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首页> 美国卫生研究院文献>GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW >Pay for performance – motivation to succeed in Advanced Trauma Life Support courses – a question of background or funding?
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Pay for performance – motivation to succeed in Advanced Trauma Life Support courses – a question of background or funding?

机译：为绩效付费-成功获得高级创伤生命支持课程的动力-背景或资金问题？

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>Objective: To correlate students’ performance with their professional background and motivation to take part in Advanced Trauma Life Support (ATLS) courses. We base our analysis on the self-determination theory that differentiates intrinsic (ambition to perform by individual itself) from extrinsic motivation (incentive by external stimuli).>Design: We present a non-blinded, monocentric, non-randomized descriptive study of 376 students taking part in an ATLS course at one course site in Germany. Part of a two-day ATLS course are two written tests; we correlate test scores with background information provided by the students in a questionnaire of 13 items (age, sex, adress, board certification, specialty, subspecialty, position, hospital level of care, hospital operator and hospital participation in trauma network, motivation, funding source, condition of funding).>Setting: The students were recuited at the BG Trauma Center Ludwigshafen (Germany), a large 528-bed trauma center and one of 13 ATLS course sites in Germany.>Participants: 449 ATLS course students taking part in ATLS courses at the above-mentioned course site from February 2009 to May 2010 were sent a questionnaire asking for their background. All 449 course students were eligible to participate. 376 (83.7%) questionnaires were returned, pre- and post-test results of all students aquired and included into our calculations. 312 (83%) were male and 64 (17%) female. The majority (59.3%) of recruited students came from trauma surgery, 21.8% from anesthesiology, 8% from general surgery, 4% from abdominal surgery, 0.5% from vascular or thoracic surgery each and 5.9% from other specialties.>Results: Neither age, sex, subspecialty, hospital level of care, hospital operator, or hospital participation in trauma network played a role with respect to motivation or test results. The high degree of intrinsic motivation of consultants (92.3%) had no impact on their test results. Anesthesiologists were higher motivated (75.6% intrinsically motivated) in contrast to all surgical colleagues (63.6%), which showed significant differences in the pre- (89.8% vs. 85.3%, p=0.03) but not the post-test. Of all 13.6% students who were self-payers, 94.1% were intrinsically motivated; the 86.2% whose course fee was accounted for were less likely to be intrinsically motivated (63.9%). Sponsoring however did not have a negative impact on test results. Conditional funding (sponsored only on passing both tests) was detrimental to motivation: 0% of these individuals were intrinsically motivated and they scored significantly lower (82.5%) than all other students in the post-test (86.9%, p=0.002). Overall, intrinsically motivated students overtopped extrinsically motivated students in the post-test (88.0% vs. 83.4%, p<0.001).>Conclusions: ATLS course participation is not compulsory for medical doctors in Germany. Intrinsic motivation to take part in these courses is a key prerequisite to increase performance, irrespective of the background of the students. Intrinsically motivated students are ready to invest into their education and vice versa. Conditional funding (course fee only sponsored on passing the course) evokes no intrinsic motivation at all and causes worse results.
机译：>目标：将学生的表现与其专业背景和参加高级创伤生命支持（ATLS）课程的动机相关联。我们的分析基于自我决定理论，该理论将内在的（雄心勃勃地追求个人自身的成就）与外在的动机（通过外部刺激来激励）区分开。>设计：我们提出了一种非盲目的，单中心的，非盲目的对376名在德国一个课程站点参加ATLS课程的学生的描述性随机研究。为期两天的ATLS课程的一部分是两个笔试。我们将考试成绩与学生在13个项目（年龄，性别，地址，董事会认证，专长，专科，职位，医院护理水平，医院操作员和医院参与创伤网络，动机，资金的调查表）中提供的背景信息相关联>设置：这些学生被招募到位于德国路德维希港的BG创伤中心，拥有528个床位的大型创伤中心和德国13个ATLS课程地点之一。>参与者：从2009年2月至2010年5月，在上述课程站点上参加ATLS课程的449名ATLS课程学生被发送了一份问卷，询问他们的背景。所有449名课程学生都有资格参加。返回了376份（83.7％）问卷，所有学生的测试前和测试后结果均已包括在内，并计入我们的计算中。男性为312位（83％），女性为64位（17％）。被录取的学生中的绝大部分（59.3％）来自创伤外科，麻醉科占21.8％，普外科占8％，腹部外科占4％，血管或胸腔外科占0.5％，其他专业占5.9％。>结果：：年龄，性别，专科，医院护理水平，医院操作员或医院参与创伤网络均未对动机或测试结果产生影响。顾问的高度内在动力（92.3％）对他们的测试结果没有影响。与所有外科同事（63.6％）相比，麻醉师的积极性更高（内在动力为75.6％），这表明麻醉前（89.8％vs. 85.3％，p = 0.03）有显着差异，但测试后没有。在所有13.6％自费学生中，有94.1％具有内在动机；占课程费用86.2％的人是出于内在动机的（63.9％）。但是，赞助商对测试结果没有负面影响。有条件的资助（仅在两项考试均通过时才资助）不利于动机：这些人中有0％具有内在动机，并且在测验后的得分（86.9％，p = 0.002）比所有其他学生低得多（82.5％）。总体而言，在后测中，有内在动机的学生胜过由内在动机的学生（88.0％比83.4％，p <0.001）。>结论：在德国，医生不强制参加ATLS课程。参加这些课程的内在动力是提高成绩的关键前提，而不论学生的背景如何。具有内在动机的学生已准备好投资于他们的教育，反之亦然。有条件的资助（仅在通过课程时才赞助学费）完全没有内在的动机，并导致更糟糕的结果。

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