Eine Erhebung der Motivation zur studentischen Lehre, des Burnout-Risikos und der Arbeitszufriedenheit bei Hausärzten im ländlichen Raum

Background: In rural areas, the shortage of general practitioners (GPs) is a serious and progressive problem nowadays. Solutions include the training of medical students in those rural regions as well as the strengthening of general practice in medical curriculum (Master Plan 2020). GPs in these regions may thus be faced with new tasks, so that the motivation to participate in medical education, the burnout risk, job satisfaction, as well as occupational perspective were investigated in a model region with corresponding structural characteristics. Methods: In the district of Siegen-Wittgenstein (North Rhine-Westphalia) the study HaMedSi ("GPs for Medical Education in Siegen-Wittgenstein) was carried out. All general practitioners were invited to take part in the study. In addition to demographic structural characteristics, work satisfaction (WSQ), burnout risk (MBI-D), occupational perspectives and teaching motivation were investigated. Furthermore, a new questionnaire ("Motivation of Medical Education Questionnaire”, MoME-Q) was developed to determine teaching motivation. Results: With n=85 of 158 GPs (53.8%) a representative proportion took part in the study. With regard to the motivation to participate in student teaching, the questionnaire was reduced from initially 28 to 24 questions. The initially assumed 4-factor structure turned out to be a two-factor model with the factors "commitment" and "personal benefit". It turned out that physicians with practice assistants and physicians with previous experience in teaching showed a higher commitment. Regarding the burnout risk, 12% of the study participants showed a high degree of emotional exhaustion, 13% a high degree of depersonalization and 26% a low degree of personal accomplishment. With regard to job satisfaction, weekly working hours correlated significantly with the subscale "burden". Regarding the occupational perspective and actual care reality, it can be seen that almost half of the physicians are older than 55 years and in many cases there are no concrete concepts for continuing the practice or the efforts to find a successor have often already been stopped. Discussion: It was possible to investigate a complete population of general practitioners in a limited geographical area. In this context, a questionnaire was developed, tested and modified to assess the motivation to participate in medical education. A validation of the instrument at another cohort is planned in a next step. It was also possible to determine the burnout risk and job satisfaction of GPs and to correlate them with demographic structural characteristics. This revealed certain risk groups and constellations for which certain tailor-made interventions now could be developed and carried out. The results regarding the occupational perspective showed that the system only works if many GPs work beyond the retirement age. The demographic change will presumably further aggravate the precarious situation.