Understanding Physician Work Motivation

Physician Work Motivation: A Measure Validation Study

Development and validation of a measure of physician work motivation.

Study Overview

• Status: Unknown
• Conditions: Physician Work Motivation
• Intervention / Treatment: Other: No intervention employed. Study is based on a cross-sectional observational design.

Detailed Description

Not that long ago, most physicians were solo practitioners. Today, more physicians are working in large, integrated delivery systems, and many are employed by hospitals and multispecialty group practices. These dramatic changes in the physician work environment raise important questions on how evolving physician payment and care delivery models support or undermine your motivation and ability to deliver high-quality patient care.

To evaluate the impact of workplace changes on what motivates physician to deliver good patient care, this study aims to develop an accurate measure of physician work motivation. Simultaneously, the investigators plan to test hypotheses on the role of various workplace and psychological factors in physicians' work motivation. Namely, the investigators hypothesize that:

20 to 25% of the variance in work motivation is explained by psychological needs satisfaction; 5 to 10% of the variance in self-reported overall health status and depression is explained by work motivation; 5% of the variation in work motivation is explained by work that is seen as a calling; and 5 to 10% of the variation in medicine viewed as a calling is explained by the learning environment.

• Study Type: Observational
• Enrollment (Anticipated): 4500

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years to 90 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Population #1 includes practicing physicians in all medical specialties. Population #2 includes resident physicians in all medical specialties. Population #3 includes fourth year medical students in all US allopathic medical schools.

Description

Inclusion Criteria:

• practicing physicians in all medical specialties
• resident physicians in all medical specialties
• fourth year medical students in US allopathic medical schools

Exclusion Criteria:

• physicians without an active medical license.
• resident physicians without an active medical license.
• fourth year medical students in US osteopathic medical schools

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
physicians; Nationally-representative sample of physicians in all specialties who have direct or indirect patient care responsibilities	Other: No intervention employed. Study is based on a cross-sectional observational design.
resident physicians; Nationally-representative of resident physicians in all specialties	Other: No intervention employed. Study is based on a cross-sectional observational design.
medical students; Nationally-representative sample of 4th year medical students in all US allopathic medical schools.	Other: No intervention employed. Study is based on a cross-sectional observational design.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Internalization of work motivation (self-reported)	Composite measure comprised of 15 items using 7-point Likert-type response categories (not at all true-very true) to assess extent of psychological internalization of work motivation	Up to 4 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Psychological needs satisfaction at work (self-reported)	Composite measure comprised of 12 statements using 7-point Likert-type response categories (not at all true-very true) to assess perceived fulfillment of needs for autonomy, self-efficacy/competence, relatedness, and purpose in work context	Up to 4 months
Overall health status (self-reported)	Proportion of respondents reporting own overall health as "excellent," "very good," or "good" vs. "fair" or "poor"	Up to 4 months
Depression (self-reported)	Proportion of respondents reporting a score of >3 on a two-item depression screening instrument (patient health questionnaire-2)	Up to 4 months
Medicine as a calling	Composite measure comprised of 15 statements using true/false response scale to assess view of work as "calling," "career," or "job"	Up to 4 months
Medical learning environment that supports professionalism	Composite measure comprised of 13 statements using 5-point Likert-type response scale (strongly disagree-strongly agree) to assess experiences of medical professionalism in medical students' learning environments	Up to 4 months

Collaborators and Investigators

• Sponsor: American Medical Association
• Collaborators: Johns Hopkins University; University of California, San Francisco; University of Rochester; Illinois Institute of Technology; American Medical Group Association; Advocate Physician Partners
• Investigators: Principal Investigator: Audiey Kao, MD, PhD, American Medical Association

Publications and helpful links

General Publications

• Shearer DA. Management styles and motivation. Radiol Manage. 2012 Sep-Oct;34(5):47-52.
• Wright SM, Beasley BW. Motivating factors for academic physicians within departments of medicine. Mayo Clin Proc. 2004 Sep;79(9):1145-50. doi: 10.4065/79.9.1145.
• Williams GC, Rodin GC, Ryan RM, Grolnick WS, Deci EL. Autonomous regulation and long-term medication adherence in adult outpatients. Health Psychol. 1998 May;17(3):269-76. doi: 10.1037//0278-6133.17.3.269.
• Williams GC, Deci EL. Internalization of biopsychosocial values by medical students: a test of self-determination theory. J Pers Soc Psychol. 1996 Apr;70(4):767-79. doi: 10.1037//0022-3514.70.4.767.
• Williams GC, Wiener MW, Markakis KM, Reeve J, Deci EL. Medical students' motivation for internal medicine. J Gen Intern Med. 1994 Jun;9(6):327-33. doi: 10.1007/BF02599180.
• Cerasoli CP, Nicklin JM, Ford MT. Intrinsic motivation and extrinsic incentives jointly predict performance: a 40-year meta-analysis. Psychol Bull. 2014 Jul;140(4):980-1008. doi: 10.1037/a0035661. Epub 2014 Feb 3.
• Gonzalez MG, Swanson DP, Lynch M, Williams GC. Testing satisfaction of basic psychological needs as a mediator of the relationship between socioeconomic status and physical and mental health. J Health Psychol. 2016 Jun;21(6):972-82. doi: 10.1177/1359105314543962. Epub 2014 Aug 7.
• Murayama K, Matsumoto M, Izuma K, Matsumoto K. Neural basis of the undermining effect of monetary reward on intrinsic motivation. Proc Natl Acad Sci U S A. 2010 Dec 7;107(49):20911-6. doi: 10.1073/pnas.1013305107. Epub 2010 Nov 15.
• Wrzesniewski A, Schwartz B, Cong X, Kane M, Omar A, Kolditz T. Multiple types of motives don't multiply the motivation of West Point cadets. Proc Natl Acad Sci U S A. 2014 Jul 29;111(30):10990-5. doi: 10.1073/pnas.1405298111. Epub 2014 Jun 30.

Study record dates

Study Major Dates

• Study Start: October 1, 2014
• Primary Completion (Anticipated): May 1, 2015
• Study Completion (Anticipated): September 1, 2015

Study Registration Dates

• First Submitted: September 28, 2014
• First Submitted That Met QC Criteria: October 10, 2014
• First Posted (Estimate): October 13, 2014

Study Record Updates

• Last Update Posted (Estimate): January 14, 2015
• Last Update Submitted That Met QC Criteria: January 12, 2015
• Last Verified: January 1, 2015

More Information

Terms related to this study

• Other Study ID Numbers: AMAHSA0901