Main Article Content
Postgraduate education, Self-determination theory, Motivation, Job Satisfaction, Netherlands
Background: Quality of the educational environment affects trainee performance and well-being in postgraduate healthcare education. In pharmacy practice the quality of the educational environment has not been extensively studied. Self-determination Theory can assist in understanding the underlying mechanisms. Objectives: In this study, the quality of the educational environment and its relationship with satisfaction and frustration of trainees’ basic psychological needs and motivation were investigated in a Dutch community pharmacy postgraduate education programme. Methods: In a cross-sectional study, pharmacists specializing to become community pharmacists completed the Scan of Postgraduate Educational Environment Domains (SPEED), the Basic Psychological Need Satisfaction and Frustration Scale for the Work Domain, and the Academic Motivation Scale. Confirmatory factor analysis followed by path analysis was used to analyse the relationships between the variables. Results: Out of 232 trainees, 205 responded (88%). Most trainees (82%) were positive about the quality of the educational environment. The resulting path model displayed a moderate to good fit. The perceived quality of the educational environment had a moderate positive association with basic psychological needs satisfaction (Factor loading = 0.40) and a similar negative association with basic psychological needs frustration (Factor loading = -0.47). Basic psychological needs frustration had a moderate association with an increased sense of internal and external pressures also known as controlled motivation (Factor loading = 0.31). Intrinsic motivation was not affected by the perceived quality of the educational environment. Conclusions: The educational environment was perceived as positive in most community pharmacies. However, having a less positive or a negative perception was associated with reduced satisfaction and increased frustration of trainees’ basic needs for autonomy, compentence and relatedness. Moreover, basic psychological needs frustration was associated with an increased perception of controlled motivation. We recommend supporting supervisors in creating a positive educational environment in pharmacy practice, thereby reducing the risk of basic psychological needs frustration and increased controlled motivation amongst trainees.
2. Brewster S, Holt R, Portlock J, et al. The role of community pharmacists and their position in the delivery of diabetes care: An update for medical professionals. Postgrad Med J. 2020;96(1138):473-479. https://doi.org/10.1136/postgradmedj-2020-137511
3. Husted GR, Hansen RN, El-Souri M, et al. What do persons with diabetes want from community pharmacies? A qualitative study. Pharm Pract. 2022;20(2). https://doi.org/10.18549/pharmpract.2022.2.2677
4. Stallings AM, Dixon C, Carter A, et al. Evaluation of a Pharmacist-Managed Hypertension Clinic in a Rural Primary Care Setting. J Pharm Pract. 2021;34(6):844-849. https://doi.org/10.1177/0897190020926841
5. Ten Cate O. Entrustability of professional activities and competency-based training. Med Educ. 2005;39(12):1176-7. https:// doi.org/10.1111/j.1365-2929.2005.02341.x
6. Scheele F, Teunissen P, Luijk SV, et al. Introducing competency-based postgraduate medical education in the Netherlands. Med Teach. 2008;30(3):248-253. https://doi.org/10.1080/01421590801993022
7. Westein MPD, de Vries H, Floor A, et al. Development of a Postgraduate Community Pharmacist Specialization Program Using CanMEDS Competencies, and Entrustable Professional Activities. Am J Pharm Educ. 2019;83(6):6863. https://doi.
8. Dijkstra IS, Pols J, Remmelts P, et al. How educational innovations and attention to competencies in postgraduate medical education relate to preparedness for practice: The key role of the learning environment. Perspect Med Educ. 2015;4(6):300-307.
9. Lases LSS, Arah OA, Busch ORC, et al. Learning climate positively influences residents’ work-related well-being. Adv Health Sci Educ. 2019;24(2):317-330. https://doi.org/10.1007/s10459-018-9868-4
10. Chew Q, Holmboe E, Sim K. Learning environment, stress and coping in psychiatry residents within a national training program: a longitudinal study. Perspect Med Educ. 2019;8(3):160-166. https://doi.org/10.1007/s40037-019-0512-7
11. Posada Uribe MA, Vargas González V, Orrego Morales C, et al. Educational Environment and Mental Wellbeing of Medical and Surgical Postgraduate Residents in Medellin, Colombia. Revista Colombiana de Psiquiatria. 2021;52(1):20-28. https://doi.
12. Schonrock-Adema J, Bouwkamp-Timmer T, van Hell EA, et al. Key elements in assessing the educational environment: where is the theory? Adv Health Sci Educ Theory and Practice. 2012;17(5):727-742. https://doi.org/10.1007/s10459-011-9346-8
13. van Vendeloo SN, Prins DJ, Verheyen CCPM, et al. The learning environment and resident burnout: a national study. Perspect Med Educ. 2018;7(2):120-125. https://doi.org/10.1007/s40037-018-0405-1
14. Chan CYW, Sum MY, Lim WS, et al. Adoption and correlates of Postgraduate Hospital Educational Environment Measure (PHEEM) in the evaluation of learning environments–A systematic review. Med Teach. 2016;38(12):1248-1255. https://doi.or
15. Chew QH, Ang LP, Tan LL, et al. A cross-sectional study of burnout and its associations with learning environment and learner factors among psychiatry residents within a National Psychiatry Residency Programme. BMJ Open. 2019;9(8). https://doi.
16. Genn JM. AMEE Medical Education Guide No. 23 (Part 2): Curriculum, environment, climate, quality and change in medical education - A unifying perspective. Med Teach. 2001;23(5):445-454. https://doi.org/10.1080/01421590120063330
17. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68-78. https://doi.org/10.1037/0003-066x.55.1.68
18. Van den Broeck A, Ferris DL, Chang C, et al. A Review of Self-Determination Theory’s Basic Psychological Needs at Work. J Manage. 2016;42(5):1195-1229. https://doi.org/10.1177/0149206316632058
19. Guay F, Ratelle CF, Chanal J. Optimal learning in optimal contexts: The role of self-determination in education. Can Psychol. 2008;49(3):233-240. https://doi.org/10.1037/a0012758
20. Kusurkar RA, Ten Cate TJ, van Asperen M, et al. Motivation as an independent and a dependent variable in medical education: A review of the literature. Med Teach. 2011;33(5):e242-e262. https://doi.org/10.3109/0142159x.2011.558539
21. Kusurkar RA, ten Cate TJ, Vos CMP, et al. How motivation affects academic performance: a structural equation modelling analysis. Adv in Health Sci Educ. 2013;18(1):57-69. https://doi.org/10.1007/s10459-012-9354-3
22. Specialist Registration Committee, chamber for community pharmacy. 2023 [accessed 06-01-2023]. Available from: https://www.knmp.nl/index.php/beroepsontwikkeling/colleges-en-commissies/specialisten-registratie-commissie-openbare-farmacie
23. Boor K, Van Der Vleuten C, Teunissen P, et al. Development and analysis of D-RECT, an instrument measuring residents’ learning climate. Med Teach. 2011;33(10):820-827. https://doi.org/10.3109/0142159x.2010.541533
24. Akdeniz M, Kavukcu E, Ilhanlı N. DREEM in primary care: students’ perspectives on educational environment of family medicine internship in primary care centres: experiences at Akdeniz University Faculty of Medicine in Turkey. Postgrad Med.
25. Schönrock-Adema J, Visscher M, Raat JAN, et al. Development and validation of the scan of postgraduate educational environment domains (SPEED): A brief instrument to assess the educational environment in postgraduate medical education.
PLoS ONE. 2015;10(9):e0137872. https://doi.org/10.1371/journal.pone.0137872
26. Irby DM, O’brien BC, Stenfors T, et al. Selecting Instruments for Measuring the Clinical Learning Environment of Medical Education: A 4-Domain Framework. Acad Med. 2021;96(2):218-225. https://doi.org/10.1097/acm.0000000000003551
27. Chen B, Vansteenkiste M, Beyers W, et al. Basic psychological need satisfaction, need frustration, and need strength across four cultures. Motiv Emot. 2015;39(2):216-236. https://doi.org/10.1007/s11031-014-9450-1
28. Schultz PP, Ryan RM, Niemiec CP, et al. Mindfulness, Work Climate, and Psychological Need Satisfaction in Employee Wellbeing. Mindfulness. 2015;6(5):971-985. https://doi.org/10.1007/s12671-014-0338-7
29. Tjin A Tsoi SLNM, de Boer A, Croiset G, et al. How basic psychological needs and motivation affect vitality and lifelong learning adaptability of pharmacists: a structural equation model. Adv Health Sci Educ. 2018;23(3):549-566. https://doi.
30. Vallerand RJ, Pelletier LG, Blais MR, et al. The academic motivation scale: A measure of intrinsic, extrinsic, and amotivation in education. Educational and Psychological Measurement. 1992;52(4):1003-1017. https://doi.org/10.1177/001316449205200
31. Violato C, Hecker KG. How to use structural equation modeling in medical education research: A brief guide. Teach Learn Med. 2007;19(4):362-371. https://doi.org/10.1080/10401330701542685