Sharon Tjin A Tsoi

Poor performance, such as making medication errors, endangers patient safety. Healthcare professionals need to take responsibility for their professional development in order to ensure patient safety. Lack of motivation seems to be one of the most important barriers for healthcare professionals to engage in professional development; therefore it is important to investigate their motivation for Continuing Education (CE) and Continuing Professional Development (CPD). As stated by Self-Determination Theory (SDT), the desirable type of motivation, i.e. autonomous motivation (AM), is associated with satisfying the Basic Psychological Needs (BPN) of individuals and the less desirable type, i.e. controlled motivation is associated with thwarting BPN. Regulators and CE providers can help health professionals develop their self-regulated learning skills needed for effective CPD by investigating and fulfilling their BPN.

In this thesis we aimed to enhance our understanding of pharmacists’ motivation in CE. Different topics ranging from motivation as a dependent and an independent variable, the dynamics of motivation and structural relations between BPN, motivation and outcomes like well-being and lifelong learning adaptability are covered.

Chapter 1 sets the stage for the research conducted in the thesis. The terminology of CE, CPD and lifelong learning is explained and the development of CE and CPD in the international pharmacy workforce is described. Although CPD started in the eighties, thirty years later poor performance among healthcare professionals is still an issue. Implementing an effective CE/CPD system seems challenging because of important barriers such as a lack of motivation.

An overview of the learning context of Dutch pharmacists is provided and an explanation is given for the motivation lens used in this thesis. Motivation is investigated from a Self-Determination Theory (SDT) perspective, the theoretical framework of which is further elaborated in this chapter. Two main types of motivation are described: 1) Autonomous Motivation (AM) that is desirable and comes from within a person and 2) Controlled Motivation (CM) that is less desirable and is externally driven. Finally, a conceptual model of the role of BPN and motivation in CE/CPD, well-being, professional performance and patient care is presented. This chapter concludes with broad research questions followed by specific research questions and an outline of the thesis.

Chapter 2 unravels the motivational profiles found in an exploratory study conducted with 425 pharmacists. Based on their AM and CM scores, different profiles were found with K-means cluster analysis. The profiles that emerged were a good quality profile (GQL– with high AM and low CM), a high quantity profile (HQT– with high AM and high CM), a poor quality profile (PQL– with low AM and high CM) and a low quantity profile (LQT– with low AM and low CM). The profiles differed in their demographic characteristics. The highest percentage of females (35.5%), hospital pharmacists (42.5%) and pharmacists who worked more than 10 years (34.4%) belonged to the GQL profile. The highest percentage of community pharmacists (34.5%), pharmacists who worked less than 10 years (36.2%) and pharmacists in training (37.3%) belonged to the HQT profile. The highest percentage of pharmacy owners (36.4%) belonged in the LQT profile. These findings call for the development of different educational formats to cater to all types of motivation, instead of the one-size-fits-all approach of the traditional CE system.

Chapter 3 presents the results of an exploratory study of possible factors that could influence pharmacists’ CE participation. Apart from demographic factors, we wanted to know if motivation could also affect the CE participation of pharmacists. CE participation was measured using the central