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      What motivates medical students to select medical studies: a systematic literature review

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          Abstract

          Background

          There is a significant shortage of health workers across and within countries. It is of utmost importance to determine the factors that motivate students to opt for medical studies. The objective of this study is to group and review all the studies that investigated the motivational factors that underpin students’ selection of medical study in recent years.

          Methods

          The literature search was carried out by two researchers independently in PubMed, Google Scholar, Wiley and IndMED databases for articles published from year 2006 till 2016. A total of 38 combinations of MeSH words were used for search purpose. Studies related to medical students and interns have been included. The application of inclusion and exclusion criteria and PRISMA guidelines for reporting systematic review led to the final selection of 24 articles.

          Results

          The majority of the studies ( n = 16; 66.6%) were from high-income countries followed by an equal number from upper-middle and lower-middle income countries ( n = 4,16.7%). None of the studies were from low-income countries. All of the studies were cross-sectional in nature. The main motivating factors that emerged were scientific (interest in science / medicine, social interest and academia, flexible work hours and work independence), societal (prestige, job security, financial security) and humanitarian (serving the poor and under priviledged) in high-, upper-middle and lower-middle income countries, respectively. The findings were comparable to Maslow’s hierarchy of needs theory of motivation.

          Conclusion

          This systematic review identifies the motivational factors influencing students to join medical studies in different parts of the globe. These factors vary per country depending on the level of income. This study offers cues to policy makers and educators to formulate policy in order to tackle the shortage of health workers, i.e. medical doctors. However, more research is needed to translate health policy into concrete and effective measures.

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          Most cited references32

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          A theory of human motivation.

          A. MASLOW (1943)
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            Motivation as an independent and a dependent variable in medical education: a review of the literature.

            Motivation in learning behaviour and education is well-researched in general education, but less in medical education. To answer two research questions, 'How has the literature studied motivation as either an independent or dependent variable? How is motivation useful in predicting and understanding processes and outcomes in medical education?' in the light of the Self-determination Theory (SDT) of motivation. A literature search performed using the PubMed, PsycINFO and ERIC databases resulted in 460 articles. The inclusion criteria were empirical research, specific measurement of motivation and qualitative research studies which had well-designed methodology. Only studies related to medical students/school were included. Findings of 56 articles were included in the review. Motivation as an independent variable appears to affect learning and study behaviour, academic performance, choice of medicine and specialty within medicine and intention to continue medical study. Motivation as a dependent variable appears to be affected by age, gender, ethnicity, socioeconomic status, personality, year of medical curriculum and teacher and peer support, all of which cannot be manipulated by medical educators. Motivation is also affected by factors that can be influenced, among which are, autonomy, competence and relatedness, which have been described as the basic psychological needs important for intrinsic motivation according to SDT. Motivation is an independent variable in medical education influencing important outcomes and is also a dependent variable influenced by autonomy, competence and relatedness. This review finds some evidence in support of the validity of SDT in medical education.
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              Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital

              Background The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. Methods A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co-workers and achievements) was used. Two categories of health care professionals, medical doctors and dentists (N = 67) and nurses (N = 219) participated and motivation and job satisfaction was compared across socio-demographic and occupational variables. Results The survey revealed that achievements was ranked first among the four main motivators, followed by remuneration, co-workers and job attributes. The factor remuneration revealed statistically significant differences according to gender, and hospital sector, with female doctors and nurses and accident and emergency (A+E) outpatient doctors reporting greater mean scores (p 55 years of age reported higher job satisfaction when compared to the other groups. Conclusions The results are in agreement with the literature which focuses attention to management approaches employing both monetary and non-monetary incentives to motivate health care professionals. Health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation. Strategies based on the survey's results to enhance employee motivation are suggested.
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                Author and article information

                Contributors
                0172-2755215 , sonugoel007@yahoo.co.in
                federica.angeli@maastrichtuniversity.nl , f.angeli@uvt.nl
                nonita183@yahoo.com
                neetu.singla12@gmail.com
                d.ruwaard@maastrichtuniversity.nl
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                17 January 2018
                17 January 2018
                2018
                : 18
                : 16
                Affiliations
                [1 ]ISNI 0000 0004 1767 2903, GRID grid.415131.3, School of Public Health, PGIMER, Sector-12, ; Chandigarh, 160012 India
                [2 ]ISNI 0000 0001 0481 6099, GRID grid.5012.6, Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, , Maastricht University, ; Maastricht, The Netherlands
                [3 ]ISNI 0000 0001 0943 3265, GRID grid.12295.3d, Department of Organization Studies, School of Social and Behavioural Sciences, , Tilburg University, ; Tilburg, the Netherlands
                [4 ]ISNI 0000 0001 0481 6099, GRID grid.5012.6, Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, , Maastricht University, ; Maastricht, The Netherlands
                Article
                1123
                10.1186/s12909-018-1123-4
                5772649
                29343262
                7914ea9f-0496-4f8d-bd58-8f27d785f634
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 12 May 2017
                : 9 January 2018
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Education
                motivation,medical students,rural areas,systematic review
                Education
                motivation, medical students, rural areas, systematic review

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