Context / probleemstelling of aanleiding

Probleemstelling (inclusief theoretische onderbouwing en onderzoeksvraag/vragen):

Health professions education students are taught by university faculty and by clinicians who teach alongside their clinical practice. This distributed healthcare education model aims to ensure high-quality education, but is at risk due to high learner demand, educator shortage, and economic pressures. Motivation to teach is important for educators’ performance and well-being, but the factors influencing it are understudied. Understanding these factors may contribute to the model’s sustainability and educator retention. The present systematic review therefore aimed to search and synthesise the literature on factors influencing clinical educators’ motivation to teach.

Self-determination Theory’s concepts of autonomous motivation (AM, personal importance and interest), controlled motivation (CM, for rewards or out of pressure), and amotivation (disinterest or unachievable challenges), were used to analyse clinical educators’ motivation to teach.

Methode:

Medline, Embase, PsycINFO, CINAHL, and ERIC were searched from inception until March 2024 using the terms ‘Motivation’ AND ‘Educators’ AND ‘Health Professions Education’. We searched the grey literature without restrictions through OpenGrey. Inclusion criteria were: a) Original research focusing on motivation to teach, b) Original research on educators in undergraduate/postgraduate health professions education, and c) Quantitative, qualitative and mixed-methods studies. Exclusion criteria were: a) Research focused on incentives to recruit educators, b) Non-empirical research, c) Literature reviews, and d) Research published in languages other than English. Two authors screened the titles, abstracts, and full papers, used standardized checklists for evaluating article quality, and extracted data from the included articles while resolving differences through consensus. Framework synthesis was conducted based on factors influencing AM, CM and amotivation, which represented nested themes under the framework of environmental factors influencing educator’s motivation from ‘above’ (i.e., interactions with stakeholders and societal expectations), ‘within’ (i.e., personal beliefs and personality dispositions), and ‘below’ (i.e., learner-related factors).¹

Resultaten (en conclusie):

Twenty nine studies from diverse disciplines and settings were included. Overall, educators reported having AM more than CM, favouring enjoyment, connectedness, professional development, feeling valued for their teaching efforts, and altruistic reasons to teach, over being motivated by rewards. Examples of factors influencing educators’ motivation from above were: a) autonomy support from managers (for AM), b) incentives and rewards (for CM), and c) a lack of support from the educational programme (for amotivation). Examples of factors influencing educators’ motivation from within were: a) professional growth and mastery (for AM), and b) status and pride (for CM). Examples of factors influencing educators’ motivation from below were: a) learners’ interest and engagement in learning (for AM), b) recognition and appreciation from learners (for CM), and c) difficult and unprepared learners (for amotivation).

Discussie (beschouwing resultaten en conclusie in het kader van de theorie):

The results indicate that educators from diverse disciplines and settings reported AM over CM to teach, supporting the distributed health professions training model and the superiority of intrinsic over extrinsic motivators to promote retention. They also shed light on the complexity of factors supporting/thwarting educators’ motivation to teach, providing new insights developing Self-determination Theory-based strategies and interventions to optimise learning/work environments. These strategies can help maximise autonomous reasons to teach and mitigate controlling and amotivating factors, thereby enhancing job satisfaction and retention.

We did not find any factors from ‘within’ for amotivation. Whether these have not been investigated or are not important is unknown. This, as well as the interplay between the different identified factors and how individual differences may influence motivation to teach, thus merits further research. Since the included articles predominantly originated from the Global North, further work is needed to explore the experiences from the Global South.

Referenties:

Reeve J, Su Y-L. 2014. Teacher Motivation. In: Gagné M (ed.) The Oxford Handbook of Work Engagement, Motivation, and Self-Determination Theory. New York: Oxford University press, pp: 349-362.

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