The Basic Psychological Needs at Work Scale: Measurement Invariance between Canada and France

Are They Created Equal? A Relative Weights Analysis of the Contributions of Job Demands and Resources to Well-Being and Turnover Intention

Building upon the Job Demands-Resources (JD-R) model (Demerouti et al., 2001) and the extensive research on employee turnover intention and well-being, we examined various demands and resources in relation to these outcomes. This study examined the differential relationship between job demands, and personal and job resources, and two organizational outcomes: turnover intention and emotional exhaustion. The job demands were role overload, role conflict, role ambiguity, and work-life balance. The job resources were resilience, servant leadership, relatedness, autonomy, job opportunities, pay satisfaction, and person-organization fit. An online questionnaire was administered to full-time employees via Qualtrics panel (N = 364). Job demands were positively related to emotional exhaustion, and personal and job resources were negatively related to turnover intention. Using relative weights analysis, demands and resources were found to account for different amounts of variance in the outcome variables. This study informs our understanding of and contributes to the advancement of the JD-R model to encompass various job demands and personal and job resources and their differential relationship to emotional exhaustion and turnover intention.

Switching off automatic pilot to promote wellbeing and performance in the workplace: the role of mindfulness and basic psychological needs satisfaction

Introduction and method

Building on self-determination theory, this study aims to advance the happy-productive worker thesis by examining a sequential mediation linking trait mindfulness to task performance through basic psychological need satisfaction and psychological wellbeing at work. Whereas most of the papers published on the topic stem from USA and Europe, we tested our model in a Canadian sample of 283 French-speaking workers.

Results

Based on structural equation modeling, results show that the three need satisfactions at work mediate the relationship between trait mindfulness and psychological wellbeing at work. Rather than observing a sequential mediation, we find an indirect effect of trait mindfulness on task performance through the satisfaction for one of the basic psychological need (i.e., competence).

Discussion

The present research goes beyond previous studies by exploring a new pair of happy construct-productive criteria alongside an emergent intrapersonal factor contributing to this relationship.

Impact of Organizational Justice, Support, Resilience, and Need Satisfaction on French Social Workers' Psychological Well-Being

PURPOSE

Based on an approach to psychological health at work and on social exchange theory, this study tested the relationships between the four dimensions of organizational justice (distributive, procedural, interpersonal, and informational), supervisor and coworker support, resilience and psychological well-being (PWB).

METHOD

Using a cross-sectional design with one measurement, a sample of 369 French social workers responded to an online questionnaire. Analysis were based on correlations, and on mediations with Hayes and Preacher's (2014) method.

RESULTS

The results showed that satisfaction of the three psychological needs, procedural justice, supports, and resilience explained PWB. Mediation analyses showed that satisfaction of the need for autonomy played a mediating role between interpersonal justice, procedural justice, and PWB. Satisfaction of the needs for competence and autonomy played a mediating role between coworker support and PWB. Satisfaction of the three needs played a mediating role between resilience and PWB.

DISCUSSION AND CONCLUSION

The results pointed out the relevance of need satisfaction in predicting PWB. These findings confirm the relevance of justice, support, and resilience for social workers' well-being, and of the importance of need satisfaction that plays a critical role.

Community experiences in the strategic human resource management black box

Recent research suggests experiencing community at work (i.e., perceiving a sense of community [SOC] and a sense of community responsibility [SOC-R]) is important for employee and organizational outcomes, however, we know very little about how these constructs operate in human resource management contexts. This study peers into the strategic human resource management "black box," which is an organizational setting where psychological and social variables are believed to influence employee perceptions in ways that impact their individual functioning, and subsequently improve organizational outcomes. Specifically, the study tests hypotheses regarding the relationship between high-involvement work climate (i.e., a human resource context), psychological need satisfaction, SOC, SOC-R, organizational identification, and organizational citizenship behaviors, in an attempt to theoretically ground, and empirically test, if experiences of community matter in the human resource management "black box." Data from 312 employees across multiple organizations were analyzed using partial least squares structural equation modeling, and the findings reveal that experiences of community likely play an important role in the strategic human resource black box. The findings highlight that human resource practitioners, and scholars at the intersection of community psychology and human resource management, should consider further evaluation and action around experiences of community at work. Such a focus may help to create and build more socially sustainable organizational contexts for employees where they can thrive while organizations attempt to achieve collective goals.

Preferences for a Mental Health Support Technology Among Chinese Employees: Mixed Methods Approach

BACKGROUND

Workplace mental health is under-studied in China, making it difficult to design effective interventions. To encourage the engagement with interventions, it is crucial to understand employees' motivation toward seeking help through technologies.

OBJECTIVE

This study aimed to understanding how Chinese employees view digital mental health support technology and how mental health support technology could be designed to boost the motivation of Chinese employees to use it.

METHODS

A mixed methods approach was used. In total, 458 Chinese employees (248/458, 54% female) in 5 industries (manufacturing, software, medical, government, and education) responded to a survey, and 14 employees and 5 managers were interviewed.

RESULTS

Government data and employee responses showed that mental health support in China is limited. In the workplace, Chinese employees experience a lower sense of autonomy satisfaction compared with competence and relatedness. Although managers and employees try to empathize with those who have mental health issues, discrimination and the stigma of mental illness are rife in Chinese workplaces. Digital technologies are perceived as a potential medium for mental health interventions; however, privacy is a major concern.

CONCLUSIONS

The results of this study demonstrated the potential of self-help digital mental health support for Chinese employees. Interdisciplinary cooperation between design engineers and mental health researchers can contribute toward understanding the issues that engage or disengage users with digital mental health interventions.

Ambiguity and uncertainty tolerance and psychological needs of medical students: A cross-sectional survey

BACKGROUND

Although the ubiquitous presence of ambiguity and uncertainty in medical practice is widely acknowledged, a greater understanding of contextual factors for educators to consider in helping students learn to respond to ambiguity and uncertainty adaptively is needed. Drawing on self-determination theory, the purpose of this study was to explore the unique roles of basic psychological needs-autonomy, competence and relatedness-in medical students' tolerance of ambiguity and uncertainty.

METHODS

This was a cross-sectional survey study of third-year medical students (n = 70) at a large Canadian university. In regression analysis, the three basic psychological needs were entered as predictors of medical students' tolerance of ambiguity and uncertainty while controlling for students' age and gender.

RESULTS

Of the three needs, the need for competence was determined to be statistically significant in relation to students' tolerance of ambiguity and uncertainty (β = 0.326; p = 0.038). The needs for autonomy and relatedness were determined to be not statistically significant (β = -0.170; p = 0.274 and β = 0.154; p = 0.218, respectively).

DISCUSSION

We observed that medical students, who experienced satisfaction of the need for competence in the learning environment, reported greater tolerance of ambiguity and uncertainty. Potential implications for medical education are discussed, based on self-determination theory.

Psychometric Investigation of the Workplace Social Courage Scale (WSCS): New Evidence for Measurement Invariance and IRT Analysis

This study, after presenting a review of the existent literature on courage and social courage in the workplace, has the purpose of providing new evidence about the psychometric properties of an Italian-language version of the Workplace Social Courage Scale (WSCS), verifying its measurement invariance across gender and the discrimination properties of its items through IRT analysis. The aim of the research is testing the Italian version of the WSCS; for this scope, four studies have been conducted on four different samples analyzing the factorial structure, the internal consistency, the measurement invariance across gender, and the convergent and concurrent validity. The results support the psychometric properties in terms of factor structure, reliability, validity, and utility, showing positive relationships with the criterion variables: satisfaction of work-related basic needs, prosocial rule breaking and work performance. The current study extends prior findings by providing further insights about the construct of courage and social courage in the workplace, especially in the Italian context. As, to date, little is known about the impact of social courage on work and organizational outcomes, the availability of a reliable, valid, and cross-culturally supported instrument can promote the role of this construct in positive organizational behavior research.

Competence is Essential but not Sufficient

Physician loneliness is on the rise, negatively impacting physician well-being and patient care. Some authors have suggested that addressing professional loneliness should begin in medical school. To test this idea, we investigated how medical students' psychological needs impact their performance. Students' survey responses (autonomy, competence, and relatedness needs) were linked with their clinical decision-making scores. In regression analysis, relatedness was determined to be the largest and the only significant predictor of student performance. The findings corroborate the idea of fostering relatedness in medical training. Determining what strategies support relatedness and connection in the digital era is the next logical step.

Paternalistic Leadership and Subordinates' Trust in Supervisors: Mediating Effects of Basic Psychological Needs Satisfaction

Subordinates' trust is critical for a supervisor's exercise of leadership to effectively influence subordinates' work outcomes. However, the optimal approach for facilitating trust is still under debate, between instrumentality-based and motivation-based perspectives. On the basis of self-determination theory (SDT), the current study explored the direct effects of paternalistic leadership on trust in supervisors (TS) and the mediating role of the satisfaction of subordinates' basic psychological needs. In a survey of 1,076 teachers in China, we found that paternalistic leadership affected trust directly, and that subordinates' need for competence, autonomy, and relatedness also mediated the leadership-trust relationship to different degrees. The theoretical and practical implications of these findings are discussed.

Subjective Well-Being and Its Intrinsic and Extrinsic Motivational Correlates in High Performance Executives: A Study in Chilean Managers Empirically Revisiting the Bifactor Model

This study analyzes the relationship between work satisfaction, family satisfaction, and general well-being in high performance managers in Santiago, Chile. The importance of the satisfaction of intrinsic and extrinsic needs and motivations was examined to advance in the development of a positive organizational psychology, which investigates the factors that reinforce well-being. Seventy-five executives from large and medium-sized companies were surveyed and 8 in-depth interviews were carried out. The main predictors of well-being are, from family satisfaction, the family's ability to cope with stress and, from work satisfaction, extrinsic aspects such as material conditions of the job and stability, and intrinsic aspects such as recognition and the ability to organize one's own work. The more general regression model shows that extrinsic job and family satisfaction predict general well-being, not intrinsic satisfaction. The results are discussed in the framework of classical models of motivation, such as Herzberg's, their relationship to Deci and Ryan's self-determination theory, and the current study of well-being in organizations.

Validation of Work Need Satisfaction Scales Among Chinese Working Adults: A Psychology of Working Theory Perspective

This study translated the Work Need Satisfaction Scales (WNSS), which was conceptualized in the Psychology of Working Theory (PWT), and tested the reliability and validity of the Chinese version (WNSS-C). In Study 1 ( N = 423), the WNSS was translated into Chinese, and an exploratory factor analysis yielded a five-factor solution representing needs related to survival, social contribution, competence, relatedness, and autonomy. In Study 2 ( N = 425), confirmatory factor analyses found no significant differences between the correlated five-factor, higher-order, and higher-order self-determination needs models. The results suggest the effectiveness of using a flexible five-factor model. Then, configural, metric, and scalar invariance models were tested, demonstrating that the WNSS-C is equivalent across gender, age, education level, and job position. Finally, we tested the concurrent, convergent, and discriminant validity of the WNSS-C and demonstrated that WNSS-C is a useful tool in the Chinese context.

Factor structure and measurement invariance of the Basic Psychological Needs Scale in three South African samples: A bifactor exploratory structural equation modelling approach

The Basic Psychological Needs Scale (BPNS) is still being used but validation studies that applied confirmatory factor analysis (CFA) revealed that the scale has inadequate psychometric properties. CFA is based upon restrictive statistical assumptions that may result in biased parameter estimates. There are statistical developments that overcome these limitations. This study explored the factorial validity of the scale in three South African student samples who completed the English (n = 326), Afrikaans (n = 478), or Setswana (n = 260) version of the BPNS. CFA, bifactor CFA, exploratory structural equation modelling (ESEM) and bifactor ESEM were applied to the data. The three-factor bifactor ESEM model yielded the best fit, but model fit was inadequate for the English and Setswana versions, and almost adequate for the Afrikaans version. After removal of problematic items based on substantive reasons, high modification indices, and high expected parameter change values, reduced bifactor ESEM models displayed adequate fit. The general factor showed sufficient reliability scores for all language versions. Subscales exhibited insufficient reliability scores, except for the Competence and Relatedness subscales of the BPNS-Afrikaans. A reduced three-factor bifactor ESEM model was partially metric invariant for the English and Afrikaans groups. The BPNS-Afrikaans showed potential for use, but alternative measures of basic psychological needs should be considered for the English and Setswana groups in the current context. The cross-cultural application of basic psychological needs in a South African context is questioned. An emic approach to exploring and conceptualising basic psychological needs in African contexts is recommended.

Motivational Strategies Used by Exercise Professionals: A Latent Profile Analysis

BACKGROUND

Using self-determination theory as a framework, the aim of this study was 2-fold: (1) identify different profiles of motivational strategies used by exercise professionals and (2) examine associations of these motivational profiles with work-related variables: measures, perceived job pressures, need satisfaction/frustration, and perceived exercisers' motivation.

METHODS

Participants were 366 exercise professionals (193 males; experience = 7.7 [5.8] y) currently working in health and fitness settings.

RESULTS

Latent profile analysis identified a 3-profile model: (1) most need-supportive and least controlling (NS+; n = 225), (2) less need-supportive and slightly controlling (NS-; n = 42), and (3) most controlling and slightly need-supportive (mixed; n = 99). Professionals working less than 20 hours per week, more experienced, and female were more likely to integrate NS+, which was also associated with higher levels of work-related need satisfaction and clients' perceived self-determination, and lower levels of job pressures and need-frustration. Conversely, NS- displayed the most maladaptive pattern of associations.

CONCLUSIONS

The present findings highlight the importance of analyzing the correlates of different professional profiles, namely to help health and fitness organizations to provide high-quality motivational practices within an appropriate environment both for professionals and clients.

Advancing the Conceptualization and Measurement of Psychological Need States: A 3 × 3 Model Based on Self-Determination Theory

Based on Self-Determination Theory (SDT), this research aimed to investigate whether employees’ psychological need states could be expanded from two (need satisfaction and frustration) to three (need satisfaction, frustration, and unfulfillment). Relying on exploratory structural equation modeling (ESEM) and bifactor-ESEM, this research also offered to test the construct validity of the Psychological Need States at Work-Scale (PNSW-S) and to explore its criterion-related validity. Results from two studies and three distinct samples of employees (French and English speaking) provided support for the unfulfillment of the needs for autonomy, competence, and relatedness to be modeled as a distinct need state when tested alongside the satisfaction and frustration of those three needs. Moreover, results indicated that the different need states appeared to stem from distinct experiences (perceived supervisors’ supportive and thwarting behaviors) and that these need states had well-differentiated effects in terms of employee functioning (job satisfaction, job boredom, and work-related rumination). Our research therefore deepens our understanding of the nature of psychological need states in the workplace and offers a multidimensional instrument allowing to simultaneously assess not only need satisfaction and frustration, but also need unfulfillment. It also indicates that SDT’s explanatory framework may be expanded from two to three need processes to explain the effect of the socio-contextual environment on individual functioning.

Students' perceptions of learning environment and their leisure-time exercise in medical school: Does sport background matter?

INTRODUCTION

The effectiveness of medical school efforts in addressing suboptimal student wellbeing rests, in part, on how students perceive their learning environment. The study aim was to determine whether students' sport background was a contributing factor in students' perceptions of the medical program as supportive of their basic psychological needs for autonomy, competence, and relatedness. We also examined the relationship between sport background and students' leisure-time exercise in medical school.

METHODS

Using an online questionnaire, quantitative data were collected from students enrolled in the 4‑year medical program at a large Canadian university. Two hundred (n = 200) students had complete responses on the measures used in the study. Analysis of variance and correlational analysis were used to examine the relationships between students' sport background, their perceptions of the learning environment, and leisure-time exercise in medical school.

RESULTS

Compared with students with no sport background, students with a team sport background perceived their need for relatedness to be satisfied to a greater degree in the medical program. Students who pursued sports at higher levels of involvement (competitively) perceived the medical program as more autonomy-supportive than students who pursued sports at lower levels of involvement (recreationally). Irrespective of their sport background, students' involvement in leisure-time exercise decreased over the years in the medical program. However, students with a sport background engaged in leisure-time exercise in medical school to a greater extent than students with no sport background.

DISCUSSION

The findings indicate that sport background is associated with students' perceptions of the learning environment as supportive of their needs for autonomy and relatedness, but not for competence, and is linked to their leisure-time exercise in medical school. The observed relationships could help inform medical schools curricular initiatives in preventing student burnout right from the start of medical school.

The Influence of Students' Perceptions of Learning Environment on Coping with Academic Challenges: A Structural Equation Modeling Study

Theory: Self-compassion has been identified as a promising interventional target enabling medical learners to respond effectively to stressors and challenges of medical training. Determining factors in the learning environment that support self-compassion is critical for developing such interventions. What is already known in terms of environmental or contextual factors is that learning environments that are supportive of students' basic psychological needs for autonomy, competence, and relatedness result in better learning and wellbeing outcomes. As such, satisfaction of basic psychological needs in the learning environment was tested for potential effects on self-compassion among medical students. Hypothesis: It was hypothesized that medical students who perceived their needs for autonomy, competence, and relatedness were supported in the learning environment would be more likely to respond to stressors and challenges by means of positive processes of self-compassion (common humanity, mindfulness, self-kindness) and less likely by means of negative processes of self-compassion (isolation, over-identification, self-judgment). Two models were tested: Model 1 contained the effects of the needs for autonomy, competence, and relatedness on two factors of self-compassion that comprise three positive and three negative processes, respectively. Model 2 contained the direct effects of the psychological needs on six individual processes of self-compassion. Method: Using two online surveys, authors collected data from medical students (n = 195) at a large Canadian university. The authors used the 12-item basic psychological needs scale to measure the degree of satisfaction of students' needs for autonomy, competence, and relatedness in the learning environment, as perceived by students. The 12-item self-compassion scale was used to measure the degree of compassion students exhibited toward themselves in challenging times in the medical program. The authors used structural equation modeling (SEM) to test the hypothesized relationships between basic psychological needs satisfaction and self-compassion. Results: The SEM results for Model 2 indicated an improved model fit over Model 1; however, not all the hypothesized effects were determined to be significant in the two models. In the better fitting model (Model 2), significant effects were observed between the needs for competence and relatedness and the three negative processes of self-compassion (isolation, over-identification, self-judgement). Specifically, the need for relatedness had comparable effects on all three negative processes of self-compassion. The need for competence had a significant effect only on isolation. The need for autonomy had no effects on self-compassion processes. None of the effects involving the positive processes of self-compassion (common humanity, mindfulness, self-kindness) were significant. Conclusions: Satisfaction of medical students' needs for competence and relatedness in the learning environment appears to reduce the negative processes of self-compassion. Future research is needed to determine why basic psychological needs satisfaction appears to have no effects on the positive processes of self-compassion and what factors are likely to foster these beneficial processes among medical students.

Work alienation and its gravediggers: Social class, class consciousness, and activism

Work activity is central to human psychology. However, working conditions under capitalist socioeconomic relations have been posited as psychologically alienating. Given the negative impact of work alienation on well-being and mental health, we conducted two studies of the relations between social class, work conditions, and alienation. We also examined factors that might counteract alienation – class consciousness and activism. The utility of a Marxist measure of social class – based on objective work relations – was compared with that of SES and subjective class measures. Study 1 surveyed 240 U.S. adults from diverse socioeconomic backgrounds using Amazon’s Mechanical Turk; Study 2 was a replication with 717 adults recruited via a sampling company. Across studies, alienation was predicted by perceived work exploitation, poor work relationships, and lack of self-expression, meaningfulness, self-actualization, autonomy, and intrinsic motivation at work. Only the Marxist class measure – not SES or subjective class measures – predicted alienation and alienating work conditions across studies. Working-class participants experienced more alienating work conditions and greater alienation. Alienation was correlated with class consciousness, and class consciousness was associated with activism. While SES measures have dominated the psychological study of social class, results suggest benefits to integrating Marxist measures and conceptions of social class.

Impact at two years of an intervention on empowerment among medical care teams: study protocol of a randomised controlled trial in a large French university hospital

BACKGROUND

Empowerment of hospital workers is known as a key factor of organizational performance and occupational health. Nevertheless, empowering workers remains a real challenge. As in many traditional organizations, hospitals follow a bureaucratic model defined by a managerial culture of control and a stratified organization, which at once weaken professionals' mastery of their work and hinder their commitment and performance. Based on the existing literature this protocol describes a new managerial and organizational transformation program as well as the study design of its effect on worker empowerment in a large French public hospital. The project is funded by the French Ministry of Health for a total of 498,180 €.

METHODS

This study is a randomized controlled trial conducted in a French university hospital complex (CHU). The CHU comprises 12 sub-centers (SC) with about 20 care units and 1000 employees each. Randomization is performed at SC level. The intervention lasts 12 months and combines accompaniment of healthcare teams, frontline managers and SC directors to empower first-line professionals in the experimental SC. Quantitative outcome measurements are collected over 2 years during mandatory check-ups in the occupational medicine department. The primary outcomes are structural and psychological empowerment, motivational processes, managerial practices, working conditions, health and performance. Mixed linear modeling is the primary data analysis strategy.

DISCUSSION

The protocol was approved by the CHU health ethics committee. The results of the analysis of the intervention effects will be reported in a series of scientific articles. The results will contribute to reflection on prevention and management policies, and to the development of Workplace Quality-of-Life. If the intervention is a success, the system will warrant replication in other SCs and in other health facilities.

TRIAL REGISTRATION

The study was retrospectively registered at ClinicalTrials.gov on July 4, 2019 (NCT04010773).

The Forest and the Trees: Investigating the Globality and Specificity of Employees' Basic Need Satisfaction at Work

This research assessed the underlying psychometric multidimensionality and nomological validity of 523 employees' responses to the Work-related Basic Need Satisfaction (W-BNS) scale using bifactor-exploratory structural equation modeling (bifactor-ESEM). Our results first showed the superiority of a bifactor-ESEM representation when compared to alternative representations of the data. Thus, employees' ratings of psychological need satisfaction simultaneously reflected a global need satisfaction construct, which coexisted with specific autonomy, competence, and relatedness needs satisfaction. Importantly, our findings also supported the nomological validity of employees' ratings of psychological need satisfaction in relation to measures of positive affect, negative affect, job satisfaction, perceived organizational support, organizational citizenship behaviors, work engagement, and burnout. In addition, our results also supported the presence of indirect (mediated) effects between perceived organizational support and some of the outcome variables as mediated by employees' levels of need satisfaction.

The roles of basic psychological needs, self-compassion, and self-efficacy in the development of mastery goals among medical students

Aim: Competency-based medical education aims to foster mastery goals in learners. We examined medical students' mastery approach (beneficial) and mastery avoidance (maladaptive) goals and their associations with students' basic psychological needs, self-compassion, and self-efficacy. Methods: This was a cross-sectional study employing an online questionnaire. Two hundred medical students in all four years of the medical program completed the questionnaire, containing measures of mastery goals, basic psychological needs (autonomy, competence, relatedness), self-compassion, and self-efficacy. Regression analyses were performed. Results: Of the three basic psychological needs, the need for competence was significant in explaining both types of mastery goals. Self-efficacy and self-compassion were significant in explaining mastery approach and mastery avoidance goals, respectively. Conclusions: Creating learning environments that are supportive of students' need for competence, raising students' awareness of the value of learning from mistakes in competency acquisition, and providing opportunities for students to experience self-efficacy may foster beneficial mastery approach goals in medical students.

Medical student well-being and lifelong learning: A motivational perspective

BACKGROUND

Medical school poses many pressures and challenges for individuals aspiring to health careers. Only some students, however, experience high stress and exhaustion, whereas others adaptively respond to schooling demands and engage in lifelong learning practices. By drawing on three motivation theories - self-determination theory, self-theories of ability, and achievement goal theory - this study examined the relations among motivational constructs, stress, exhaustion, and lifelong learning in medical students.

METHODS

All medical students in a 4-year program were invited to complete a questionnaire containing measures of psychological need satisfaction, self-theories of ability, achievement goals, stress, exhaustion, lifelong learning, and background characteristics. Using structural equation modeling, we tested a structural model that combined the three motivation theories to explain stress, exhaustion, and lifelong learning in medical students.

RESULTS

A total of 267 medical students participated in the study (response rate 42%). The results largely confirmed the hypothesized relations, revealing that unmet psychological needs and a fixed mind-set were associated with maladaptive cognitions (i.e., the pursuit of avoidance goals) and psychological distress (i.e., high stress and exhaustion). In contrast, psychological need satisfaction and a growth mind-set had distinct pathways to beneficial cognitions (i.e., mastery approach goals) and lifelong learning practices in medical students.

DISCUSSION

Adaptive motivations, cultivated through personal and environmental factors, may help to protect medical students from psychological distress and enhance their growth as lifelong learners. Understanding the mechanisms and pathways to desirable and undesirable outcomes in medical students is critical for creating learning environments that will serve these students well.

Physicians as Teachers and Lifelong Learners

INTRODUCTION

Lifelong learning requires sustained motivation for learning. Employing a motivational theory framework, we investigated the relationships of psychological need satisfaction, clinical teaching involvement, and lifelong learning of physicians at different career stages and in various medical specialties. We also examined the associations of physician lifelong learning with stress, burnout, teaching enjoyment, and life satisfaction, all of which are essential for physician well-being and, ultimately, for the provision of quality patient care.

METHODS

This was a cross-sectional study. Using survey methodology, quantitative data were collected from 202 practicing physicians in Canada. The questionnaire contained validated scales of physician lifelong learning and psychological need satisfaction, measures of clinical teaching (involvement and enjoyment), stress level, burnout frequency, and life satisfaction. Analysis of covariance and correlational analysis were performed.

RESULTS

On average, participants reported moderate to moderately high levels of lifelong learning, psychological need satisfaction, teaching enjoyment, and life satisfaction. Irrespective of career stage and specialty, physicians' psychological need satisfaction and involvement in clinical teaching were significant in relation to lifelong learning. That is, physicians who experienced greater psychological need satisfaction at work and those who were involved in clinical teaching had, on average, higher lifelong learning scores. Physician lifelong learning had significant associations with life satisfaction and teaching enjoyment but not with stress level and burnout frequency.

DISCUSSION

Fulfilling physicians' basic psychological needs at work and supporting them in their teaching roles is likely to enhance physician lifelong learning and, ultimately, quality of patient care.

The Work-Related Basic Need Satisfaction Scale: An Italian Validation

The main goal of the present study was to validate the Work-related Basic Need Satisfaction (W-BNS) scale in the Italian social context. Three studies were carried out. Study 1 was conducted on two samples of employees. Exploratory factor analysis and parallel analysis were run on the first sample, whereas confirmatory factor analyses were run on the second. Results supported the three-dimensional structure of the W-BNS scale. Study 2 was conducted on a third sample of employees. Results supported the construct validity of the scale, by showing that needs for competence, autonomy, and relatedness were associated with job resources (social support, job autonomy, professional growth), low burnout, and job attitudes (job satisfaction, turnover intentions, commitment). In addition, results showed that responses to the scale were not affected by social desirability bias. Study 3 was conducted to evaluate the nomological validity of the scale (the sample grouped together all respondents from Studies 1 and 2). A model was tested in which organizational commitment mediated the relationship between basic needs and two outcomes (job satisfaction, intentions to leave). Organizational commitment was measured by using the Klein et al. Unidimensional Target-free scale (the KUT). Results supported the nomological validity of the scale. In line with our expectations, the three needs were associated with the KUT, which in turn mediated the effects of needs on the outcomes. Practical implications of findings and directions for future research are discussed.

Short Is Beautiful: Dimensionality and Measurement Invariance in Two Length of the Basic Psychological Need Satisfaction at Work Scale

Self-determination theory proposes that all humans have three intrinsic psychological needs: the needs for Autonomy, Competence, and Relatedness. These needs take different forms in different areas of life. The present study examines the psychometric properties of a Swedish version of the Basic Psychological Need Satisfaction at Work (BPNS-W) scale. The fit of 10-factor structures previously suggested for related versions of the scale were compared. Cross-sectional data from 1,200 participants were examined in a confirmatory factor analysis framework. Both the original 21-item version and a reduced 12-item version of the BPNS-W were examined. The General Health Questionnaire was used for validation. The results supported a three-factor solution with correlated error variances for the reversed items. Invariance testing of the long and short scales gave best support to the short scale, for which partial scalar invariance was achieved. The external validity of the short scale was supported by a hierarchical regression analysis in which each need made a unique contribution in predicting psychological well-being. In conclusion, the results corroborate a three-factor structure of BPNS-W. Although not perfect the short scale should, it is argued, be preferred over the long version. Directions for the future development of the scale are discussed.

Professional Well-Being of Practicing Physicians: The Roles of Autonomy, Competence, and Relatedness

This study investigated the roles of basic psychological needs—autonomy, competence, and relatedness—in physicians’ professional well-being, specifically satisfaction with professional life, work-related engagement, and exhaustion. Using an online survey, quantitative data were collected from 57 practicing physicians. Overall, 65% of the participants were female; 49% were family medicine (FM) physicians, with the rest of the participants practicing in various non-FM specialties (e.g., internal medicine, pediatrics, surgery); and 47% were in the early-career stage (≤10 years in practice). Multivariate regression analyses indicated that of the three psychological needs, the need for relatedness had the largest unique contributions to physicians’ satisfaction with professional life, work-related engagement, and exhaustion, respectively. The unique contributions of the needs for autonomy and competence were relatively small. These findings extend basic psychological needs theory to the work domain of practicing physicians in an attempt to examine underpinnings of physicians’ professional well-being, a critical component of quality patient care.

Contributions of psychological needs, self-compassion, leisure-time exercise, and achievement goals to academic engagement and exhaustion in Canadian medical students

PURPOSE

To investigate the contributions of psychological needs (autonomy, competence, and relatedness) and coping strategies (self-compassion, leisure-time exercise, and achievement goals) to engagement and exhaustion in Canadian medical students.

METHODS

This was an observational study. Two hundred undergraduate medical students participated in the study: 60.4% were female, 95.4% were 20-29 years old, and 23.0% were in year 1, 30.0% in year 2, 21.0% in year 3, and 26.0% in year 4. Students completed an online survey with measures of engagement and exhaustion from the Oldenburg Burnout Inventory-student version; autonomy, competence, and relatedness from the Basic Psychological Needs Scale; self-compassion from the Self-Compassion Scale-short form; leisure-time exercise from the Godin Leisure-Time Exercise Questionnaire; and mastery approach, mastery avoidance, performance approach, and performance avoidance goals from the Achievement Goals Instrument. Descriptive and inferential analyses were performed.

RESULTS

The need for competence was the strongest predictor of student engagement (β= 0.35, P= 0.000) and exhaustion (β= -0.33, P= 0.000). Students who endorsed mastery approach goals (β= 0.21, P= 0.005) and who were more self-compassionate (β= 0.13, P= 0.050) reported greater engagement with their medical studies. Students who were less self-compassionate (β= -0.32, P= 0.000), who exercised less (β= -0.12, P= 0.044), and who endorsed mastery avoidance goals (β= 0.22, P= 0.003) reported greater exhaustion from their studies. Students' gender (β= 0.18, P= 0.005) and year in medical school (β= -0.18, P= 0.004) were related to engagement, but not to exhaustion.

CONCLUSION

Supporting students' need for competence and raising students' awareness of self-compassion, leisure-time exercise, and mastery approach goals may help protect students from burnout-related exhaustion and enhance their engagement with their medical school studies.

Frequency of satisfaction and dissatisfaction with practice among rural-based, group-employed physicians and non-physician practitioners

BACKGROUND

Widespread dissatisfaction among United States (U.S.) clinicians could endanger ongoing reforms. Practitioners in rural/underserved areas withstand stressors that are unique to or accentuated in those settings. Medical professionals employed by integrating delivery systems are often distressed by the cacophony of organizational change(s) that such consolidation portends. We investigated the factors associated with dis/satisfaction with rural practice among doctors/non-physician practitioners employed by an integrated healthcare delivery network serving 9 counties of upstate New York, during a time of organizational transition.

METHODS

We linked administrative data about practice units with cross-sectional data from a self-administered multi-dimensional questionnaire that contained practitioner demographics plus valid scales assessing autonomy/relatedness needs, risk aversion, tolerance for uncertainty/ambiguity, meaningfulness of patient care, and workload. We targeted medical professionals on the institutional payroll for inclusion. We excluded those who retired, resigned or were fired during the study launch, plus members of the advisory board and research team. Fixed-effects beta regressions were performed to test univariate associations between each factor and the percent of time a provider was dis/satisfied. Factors that manifested significant fixed effects were entered into multivariate, inflated beta regression models of the proportion of time that practitioners were dis/satisfied, incorporating clustering by practice unit as a random effect.

RESULTS

Of the 473 eligible participants. 308 (65.1 %) completed the questionnaire. 59.1 % of respondents were doctoral-level; 40.9 % mid-level practitioners. Practitioners with heavier workloads and/or greater uncertainty intolerance were less likely to enjoy top-quintile satisfaction; those deriving greater meaning from practice were more likely. Higher meaningfulness and gratified relational needs increased one's likelihood of being in the lowest quintile of dissatisfaction; heavier workload and greater intolerance of uncertainty reduced that likelihood. Practitioner demographics and most practice unit characteristics did not manifest any independent effect.

CONCLUSIONS

Mutable factors, such as workload, work meaningfulness, relational needs, uncertainty/ambiguity tolerance, and risk-taking attitudes displayed the strongest association with practitioner satisfaction/dissatisfaction, independent of demographics and practice unit characteristics. Organizational efforts should be dedicated to a redesign of group-employment models, including more equitable division of clinical labor, building supportive peer networks, and uncertainty/risk tolerance coaching, to improve the quality of work life among rural practitioners.

Resilience among Employed Physicians and Mid-Level Practitioners in Upstate New York

OBJECTIVE

To investigate the factors associated with resilience among medical professionals.

DATA SOURCES/STUDY SETTING

Administrative information from a rural health care network (1 academic medical center, 6 hospitals, 31 clinics, and 20 school health centers) was triangulated with self-report data from 308 respondents (response rate = 65.1 percent) to a 9/2013-1/2014 survey among practitioners serving a nine-county 5,600-square-mile area.

STUDY DESIGN

A cross-sectional questionnaire survey comprising valid measures of resilience, practice meaningfulness, satisfaction, and risk/uncertainty intolerance, nested within a prospective, community-based project.

DATA COLLECTION/EXTRACTION METHODS

The sampling frame included practitioners on institutional payroll, excluding voluntary/involuntary attritions and advisory board/research team members. In multivariable mixed-effects models, we regressed full-range and high-/low-resilience scores on demographics, professional satisfaction, workplace needs, risk/uncertainty intolerance, and service unit characteristics.

PRINCIPAL FINDINGS

Relational needs, uncertainty intolerance, satisfaction ≥75 percent of the time, number of practitioners on a unit, and workload were significantly associated with resilience. Higher scores were most strongly associated with uncertainty tolerance, satisfaction, and practitioner numbers. Practitioner/unit demographics were mostly nonsignificant.

CONCLUSIONS

More resilient practitioners experienced frequent satisfaction, relational needs gratification, better uncertainty tolerance, lighter workloads, and practiced on units with more colleagues. Further studies should investigate well-being interventions based on these mutable factors.

Preliminary development of the adolescent students' basic psychological needs at school scale

The aim of the present study was to develop and provide evidence for the validity of a new measure of adolescent students' psychological need satisfaction at school, using a sample of Chinese students. We conducted four studies with four independent samples (total n = 1872). The first study aimed to develop items for the new instrument and to ascertain its factorial structure using exploratory factor analysis procedures. The second study aimed to examine the instrument's factorial structure using confirmatory factor analysis procedures as well as to assess its internal consistency reliability, convergent and divergent validity. The third study aimed to assess its measurement invariance across gender and age. The fourth study aimed to test its test-retest reliability over time and predictive validity. These preliminary results showed that the new instrument has promising psychometric properties. The potential contributions of the new instrument for future research and educational practices were discussed.