questions questionnaire was sent to former residents about their characteristics, subsequent professional development, and research project characteristics. Factors associated with publication were identified by univariable and multivariable analysis with logistic regression.

RESULTS

During the study period, 156 residents trained in our obstetrics-gynecology department. The overall publication rate was 30.8% (48/156) and the median time to publication 27 months (IQR, 18-37). The resident was first author in 36 (75.0%) publications. Among the 130 (83.3%) residents who completed the questionnaire, 43 (33%) had published their research project. Overall, 74/130 (60.8%) residents used their project for their mandatory medical thesis. Factors associated with publication in univariable analysis were younger age (median), completion of a PhD, planned career in academic medicine, prospective study design, presentation at a conference or congress and use their project for their medical thesis. The only factors associated with publication in the multivariable analysis were planned career in academic medicine (aOR 5.62 95 %CI[1.84-17.19]) and the prospective study design of the research project (aOR 6.1 95 %CI[1.24-29.56]). The main reasons for nonpublication reported by resident were lack of time and failure to complete the project.

CONCLUSION

Among the mandatory clinical research projects conducted by obstetrics residents over a decade in our department, 30.8% were published. The main factors associated with publication were planned career in academic medicine and a prospective design of the research project.

Moderating effect of organizational climate on the relationship between research motivation and learning engagement among nurses taking part-time master's program: A cross-sectional study

AIMS

To investigate the moderating effects of perceived organizational climate on the relationship between research motivation and learning engagement in research among nurses pursuing a part-time master's degree.

BACKGROUND

Research motivation positively affects learning engagement in research. However, the role of perceived organizational climate has not been explored in nurses taking part-time master's program in China. This study examined the relationships between various types of research motivation and learning engagement in research and whether the perceived organizational climate moderates the relationship between the other variables.

METHODS

This cross-sectional one-center study was performed on 230 nurses by assessing learning engagement in research, research motivation and perceived organizational climate.

RESULTS

The mean age of participants was 31.3 ± 3.5 years and 91.3% were female. Participants who had been assigned a supervisor showed higher learning engagement in research than those without a supervisor (3.65 ± 0.60 vs. 3.48 ± 0.61; P < 0.001). Participants who had experience conducting research reported higher learning engagement in research than those with no experience (3.30 ± 0.71 vs. 3.14 ± 0.83; P < 0.05). The mean score of learning engagement in research was 3.39 ± 0.63. The mean scores for intrinsic, extrinsic and failure-avoidance motivation were 3.72 ± 0.61, 3.71 ± 0.71 and 3.43 ± 0.70, respectively. As for perceived organizational climate, the mean score was 122.70 out of 148. Learning engagement in research was significantly positively correlated with intrinsic research motivation, extrinsic research motivation and perceived organizational climate scores (r = 0.441, 0.336, 0.307, p < 0.001, respectively). Perceived organizational climate moderated the correlation between intrinsic and extrinsic research motivation and learning engagement in research.

CONCLUSION

Nurses taking the master's program perceived a higher level of perceived organizational climate could strengthen the relationship between intrinsic and extrinsic research motivation and learning engagement in research. More organizational support can enhance learning engagement in research by reinforcing intrinsic and extrinsic research motivation.

IMPLICATIONS FOR NURSING MANAGEMENT

Universities can assign supervisors promptly. Universities and hospitals can provide education about the importance of research in nursing and reinforce their intrinsic and extrinsic research motivation. Hospitals can adjust policies based on the needs of nurses taking the master's program to provide organizational support, to facilitate the research learning process.

Design and Transition of an Emergency E-Learning Pathology Course for Medical Students-Evaluation of a Novel Course Concept

BACKGROUND

Around the world, the emergency brought about by the COVID-19 pandemic forced medical schools to create numerous e-learning supplements to provide instruction during this crisis. The question now is to determine a way in which to capitalize on this momentum of digitization and harness the medical e-learning content created for the future. We have analyzed the transition of a pathology course to an emergency remote education online course and, in the second step, applied a flipped classroom approach including research skills training.

METHODS

In the summer semester of 2020, the pathology course at the Technical University of Munich was completely converted to an asynchronous online course. Its content was adapted in winter 2021 and incorporated into a flipped classroom concept in which research skills were taught at the same time.

RESULTS

Screencasts and lecture recordings were the most popular asynchronous teaching formats. Students reported developing a higher interest in pathology and research through group work. The amount of content was very challenging for some students.

CONCLUSION

Flipped classroom formats are a viable option when using pre-existing content. We recommend checking such content for technical and didactic quality and optimizing it if necessary. Content on research skills can be combined very well with clinical teaching content.

Motivation, self-efficacy, perception, curiosity, and barriers toward medical research among undergraduates in China

Medical research is important to scientific progress and medical education. Institutions worldwide have sought to increase student involvement in research such as clinician-scientists training programs, while little is known about how medical undergraduates perceive research. A cross-sectional study was conducted in Chongqing Medical University, Chongqing, China, with first-fourth year undergraduates. An online, anonymous, and self-rating 5-point Likert questionnaire was conducted to investigate medical undergraduates' demographic characteristics and assess motivation, self-efficacy, perception, curiosity, and barriers regarding medical research. Content validity was checked with experts and face validity was checked for clarity and understanding of the questionnaire. The Cronbach's alpha coefficient of the questions ranged from 0.813 to 0.879. A total of 3273 medical undergraduates were surveyed, and 86.62% (2835) participants (male 962, female 1873) were identified as effective. Males scored higher than females on self-efficacy (p < 0.001), perception (p = 0.017), and curiosity (p < 0.001), and lower on barriers (p < 0.001). The second year students are at the peak of their perception (p = 0.006) and lowest barrier scores (p = 0.003). Students with scientific research experience scored higher in motivation (p = 0.002), self-efficacy (p < 0.001), perception (p < 0.001), and curiosity (p < 0.001). Lack of proper mentoring opportunity (86.2%) and knowledge (84.5%) were the main barriers in conducting research. Even though they have a positive perspective, only a few undergraduates enrolled in research. Medical universities should encourage faculties to supervise and guide undergraduates' projects, and provide feasible solutions for students to learn scientific knowledge and skills. It is vital to build a research-oriented environment and academic atmosphere.

Curricula, Teaching Methods, and Success Metrics of Clinician-Scientist Training Programs: A Scoping Review

PURPOSE

To describe the literature on clinician-scientist training programs to inform the development of contemporary and inclusive training models.

METHOD

The authors conducted a scoping review, searching the PubMed/MEDLINE, CINAHL, and Embase databases from database inception until May 25, 2020. Studies presenting primary research that described and evaluated clinician-scientist training programs were identified for data abstraction. On the basis of deductive and inductive methods, information about program characteristics, curricula, teaching strategies, and success metrics was extracted. The extracted variables were analyzed using descriptive statistics.

RESULTS

From the initial 7,544 citations retrieved and 4,974 unique abstracts screened, 81 studies were included. Of the 81 included studies, 65 (80.2%) were published between 2011 and 2020, 54 (66.7%) were conducted in the United States, and 64 (79.0%) described programs that provided broad clinician-scientist training. Few programs provided funding or protected research time or specifically addressed needs of trainees from underrepresented minority groups. Curricula emphasized research methods and knowledge dissemination, whereas patient-oriented research competencies were not described. Most programs incorporated aspects of mentorship and used multiple teaching strategies, such as direct and interactive instruction. Extrinsic metrics of success (e.g., research output) were dominant in reported program outcomes compared with markers of intrinsic success (e.g., career fulfillment).

CONCLUSIONS

Although programs are providing clinician-scientists with practical skills training, opportunities exist for curricular and pedagogic optimization that may better support this complex career path. Training programs for clinician-scientists can address contemporary issues of wellness and equity by reconsidering metrics of program success and evolving the core tenets of their education models to include equity, diversity, and inclusion principles and patient-oriented research competencies.

Twelve tips for fostering the next generation of medical teachers

Medical professionals with a special interest in and focus on education are essential to provide good quality education. Despite high numbers of students expressing an interest in teaching, concerns are rising regarding the supply of medical teachers, with few junior educators on the career ladder. To date, only some medical schools offer in-depth courses to students wanting to explore or aspire a career as a specialised medical teacher. We propose twelve tips for an elective course to foster the next generation of medical teachers. This course aims to enhance theoretical foundations and educational practices to cultivate the next generation of medical teachers.

Research involvement among undergraduate health profession students in a resource-limited setting: awareness, attitude, motivators and barriers

BACKGROUND

Involvement of undergraduate health professions students (HPS) in research will facilitate evidence-based clinical practice among future healthcare practitioners. This study aimed to assess research involvement among undergraduate HPS students and associated factors in Uganda.

METHODS

A cross-sectional study was conducted using an online assessment tool sent through WhatsApp groups and E-mail addresses of HPS in 12 medical schools in Uganda between 20th September and 5th October 2021.

RESULTS

We enrolled 398 participants with a mean age of 23.9 ± 3.7 years. Of this, 267 (67.1%) were male. One hundred twenty (30.2%) participants previously participated in a research activity: 90 (58.4%) as research assistants, 39 (25.3%) published as first authors, and 25 (16.2%) as co-authors. Training on the conduct of research was received by 242 (65.8%) participants, and 326 (81.9%) had intentions of conducting research in the future. Factors influencing participation in research activities were, age ≥ 25 years (adjusted odds ratio (aOR): 1.9, 95% confidence interval (95% CI): 1.2-3.2, p = 0.012), being male (aOR: 2.1, 95%CI: 1.2-3.6, p = 0.008), and being in a clinical year i.e., year 3 (aOR: 3.2, 95% CI: 1.1-9.3, p = 0.033), year 4 (aOR: 3.3, 95% CI: 1.1-9.5, p = 0.028) and year 5(aOR: 11.6, 95% CI: 3.2-42.1, p < 0.001). Lack of funds (79.6%), and mentorship (63.3%) were reported as major barriers to research.

CONCLUSIONS

Despite a high proportion of HPS showing interest in getting involved in research, less than one-third reported previous involvement. Addressing barriers such as funding could potentially improve research involvement and output among undergraduate HPS in resource-limited settings.

Assessing publication rates from medical students' mandatory research projects in the Netherlands: a follow-up study of 10 cohorts of medical students

OBJECTIVES

The medical field is facing a clinician-scientist shortage. Medical schools could foster the clinician-scientist workforce by offering students research opportunities. Most medical schools offer elective research programmes. Subsequently, a subset of doctors graduates without any research experience. Mandatory research projects may be more sufficient to develop clinician-scientist, but take more supervision and curricular time. There is limited insight in the scientific outcomes of mandatory research experiences. This study aims to examine publication rates of a mandatory research experience, identify factors associated with publication, and includes postgraduate research engagement.

DESIGN AND SETTING

Prospective follow-up study involving 10 cohorts of medical students' mandatory research projects from Leiden University Medical Center.

PARTICIPANTS

All medical students who conducted their research project between 2008 and 2018 (n=2329) were included.

MAIN OUTCOME MEASURE

Publication rates were defined as peer-reviewed scientific publications, including research papers, reviews, and published meeting abstracts. Postgraduate research engagement was defined as research participation and dissemination of research at scientific conferences or in journals.

RESULTS

In total, 644 (27.7%) of all mandatory research experiences resulted in publication, with students mainly as first (n=984, 42.5%) or second author (n=587, 25.3%) and above world average citation impact (mean normalised journal score 1.29, mean normalised citation score 1.23). Students who conducted their research in an academic centre (adjusted OR 2.82; 95% CI 2.10 to 3.77), extended their research (adjusted OR 1.73; 95% CI 1.35 to 2.20), were involved in an excellency track (adjusted OR 2.08; 95% CI 1.44 to 3.01), or conducted clinical (adjusted OR 2.08; 95% CI 1.15 to 3.74) or laboratory (adjusted OR 2.16; 95% CI 1.16 to 4.01) research published their research more often. Later as junior doctors, this group significantly more often disseminate their research results at scientific conferences (adjusted OR 1.89; 95% CI 1.11 to 3.23) or in journals (adjusted OR 1.98; 95% CI 1.14 to 3.43).

CONCLUSIONS

Our findings suggest that a significant subset of hands-on mandatory research projects with flexible learning pathways result in tangible research output with proper impact and that such successful experiences can be considered as diving board towards a research-oriented career.

Perceptions and Motivation Regarding Performing Research in Physicians Specializing in Care for Older Adults Involved in a Mandatory Evidence-Based Medicine Training Study: A Mixed-Methods Study

PURPOSE

Evidence underpinning treatment of older persons with complex conditions is often sparse, and involving more early career physicians committed to optimizing care for older adults may help increase a relevant evidence base. We examined perception of and motivation to conduct research in physicians (residents) specializing in care of older adults.

SUBJECTS AND METHODS

Residents of an academic medical centre in the Netherlands enrolled in a 3-year training programme. The programme includes a mandatory evidence-based medicine (EBM) training study on pain and discomfort in cognitively impaired nursing home patients, in which residents perform their research over the 3-year duration of the programme. We employed a mixed-methods design with survey and qualitative interviews (December 2019-April 2020). The survey included validated scales with agreement response options rated 1-7. Qualitative interviews were underpinned by interpretative phenomenological analysis.

RESULTS

Of 38 invited residents, 23 (15 females) participated. The mean score on perceptions of research was 4.1 (SD 0.8); on intrinsic motivation 4.8 (SD 1.0); on extrinsic motivation 4.3, with a higher SD of 1.4. Eight interviews also showed diversity in the extent to which residents felt equipped to conduct the mandatory EBM training study, and research more generally, which was related to previous experiences performing research. The residents generally did not anticipate conducting research themselves despite recognizing the benefits of training in research.

CONCLUSION

Perceptions and motivation of the residents specializing in care of older people to conduct research, although considered relevant to their practice, were not very positive. The study results in recommendations to motivate physicians in geriatrics training to conduct research, eg through personalized boosting of self-efficacy. This is crucial to motivate future physicians to contribute to research relevant to older people in more ways than just delivering data for research conceived by (non-clinical) researchers.

Undergraduate research in medicine: A summary of the evidence on problems, solutions and outcomes

Scientific research plays a fundamental role in current medical practice and it is of great importance that medical students relate to it from the beginning of their professional career, since it generates multiple benefits that will be reflected during the course of their careers as university students and future professionals. However, getting involved in research during the undergraduate years is not always easy, as there are different obstacles and challenges that result in a reduced number of research students. Because of this, it is necessary to adopt appropriate strategies and measures to help facilitate this process, in order to foster the early development of essential skills that will facilitate responsible clinical practice. Knowing the evidence on this issue is fundamental to propose educational solutions depending on each context.

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Undergraduate research is the best way to promote the curriculum.

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Undergraduate research increases the likelihood of publishing articles of higher quality.

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Undergraduate research increases the likelihood of publishing more articles.

The importance of motivation in selecting undergraduate medical students for extracurricular research programmes

INTRODUCTION

Extracurricular research programmes (ERPs) may contribute to reducing the current shortage in physician-scientists, but usually select students based on grades only. The question arises if students should be selected based on their motivation, regardless of their previous academic performance. Focusing on grades and lacking to take motivation into account when selecting students for ERPs might exclude an important target group when aiming to cultivate future physician-scientists. Therefore, this study compared ERP students with lower and higher previous academic performance on subsequent academic performance, ERP performance, and motivational factors.

METHODS

Prospective cohort study with undergraduate medical students who filled in a yearly questionnaire on motivational factors. Two student groups participating in an ERP were compared: students with first-year grade point average (GPA) ≥7 versus <7 on a 10-point grading scale. Linear and logistic regressions analyses were used to compare groups on subsequent academic performance (i.e. third-year GPA, in-time bachelor completion), ERP performance (i.e. drop-out, number of credits), and motivational factors (i.e. intrinsic motivation for research, research self-efficacy beliefs, perceptions of research, curiosity), while adjusting for gender and motivational factors at baseline.

RESULTS

The <7 group had significantly lower third-year GPA, and significantly higher odds for ERP drop-out than the ≥7 group. However, there was no significant between-group difference on in-time bachelor completion and the <7 group was not inferior to the ≥7 group in terms of intrinsic motivation for research, perceptions of research, and curiosity.

CONCLUSIONS

Since intrinsic motivation for research, perceptions of research, and curiosity are prerequisites of future research involvement, it seems beneficial to focus on motivation when selecting students for ERPS, allowing students with lower current academic performance to participate in ERPs as well.

First steps in the physician-scientist pipeline: a longitudinal study to examine the effects of an undergraduate extracurricular research programme

OBJECTIVES

Medicine is facing a physician-scientist shortage. By offering extracurricular research programmes (ERPs), the physician-scientist training pipeline could already start in undergraduate phases of medical training. However, previous studies into the effects of ERPs are mainly retrospective and lack baseline measurements and control groups. Therefore, the current study mimics a randomised controlled trial to examine the effects of an ERP.

DESIGN

Prospective cohort study with baseline measurement and comparable control group.

SETTING

One cohort of 315 medical undergraduates in one Dutch University Medical Center are surveyed yearly. To examine the effects of the ERP on academic achievement and motivational factors, regression analyses were used to compare ERP students to students showing ERP-interest only, adjusted for relevant baseline scores.

PARTICIPANTS

Out of the 315 students of the whole cohort, 56 participated within the ERP and are thus included. These ERP students are compared with 38 students showing ERP-interest only (ie, control group).

PRIMARY OUTCOME MEASURE

Academic achievement after 2 years (ie, in-time bachelor completion, bachelor grade point average (GPA)) and motivational factors after 18 months (ie, intrinsic motivation for research, research self-efficacy, perceptions of research, curiosity).

RESULTS

ERP participation is related to a higher odds of obtaining a bachelor degree in the appointed amount of time (adjusted OR=2.95, 95% CI 0.83 to 10.52). Furthermore, starting the ERP resulted in higher levels of intrinsic motivation for research, also after adjusting for gender, age, first-year GPA and motivational baseline scores (β=0.33, 95% CI 0.04 to 0.63). No effect was found on research self-efficacy beliefs, perceptions of research and curiosity.

CONCLUSIONS

Previous research suggested that intrinsic motivation is related to short-term and long-term research engagement. As our findings indicate that starting the ERP is related to increased levels of intrinsic motivation for research, ERPs for undergraduates could be seen as an important first step in the physician-scientist pipeline.

Academic Success Experiences: Promoting Research Motivation andSelf-Efficacy Beliefs among Medical Students

THEORY

Medicine is facing a physician-scientist shortage. Medical training could contribute to developing physician-scientists by stimulating student research involvement, as previous studies showed this is related to research involvement in professional practice. Motivation for research and research self-efficacy beliefs are related to student research involvement. Based on social cognitive theory, success experiences in doing research may enhance research motivation and self-efficacy beliefs. However, the role and type of success experiences in promoting research self-efficacy beliefs and motivation especially early in medical training has not yet been investigated. Therefore, we examined if academic success experiences within an undergraduate course in academic and scientific skills increased research motivation and self-efficacy beliefs among medical students. Furthermore, type of success experience was taken into account by looking at the effects of academic success experiences within standard (i.e., exam) versus authentic (i.e., research report and oral presentation) assessments.

HYPOTHESES

It was hypothesized that academic success experiences increase intrinsic motivation for research and self-efficacy beliefs. Furthermore, we hypothesized that authentic assessments influence intrinsic motivation for research and self-efficacy beliefs to a larger degree than standard assessments, as the authentic assessments mirror real-world practices of researchers.

METHOD

First-year undergraduate medicine students followed a course in academic and scientific skills in which they conducted research individually. Their academic success experiences were operationalized as their grades on two authentic research assessments (written report and oral presentation) and one less authentic assessment (written exam). We surveyed students before the course when entering medical school (i.e., baseline measure) and 1 year after the course in their 2nd year (i.e., postmeasure). Both the baseline and postmeasure surveys measured intrinsic motivation for research, extrinsic motivation for research, and research self-efficacy beliefs. Linear regression analyses were used to examine the relationship between academic success experiences and intrinsic motivation for research, extrinsic motivation for research, and research self-efficacy beliefs on the postmeasure. We adjusted for prior research motivation and self-efficacy beliefs at baseline. Therefore, this adjusted effect can be interpreted as an increase or decrease in motivation. In addition, we adjusted for age, gender, and grade point average (GPA) of the first 4 months, as these variables were seen as possible confounders.

RESULTS

In total, 243 of 275 students participated (88.4%). Academic success experiences in writing and presenting research were related to a significant increase in intrinsic motivation for research. After adjusting for prior GPA, only the effect of presenting remained. Experiencing success in presenting enhanced research self-efficacy beliefs, also after adjusting for prior GPA. Higher grades on the exam did not affect intrinsic motivation for research or research self-efficacy significantly. Also, none of the success experiences influenced extrinsic motivation for research.

CONCLUSIONS

Academic success experiences on authentic research tasks, especially presenting research, may be a good way to enhance intrinsic motivation for research and research self-efficacy beliefs. In turn, research motivation and self-efficacy beliefs promote research involvement, which is a first step in the physician-scientist pipeline. Furthermore, this study established the applicability of the social cognitive theory in a research context within the medical domain.

Intrinsic vs Extrinsic Motivation as Drivers for Early Engagement in Research by Medical Students

BACKGROUND

A student's motivation is a key factor in their success in undertaking an education endeavour. However, how this relates to involvement in research by medical students is unclear.

METHODS

An electronic questionnaire was sent to all medical students at our institution. To ascertain students' motivation to undertake research, they were asked an open-ended question to describe the single major factor that would encourage them to get involved in research as a medical student. A framework of self-determination theory was used to deductively code the responses as intrinsic motivation ("IM"; e.g., interest/passion) or extrinsic motivation ("EM"; e.g. improving CV). The two groups were then contrasted in relation to their research engagement.

RESULTS

A total of 348 students were included in the survey, of whom 204 were coded as IM responses, and 144 were coded as EM responses. Students who engaged in extra-curricular research activities were more likely to report an underlying EM (48% vs 36%, p = 0.03). They were also older (23.7 ± 3.5 vs 21.9 ± 3.7, p = 0.005), and more likely to have completed a prior research degree (15% vs 3%, p = 0.01).

CONCLUSION

In this study, EM was a bigger influencer on research involvement by medical students than IM. Future studies should explore promoters of IM, and include longitudinal data in order to assess whether EM students continue to be involved in research long-term.

Factors affecting paramedicine students' learning about evidence-based practice: a phenomenographic study

BACKGROUND

Evidence-based practice is an important component of pre-service professional learning in medicine and allied health degrees, including new programmes in paramedicine. Despite substantial interest in this area, there is still a lack of clear understanding of how the skills and understandings needed to develop the capacity to apply evidence-based practice can best be learned. Evidence-based practice is often described as consisting of five steps: ask, acquire, appraise, apply and assess. This study focuses on paramedicine students' learning about the first three steps in a final year unit which explicitly aims to develop their skills in relation to these.

METHODS

We conducted a qualitative study of learning journals recorded by 101 of 121 students in a final year unit of a paramedicine degree (20 students either withheld consent for their journals to be used in the research or did not complete their journal entries). We used phenomenographic approaches to the data analysis in order to identify both variation in students' learning and the factors affecting this variation.

RESULTS

We observed variation in students' understanding of the purpose of literature analysis, the nature of medical research and its relationship to practice. In all three, we identify two main factors contributing to the variation in student learning outcomes: epistemological stance, and opportunities for metacognitive learning generated through peer interactions and self-reflection. We also found that as students begin to grapple with the complexity of medical research, this sometimes produced negative attitudes towards its value; such unintended outcomes need to be recognised and addressed.

CONCLUSIONS

We suggest key factors that should be considered in developing coursework intended to enhance students' understandings about the processes and application of evidence-based practice. Providing collaborative learning opportunities that address the architecture of variation we observed may be useful in overcoming epistemological and metacognitive barriers experienced by students.

The Association Between Pain Perception and Care Dependency in Older Nursing Home Residents: A Prospective Cohort Study

OBJECTIVES

Maintenance of independence is a challenge for nursing home residents whose pain is often substantial. The objective of this study was to explore the relationship between pain perception and care dependency in a population of Dutch nursing home residents.

DESIGN

Prospective cohort study.

SETTING AND PARTICIPANTS

Dutch nursing home residents aged 65 or older, excluding residents with a severe cognitive impairment.

METHODS

The Numeric Rating Scale (NRS) was used to rate pain perception from 0 to 10 in half-point increments and the Care Dependency Scale (CDS) to measure care dependency, with scores ranging from 15 (completely care dependent) to 75 (fully independent). Both measurements were repeated after a 2-month follow-up. Multiple linear regression analysis was used to adjust for potential confounders. Missing data were dealt with by performing tenfold multiple imputation.

RESULTS

A total of 1256 residents (65% women, mean age 83 years) were included. At baseline, the median NRS pain score was 3.0 (interquartile range 0.0-6.0) and the mean CDS score was 55.9 (SD 11.5). Cross-sectionally, for 1-point increase in pain score, care dependency increased 0.65 points [95% confidence interval (CI) 0.46-0.83]. More pain at baseline was associated with slightly lower care dependency after 2 months (beta 0.20, 95% CI 0.01-0.39). Compared with residents whose pain decreased over 2 months, residents with stable pain or increased pain had a 2.27-point (95% CI 0.83-3.70) and 2.39-point (95% CI 0.87-3.90) greater increase in care dependency, respectively.

CONCLUSIONS AND IMPLICATIONS

Pain perception and care dependency are associated in a population of older nursing home residents, and stable or increased pain is associated with increased care dependency progression. The findings of this study emphasize that pain and care dependency should not be assessed nor treated independently.

Promoting positive perceptions of and motivation for research among undergraduate medical students to stimulate future research involvement: a grounded theory study

BACKGROUND

Research is of great value to make advancements within the medical field and, ultimately, offer the best possible patient care. Physician-scientists are key in contributing to the development of medicine, as they can bridge the gap between research and practice. However, medicine currently faces a physician-scientist shortage. A possible solution to cultivate physician-scientists is to engage medical students in research in early phases of medical school. Evidence-based strategies to stimulate positive perceptions of and motivation for research among students could help to enhance research engagement. Consequently, understanding of students' perceptions of and motivation for research is needed. Therefore, this study aimed to identify conditions under which students develop positive perceptions of and motivation for research by answering the following sub-questions: 1) how do first-year medical students perceive research? and 2) which factors contribute to motivation or demotivation for conducting research?

METHODS

We conducted a qualitative study with individual interviews using a grounded theory approach, involving 13 purposively sampled first-year medical students at Leiden University Medical Center.

RESULTS

Our results suggest that first-year students are already able to identify many aspects of research. Students elaborated on the relevance of research for professional practice and personal development. Furthermore, our results suggest a relationship between perceptions of and motivation for research. Some perceptions were identical to motivating or demotivating factors to conduct research, like the relevance of research for practice and performing statistics respectively. Other motivating factors were, among others, acknowledgment, autonomy, and inspiring role models. Demotivating factors were, among others, lack of autonomy and relevance, and inadequate collaboration.

CONCLUSIONS

Our results contribute to the idea that perceptions of research are related to motivation for research, which offers possibilities for interventions to promote motivation for research by making use of student perceptions of research. Consequently, practical implications to stimulate research engagement in early phases of medical school are provided. Moreover, the results contribute to existing motivational theories like Theory of Planned Behavior and Self-Determination Theory within this specific domain.