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Laurent EMN, Ducrocq C, Cren PY, Boutaa K, Crie D, Penel N. Why do second-cycle medical students choose oncology? A literature overview. Bull Cancer 2024; 111:505-512. [PMID: 38553287 DOI: 10.1016/j.bulcan.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 05/13/2024]
Abstract
INTRODUCTION Given the current global cancer epidemic across the world, the need for healthcare professionals in this field is crucial. Little is known about the factors that drive medical students toward oncology. METHOD We conducted a systematic review of the literature (from 1980 to the present), using several search equations and selecting original articles written in English based on qualitative or quantitative surveys, to understand what motivates medical students to choose oncology. RESULTS We identified only seven articles that reported quantitative surveys; no qualitative surveys were found. These seven surveys are composed of closed-ended questions and are pragmatic questionnaires based on field knowledge, but without an underlying theory. These studies most often interrogate students already oriented towards oncology. The following five concepts associated with the choice of oncology had the highest recurrence among these seven surveys, which had been conducted in different countries and at various times: interest in cancer management, initiation of the specialty during the 2nd cycle, job opportunities, low working hours, and quality of life. DISCUSSION The literature on this topic is particularly scarce. No qualitative studies have been published in the English language. The limited data in the literature do not allow us to fully comprehend the problem.
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Affiliation(s)
- Estelle M N Laurent
- Lille University, University School of Management (IAE), ULR 4999, Lille University Management Lab., Lille, France
| | - Christophe Ducrocq
- CIREL - Education and Training Sciences, Interuniversity Center for Research in Education of Lille, Faculty of Psychology, Lille University, Villeneuve d'Ascq, France
| | - Pierre-Yves Cren
- Department of Medical Oncology, Centre Oscar-Lambret, Lille, France; ULR 2694 - Metrics: Evaluation des technologies de santé et des pratiques médicales, CHU of Lille, University of Lille, Lille, France
| | - Khaled Boutaa
- Lille University, University School of Management (IAE), ULR 4999, Lille University Management Lab., Lille, France
| | - Dominique Crie
- Lille University, University School of Management (IAE), ULR 4999, Lille University Management Lab., Lille, France
| | - Nicolas Penel
- Lille University, University School of Management (IAE), ULR 4999, Lille University Management Lab., Lille, France; Department of Medical Oncology, Centre Oscar-Lambret, Lille, France; ULR 2694 - Metrics: Evaluation des technologies de santé et des pratiques médicales, CHU of Lille, University of Lille, Lille, France.
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Dutt DD, Razavi H, Carr SE. Self-determination theory in ophthalmology education: factors influencing autonomy, competence and relatedness in medical students. MEDICAL EDUCATION ONLINE 2023; 28:2258633. [PMID: 37729582 PMCID: PMC10512850 DOI: 10.1080/10872981.2023.2258633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND The affective components of learning, including student motivation, has yet to be thoroughly investigated in undergraduate ophthalmology education. This study aims to use Self-Determination Theory (SDT) as a framework to describe the variations in student perceptions of motivation in studying ophthalmology through their satisfactions of autonomy, competence and relatedness, and to highlight factors that stimulate or hinder this. METHODS Penultimate year medical students from a single tertiary educational institution undertaking a clinical placement in ophthalmology participated in in-depth interviews to explore factors affecting their perceptions of motivation in studying ophthalmology. Interviews were transcribed and analysed according to the principles of interpretive phenomenography through the theoretical framework of SDT. RESULTS Of the 39 students invited, 10 agreed to participate. Variations in perceptions of experiences generated the outcome space. Participants experienced either amotivation, external locus extrinsic motivation, internal locus extrinsic motivation and intrinsic motivation (conceptions of the outcome space). This was described with respect to their satisfaction of autonomy, competence and relatedness (dimensions of the outcome space). Additionally, 21 factors that impacted on motivation were identified, of which five over-arching factors impacted all three basic psychological needs - guidance, growth mindset, assessment, curricular pressure and extracurricular pressure. CONCLUSIONS The findings of this study provide a unique insight into the motivation of medical students studying ophthalmology. This provides an exciting opportunity for medical educators to address the affective aspect of learning.
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Affiliation(s)
- Deepaysh D.C.S. Dutt
- Health Professions Education, The University of Western Australia, Perth, Western Australia, Australia
| | - Hessom Razavi
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia
- Lions Eye Institute, Department of Ophthalmology, Perth, Western Australia, Australia
| | - Sandra E. Carr
- Health Professions Education, The University of Western Australia, Perth, Western Australia, Australia
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Nadarajah A, Shankar PR, Jayaraman S, Sreeramareddy CT. House officers' specialist career choices and motivators for their choice- a sequential mixed-methods study from Malaysia. BMC MEDICAL EDUCATION 2022; 22:796. [PMID: 36384571 PMCID: PMC9668396 DOI: 10.1186/s12909-022-03845-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 10/29/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Shortage and maldistribution of medical specialists hamper healthcare quality. The specialist career choices of house officers determines the future composition of healthcare systems. We studied house officers'' specialist career choices and motivators for their choice. PARTICIPANTS AND METHODS We conducted online in-depth interviews among seven house officers using an interview guide developed based on a literature review. The transcripts were analyzed. Major themes were identified. A 33-item questionnaire was developed, and the main and sub-themes were identified as motivators for specialist career choice. An online survey was done among 185 house officers. Content validation of motivators for specialist choice was done using exploratory factor analysis. First, second and third choices for a specialist career were identified. Multinomial logistic regression analyses were done to determine the socio-demographic factors and motivators associated with the first choice. RESULTS HOs perceived that specialist training opportunities provide a wide range of clinical competencies through well-structured, comprehensive training programs under existing specialist training pathways. Main challenges were limited local specialist training opportunities and hurdles for 'on-contract' HO to pursue specialist training. Motivators for first-choice specialty were related to 'work schedule', 'patient care characteristics', 'specialty characteristics', 'personal factors', 'past work experience', 'training factors', and 'career prospects.' House officers' first choices were specialties related to medicine (40.5%), surgery (31.5%), primary care (14.6%), and acute care (13.5%). On multivariate analysis, "younger age", "health professional in the family", "work schedule and personal factors", "career prospects" and "specialty characteristics" were associated with the first choice. CONCLUSIONS Medical and surgical disciplines were the most preferred disciplines and their motivators varied by individual discipline. Overall work experiences and career prospects were the most important motivators for the first-choice specialty. The information about motivational factors is helpful to develop policies to encourage more doctors to choose specialties with a shortage of doctors and to provide career specialty guidance.
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Affiliation(s)
- Anuradha Nadarajah
- School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
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Nadarajah A, Ramasamy S, Shankar PR, Sreeramareddy CT. Development and validation of motivators for medical specialist career choice questionnaire (MMSCCQ) - a methodological study. BMC MEDICAL EDUCATION 2022; 22:474. [PMID: 35718765 PMCID: PMC9206890 DOI: 10.1186/s12909-022-03523-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 06/03/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION A validated instrument to assess the motivating factors influencing junior doctors' medical specialist career choices is not available. The Motivators for Medical Specialist Career Choice Questionnaire (MMSCCQ) was developed and validated in the present study. METHODS An exploratory sequential mixed-methods study was conducted among house officers (HO) of a tertiary care hospital. A literature review was used to construct an interview guide. Seven HOs participated in an online, one-on-one audio-recorded in-depth interview (IDI). Seven sub-themes and 33 codes identified by thematic analyses were used to develop the MMSCCQ. The importance of each motivator was rated on a five-point Likert scale. The MMSCCQ was pretested, and a random sample of 262 house officers was invited to participate in an online survey. Psychometric evaluation was done using reliability statistics, and exploratory and confirmatory factor analyses. RESULTS The seven main themes identified by thematic analyses were labeled as factors related to 'work schedule and personal life,' 'training opportunities', 'past work experiences', 'specialty characteristics', 'career prospects', 'patient care characteristics', and 'social factors.' The highest ratings were given to "previous job experience" and "patient care traits. "The response rate was 71%, the mean age of the 185 HOs was 26.7 years (SD = 1.6). Females made up 63.8% of the population. The internal consistency for the overall questionnaire measured by Cronbach's alpha was 0.85. Each construct demonstrated an acceptable internal consistency. Twenty-six of 33 items were maintained after an exploratory factor analysis was conducted, yielding 7 constructs with a 64.9% variance. Confirmatory factor analyses established the construct validity. CONCLUSION The MMSCCQ has acceptable reliability and construct validity. Further studies are needed to test psychometric properties in different settings.
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Affiliation(s)
- Anuradha Nadarajah
- School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
| | - Shamala Ramasamy
- Department of Psychology, International Medical University, Kuala Lumpur, Malaysia
| | | | - Chandrashekhar T Sreeramareddy
- Department of Community Medicine, International Medical University, No.126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
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Holzer BM, Ramuz O, Minder CE, Zimmerli L. Motivation and personality factors of Generation Z high school students aspiring to study human medicine. BMC MEDICAL EDUCATION 2022; 22:31. [PMID: 35016664 PMCID: PMC8753872 DOI: 10.1186/s12909-021-03099-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 12/31/2021] [Indexed: 05/10/2023]
Abstract
BACKGROUND A new generation of medical students, Generation Z (Gen Z), is becoming the predominant population in medical schools and will join the workforce in a few years' time. Medicine has undergone serious changes in high-income countries recently. Therefore, it is unclear how attractive the medical profession still is for high school students of Gen Z. The aim of this study was to investigate what motivation leads Gen Z students in their choice to study human medicine, and how they see their professional future. Our study was guided by motivation theory and the influence of personality traits and other personal factors on students' choice of university major. METHODS In a cross-sectional online survey, we included third- and fourth-year high school students in Northern Switzerland. We examined the importance of criteria when choosing a university major: personality traits, career motivation, life goals, and other considerations influencing the choice of human medicine versus other fields of study. Results Of 1790 high school students, 456 (25.5%) participated in the survey (72.6% women, mean age 18.4 years); 32.7% of the respondents aspired to major in medicine at university. For all respondents, the foremost criterion for selecting a field of study was 'interest in the field,' followed by 'income' and 'job security.' High school students aiming to study human medicine attached high importance to 'meaningful work' as a criterion; supported by 36.2% of those students answering that helping and healing people was a core motivation to them. They also scored high on altruism (p < 0.001 against all groups compared) and intrinsic motivation (p < 0.001) and were highly performance- (p < 0.001) and career-minded (p < 0.001). In contrast, all the other groups except the law/economics group had higher scores on extraprofessional concerns. CONCLUSIONS Swiss Gen Z students aspiring to study human medicine show high intrinsic motivation, altruism, and willingness to perform, sharing many values with previous generations. Adequate work-life balance and job security are important issues for Gen Z. Regarding the current working conditions, the ongoing shortage of physicians, and recent findings on physicians' well-being, the potential for improvement and optimization is high.
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Affiliation(s)
- Barbara M Holzer
- Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Oriane Ramuz
- Department of Internal Medicine Cantonal Hospital Olten, Solothurner Spitäler AG, Olten, Switzerland
| | - Christoph E Minder
- Department of Internal Medicine Cantonal Hospital Olten, Solothurner Spitäler AG, Olten, Switzerland
| | - Lukas Zimmerli
- Department of Internal Medicine Cantonal Hospital Olten, Solothurner Spitäler AG, Olten, Switzerland.
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Fukamizu J, Verstegen D, Ho SC. International trainer perceptions of simulation-based learning: a qualitative study. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2021; 12:267-273. [PMID: 34961748 PMCID: PMC8995012 DOI: 10.5116/ijme.61b3.214c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 12/10/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES This study examined trainer perceptions of simulation-based learning for Continuing Professional Development in international settings. METHODS A qualitative research methodology was used to gain insight into trainer perceptions. Seventeen international physician trainers involved in simulation training in cardiovascular catheterization and intervention were interviewed. An inductive thematic analysis was performed following steps described by Braun and Clarke; researchers inductively approached, and then carefully dissected the transcripts into individual stories, grounded the problems, and explored themes. RESULTS Trainer perceptions are largely aligned with learning theories, even though they were not specifically educated in simulation-based learning and program design principles in advance. Trainers perceive their primary role as facilitators to be most important and consider structuring sessions, facilitating group learning, and stimulating reflection to be crucial themes in simulation-based learning. They believe that building trust is an underlying principle to function in their role and feel responsible for being prepared to improve trainee satisfaction as adult learners. Trainers believe that learning from making mistakes is an important mechanism in simulation-based learning, but they give less attention to giving feedback. CONCLUSIONS Trainers with basic training in facilitation skills in a classroom may unconsciously follow teacher-student instructional models with which they are familiar. This study confirms that trainers in simulation-based learning need pedagogical and facilitating skills to guide trainees and facilitate group processes. Educational training for trainers should include building trust and giving feedback in a more explicit place. In future studies, a mixed-method methodology is suggested to evaluate multi-layered complexities of educational practices.
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Affiliation(s)
| | - Daniëlle Verstegen
- School of Health Professions Education/Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht Netherlands, the Netherland
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Crafford L, Wouters A, Bronkhorst E, Gous AGS, Kusurkar RA. Exploring Factors Associated With the Motivation of Clinical Pharmacists: A Focus on the South African Context. Front Med (Lausanne) 2021; 8:747348. [PMID: 34888322 PMCID: PMC8650006 DOI: 10.3389/fmed.2021.747348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/01/2021] [Indexed: 11/14/2022] Open
Abstract
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.
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Affiliation(s)
- Lucille Crafford
- Division of Clinical Pharmacy, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,Amsterdam University Medical Centers, Research in Education, Faculty of Medicine Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Anouk Wouters
- Amsterdam University Medical Centers, Research in Education, Faculty of Medicine Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Elmien Bronkhorst
- Division of Clinical Pharmacy, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Andries G S Gous
- Division of Clinical Pharmacy, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Rashmi A Kusurkar
- Amsterdam University Medical Centers, Research in Education, Faculty of Medicine Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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van der Burgt S, de la Croix A, Croiset G, Broekman M, Peerdeman S, Kusurkar R. Do medical specialists cope with stressors through fulfillment of basic psychological needs of self-determination theory. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2021; 12:245-256. [PMID: 34864644 PMCID: PMC8995015 DOI: 10.5116/ijme.618a.463c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 11/09/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To explore factors influencing work motivation negatively and the role of the fulfillment of basic psychological needs, described by the self-determination theory of motivation, as a possible coping mechanism for medical specialists. METHODS A qualitative study was conducted in an academic medical center in the United States. Twelve medical specialists from different disciplines were recruited through convenience, snowball, and purposive sampling and shadowed for two days each. Semi-structured interviews were conducted afterwards. Data were transcribed, and thematic analysis was used for coding. Themes were finalized through discussion and consensus. RESULTS Medical specialists experience three main themes that are identified as stressors; 1) administrative tasks, so-called "administrative jungle", 2) delays and inefficiencies, and 3) poor patient outcomes. To be able to cope with these stressors, medical specialists construct different copingnarratives. Two coping narratives could be linked to autonomy: a narrative of acceptance and a narrative of reinstating autonomy. One coping narrative could be linked to relatedness: a narrative of relationships. No coping narrative could be linked to competence. CONCLUSIONS The results indicate that coping narratives about autonomy and relatedness are used to cope with moments of pressure, demand, or difficulty, so that patient care can continue to be the first priority. Becoming aware of these coping narratives, using them and reflecting on one's own can help medical specialists in successfully coping with stressors in their work lives. In turn, this can improve specialists wellbeing and performance for patient care as motivation remains.
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Affiliation(s)
- Stéphanie van der Burgt
- Amsterdam UMC, Vrije University Amsterdam, Department of Research in Education, VUmc School of Medical Scienc-es, Institute for Education and Training, Amsterdam, the Netherlands
| | - Anne de la Croix
- Amsterdam UMC, Vrije University Amsterdam, Department of Research in Education, VUmc School of Medical Scienc-es, Institute for Education and Training, Amsterdam, the Netherlands
| | - Gerda Croiset
- Amsterdam UMC, Vrije University Amsterdam, Department of Research in Education, VUmc School of Medical Scienc-es, Institute for Education and Training, Amsterdam, the Netherlands
| | - Marike Broekman
- Cushing Neurosurgery Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Saskia Peerdeman
- Department of neurosurgery, Amsterdam UMC loc VUMC, Amsterdam, the Netherlands
| | - Rashmi Kusurkar
- Amsterdam UMC, Vrije University Amsterdam, Department of Research in Education, VUmc School of Medical Scienc-es, Institute for Education and Training, Amsterdam, the Netherlands
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