Development and internal validation of an instrument to measure the motivation of residents for family medicine

Figures & data

Table 1. Items SMMS and STRONG.

	SMMS: Strength of motivation for medical school (with subscale)	STRONG: STRength mOtiviatioN General Practitioner
1	I would always regret my decision if I hadn’t availed myself of the opportunity to study medicine (2).	I would always regret it if I did not take the opportunity to do a residency programme in family medicine (2).
2^a	I would quit studying medicine if I were 95% certain that I could never become the specialist of my choice (3).	I would discontinue residency if I were 95% sure that I couldn’t work in family medicine (–).
3	I would still choose medicine even if that means studying in a foreign country in a language I have not yet mastered (2).	I would also like to start or continue residency in family medicine if I could only do this abroad in a language I do not speak at the moment (1).
4^a	As soon as I discovered that it would take me 10 years to qualify as a doctor, I stopped studying. (3)	As soon as I discovered that it would take 10 years to get a specialist degree in family medicine, I would discontinue residency (2).
5	Even if I could not maintain my social life, I would continue medical training (1).	Even if I could hardly maintain my social life, I would continue residency in family medicine (1).
6	I wouldn’t consider any other profession than becoming a doctor (2).	I wouldn’t consider any other profession than becoming a general practitioner (2).
7	I would still choose medicine even if that meant I could never go on holidays with my friends anymore (1).	I would also choose to become a general practitioner even if that meant I would never be able to go on holiday with my friends or family anymore (1).
8^a	I would stop studying medicine if I started scoring low marks and failing tests often (3).	I would discontinue residency in family medicine if it turned out that I kept getting negative feedback about the way I work (1).
9^a	If studying took me more than an average of 60 h a week, I would seriously consider quitting (1).	If the residency in family medicine would cost me more than an average of 60 h of work per week all year round, I would seriously consider dropping out of residency (1).
10	I intend to become a doctor even though that would mean taking CME courses two evenings a week throughout my professional career (1).	I intend to become a general practitioner, even though that would mean taking CME courses two evenings a week throughout my professional career (–).
11^a	It wouldn’t bother me too much if I could no longer study medicine (2).	It wouldn’t bother me too much if I could not become a general practitioner (any more) (2).
12	I would like to become a doctor, even if that means giving precedence to my work over my family (1).	I want to become a general practitioner if that would mean giving precedence to my work over my family (1).
13^a	I would quit studying as soon as it became apparent that there were no jobs or resident positions after graduation (3).	I would discontinue residency as soon as it became apparent that there were no jobs in family medicine (–).
14^a	I would not have chosen medicine if it had caused me to accumulate substantial financial debts (3).	I would not have chosen family medicine if it had caused me to accumulate substantial financial debts (1).
15	I would be prepared to retake my final high school exams to get higher marks if this would be necessary to study medicine (2).	I would be prepared to retake my state exams to achieve a higher average mark if this would be necessary to become a specialist in family medicine (1).
16^a		As soon as I discovered that I had to go to a rural region to become a general practitioner, I would discontinue residency (2).

Notes: Subscales SMMS: 1 = willingness to sacrifice, 2 = readiness to start, 3 = persistence. Subscales STRONG: 1 = willingness to sacrifice, 2 = persuasion.

^aTo be reverse scored.

Figure 1. Screeplot of the factor analysis. The x-axis shows the questionnaire items. The y-axis shows the eigenvalues per item.

Table 2. Factors loadings of the STRONG items.

No.	STRONG item	Factor 1	Factor 2
3	I would also like to start or continue residency in family medicine if I could only do this abroad in a language I do not speak at the moment.	0.52	0.01
5	Even if I could hardly maintain my social life, I would still continue residency in family medicine.	0.70	0.08
7	I would also choose to become a general practitioner even if that meant I would never be able to go on holiday with my friends or family anymore.	0.82	0.07
8	I would discontinue residency family medicine if it turned out that I kept getting negative feedback about the way I work.	0.40	0.09
9	If the residency in family medicine would cost me more than an average of 60 h of work per week all year round, I would seriously consider dropping out of residency.	0.57	0.10
12	I want to become a general practitioner if that would mean giving precedence to my work over my family.	0.68	0.09
14	I would not have chosen family medicine if it had caused me to accumulate substantial financial debts.	0.54	0.05
15	I would be prepared to retake my state exams to achieve a higher average mark if this would be necessary to become a specialist in family medicine.	0.60	0.06
1	I would always regret it if I did not take the opportunity to do a residency programme in family medicine.	0.06	0.69
4	As soon as I discovered that it would take 10 years to get a specialist degree in family medicine, I discontinued residency.	0.15	0.28
6	I wouldn’t consider any other profession than becoming a general practitioner	0.31	0.45
11	It wouldn’t bother me too much if I could not become a general practitioner (any more).	0.17	0.76
16	As soon as I discovered that I had to go to a rural region to become a general practitioner, I discontinued residency.	0.26	0.46
	Deleted items
2	I would discontinue residency if I were 95% sure that I couldn’t work in family medicine.	0.32	0.21
10	I intend to become a general practitioner, even though that would mean taking CME courses two evenings a week throughout my professional career.	0.13	0.23
13	I would discontinue residency as soon as it became apparent that there were no jobs in family medicine.	0.23	0.10

Bold indicates to which factor the respective item was assigned.

Data availability statement

The datasets generated and/or analysed during the current study are not publicly available due to data protection guidelines of the institution but are available from the corresponding author upon reasonable request.