Factors affecting residents’ internal motivation, grit and well-being

Abstract

Abstract Background: In competency-based medical education for postgraduate training, residents face many challenging situations, which some might compromise their well-being or lead them to exhaustion or burnout. Factors in self-determination theory and grit are important part for residents pursue to learning outcome achievement and good well-being. This study aimed to explore a relationship between internal motivation, grit, well-being, and other factors related to internal motivation, grit, well-being among non-western Asian residents. Methods An explanatory sequential mixed-methods study using a survey to explore correlations between satisfaction with psychological needs, grit, and WHO well-being from September to November 2021, among residents in Ramathibodi Hospital, Mahidol University. The students who scored the highest and lowest on each part were purposively invited to participate to the second phase. In Phase 2, a semi-structure interviews were applied. A thematic analysis was used by two researchers and the data was collected until saturation point was met. Results A total of 245 residents (51% major ward, 65% female) participated in the first phase. There was a strong association between internal motivation, grit, and well-being (r = 0.46–0.90). In comparison, female residents score higher on autonomy and relatedness (p = 0.04, 0.01), while residents with less family responsibility score higher on relatedness than other residents (p = 0.01). Residents who get more sleep also score higher on autonomy, relatedness, and well-being (p < 0.05). Residents who exercise more than five times per week have higher scores for well-being (p < 0.01). In phase II, 30 residents participating thematic analysis revealed that residents' internal motivation, grit, and well-being were promoted by a supportive learning environment, a well-designed curriculum, the actions and personalities of faculty members, and good personal factors. Conclusion Internal motivation were significantly correlated with grit, well-being, gender, family burdens, exercise, and sleep hours. Priority should be given on how to promote internal motivation, grit and well-being by enhancing a positive learning environment, creating a well-designed curriculum, fostering good characteristics and actions of faculty members, and supporting residents' personal lives.