The Role of Motivation in Continuing Education for Pharmacists

Healthcare professionals, including pharmacists, need to continuously update their knowledge and are, therefore, expected to participate in Continuing Education (CE) and Continuous Professional Development (CPD) activities on a regular basis. Lack of intrinsic (or autonomous) motivation appears to be an important barrier for engaging in high quality learning and can have consequences for poor performance and patient safety. This thesis aims to enhance our understanding of pharmacists’ motivation in CE/CPD. Different topics ranging from motivation as a dependent and an independent variable, the dynamics of motivation and structural relations between basic psychological needs (BPN), motivation and outcomes like well-being and lifelong learning adaptability were investigated. The Self-Determination Theory (SDT; Ryan & Deci) was used as a theoretical framework to investigate how we can preserve motivation as an enabler for pharmacists’ engagement in CE/CPD. Within SDT two types of motivation are distinguished: Autonomous Motivation (AM, desirable and internalized in an individual) and Controlled Motivation (CM, less desirable and driven by external forces). The change of motivation from CM to AM and vice versa depends on fulfillment or frustration of three basic psychological needs (BPN): autonomy, relatedness and perceived competence. When these needs are satisfied, AM, wellbeing and good performance is promoted; when these needs are frustrated, negative consequences like increasing CM, ill-being and poor performance may ensue. In our study of pharmacists working in community and hospital pharmacies in the Netherlands we have found different motivational profiles based on the quality and quantity of their motivation. Furthermore, motivation appears to influence CE/CPD participation. In a 2-year longitudinal study we found evidence that the less-desirable form of motivation (CM) increases at the expense of the more desirable form (AM). Finally, it was established that frustration of BPN function as negative predictors for vitality and lifelong learning adaptability of professional pharmacists. Our findings suggest that the quality of pharmacists’ motivation can be an important factor in explaining success or failure of a CE/CPD system. Based on our research, we suggest characteristics of a motivating, vitalizing and sustainable CE/CPD system on two organizational levels. The first level describes an autonomy-supportive approach at the level of regulations for the CE/CPD system. Collaboration between regulators, pharmacists’ associations and CE providers at this level could help design CE/CPD regulations that stimulate AM and prevent an increase of CM. The second level describes the implementation of autonomy-support in the design of CE activities. It is proposed that teachers/experts are professionalized in autonomy-supportive teaching. Quality assurance of CE/CPD providers and CE activities could help to establish and maintain a motivating CE/CPD-system. In the last section of this thesis suggestions are given for further research to improve our understanding of the role of motivation, fulfillment or frustration of BPN and lifelong learning in pharmacists’ participation in CE/CPD activities. Lessons learned from global systems and other national systems can inspire the design of a motivating and vitalizing CE/CPD system