Eine qualitative Untersuchung zur Entwicklung der Studienmotivation angehender Humanmediziner

Introduction: This study analyses central factors of influence on the studies-related motivation of prospective physicians at the University of Lübeck and its development over time. The identification of these factors allows for inferences regarding how academic teaching can stimulate contentment, health, and commitment of future doctors optimally. This might also impact the share of alumni who work as physicians in Germany after their graduation instead of moving abroad or working in non-medical functions. Methods: The results have been obtained by qualitative analysis of guideline-based group discussions according to the qualitative content analysis of Mayring. Results: Regarding the development of the motivation over time, four groups of students are to be distinguished (rather constant motivation, increasing motivation, decreasing motivation, frequent 'up and down' of the motivation). Generally, the pre-clinical phase and the preliminary medical examination were evaluated as a profound stress to the motivation. The group with a decreasing motivation shows significant mental burden and disillusionment. Solidarity among fellow students, the presence of medical role models, strong interests in a particular field of medicine, and the aim to become a 'good' physician are particularly motivating. Particularly discouraging were insufficient contact with patients, a deficient teaching of practical and communicative skills, and the contact with overburdened and disillusioned physicians. Conclusions: Central recommendations for medical education relate to a stronger focus on practical and communicative skills, to the support of students' mental-physical health, and to a didactically more valuable design of academic teaching. These recommendations give evidence of a benefit by the introduction or expansion of pre-existing electives in family medicine as well as by the introduction of an mandatory quarter in family medicine.