Flourishing in clinical contexts: motivation of junior doctors from the perspective of self - determination theory

Attracting and retaining competent and engaged staff, including junior doctors, is a challenge for healthcare organisations. It is crucial to (also) pay attention to what healthcare professionals need to flourish, both for themselves and for the quality of care. Self-determination theory has been used to investigate how the interaction between the (social) environment and the individual influences junior doctors’ motivation.
The three basic psychological needs – autonomy, competence, and relatedness – play a central role in fostering motivation in the learning and working environment. Junior doctors stressed that social interactions and relatedness, a physical space for concentration and focus, and opportunities to practice in an open and safe environment are essential for their motivation. Both direct contact - with healthcare professionals and patients - and (in)direct communication and policy from different layers of healthcare organisations can fulfil or frustrate the three basic psychological needs. Moreover, it was found that consultants - supervisors - who match the perspective and experience of junior doctors as learners in terms of communication style promote intrinsic motivation and well-being.
The findings underline the importance of autonomy, competence, and relatedness for junior doctors. For the daily practice of medical training, this means that regular dialogue between junior doctors and supervisors is needed to align mutual expectations and learning needs. Future research can further identify how this collaborative relationship evolves and develops longitudinally. Integrating these basic psychological needs into all levels of healthcare organisations appears valuable in creating a motivating work and learning culture for all healthcare professionals.