What influences clinical educators' motivation to teach? A BEME systematic review and framework synthesis based on self-determination theory: BEME Review No. 90.

Background: Health professions learners are taught by full-time university faculty and by clinicians who teach alongside their clinical practice. This distributed healthcare education model ensures high-quality education but is at risk due to high learner demand, shortage of educators, and economic pressures. Understanding what factors influence clinical educators' motivation to teach may contribute to the model's sustainability and educator retention.

Workplace Causality Orientations Moderate Impostorism and Burnout: New Insights for Wellness Interventions in Graduate Medical Education.

Impostor phenomenon (IP) is strongly linked to physician burnout, but the nature of this association is not well understood. A better grasp of the mechanism between these constructs could shed new light on ways to mitigate physician IP and burnout. Grounded in self-determination theory (SDT), the present study explores whether and how residents' general causality orientations at work-impersonal, controlled, and autonomous-each moderate the effect of IP on physician burnout.

Autonomy Versus Independence: Implications for Resident and Faculty Engagement, Performance, and Well-Being.

Description Research shows that when educational leaders support their learners' autonomy, it positively impacts both parties. This is particularly important in graduate medical education (GME), given that there is a strong emphasis on resident performance, evaluation, and development. Unfortunately, GME faculty often misunderstand autonomy as the resident's desire for independence or "freedom," when in fact it refers to the core psychological need to feel volitional and agentic.

Virtual Care Integration: Balancing Physician Well-Being.

Background And Objectives: According to self-determination theory (SDT), fulfillment of three basic psychological needs-autonomy, competence, and relatedness-positively impacts people's health and well-being. Amid the COVID-19 pandemic, an accelerated adoption of virtual care practices coincided with a decline in the well-being of physicians. Taking into account the frequency of virtual care use, we examined the relationship between workplace need fulfillment and physician well-being.

Not all 'impostors' are created equal: A dimensional, person-centered, and theory-based analysis of medical students.

Purpose: Research on the impostor phenomenon (IP) is rapidly growing in medical education due to its relationship with distress and burnout. How IP is theoretically conceptualized and analyzed has been inconsistent, however, which limits our understanding of results and how to act on them. We hypothesized that a person-centered analysis, in combination with a robust theoretical framework, would provide a more specific 'profile' of medical student IP and help to optimize supports for their well-being.

Cultivating physician empathy: a person-centered study based in self-determination theory.

While physician empathy is a vital ingredient in both physician wellness and quality of patient care, consensus on its origins, and how to cultivate it, is still lacking. The present study examines this issue in a new and innovative way, through the lens of self-determination theory. Using survey methodology, we collected data from  = 177 (44%) students at a Canadian medical school.

Community physician perceptions of managing complex child and adolescent psychiatric patients: a self-determination theory perspective.

Children and adolescents with complex mental health needs often require a level of care that is unsustainable in tertiary settings. Yet, the psychological impact of this on community physicians, who are tasked with providing quality care to this population, is not well understood. Grounded in Self-Determination Theory (SDT), the present study explores how the challenges of caring for these patients is affecting community physicians' basic psychological needs (autonomy, competence, and relatedness) and intrinsic motivation.

Family Physician Motivation and Well-Being in the Digital Era.

Purpose: Family physicians rapidly shifted to using virtual care during the COVID-19 pandemic, yet it is largely unknown if this change has impacted their workplace motivation. A better understanding of this matter is essential for optimizing the integration of virtual care into standard practice and for supporting family physician well-being. Using a self-determination theory lens, we examined if family physicians experienced autonomous (vs controlled) motivation toward using virtual care, how this related to their subjective well-being, and whether satisfaction (vs frustration) of their basic psychological needs at work mediated that relationship.

Profiles of physician motivation towards using virtual care: differences in workplace need fulfillment.

Background: Physicians appear to vary in their motivation towards using virtual care, but to what extent is unclear. To better understand this variance, which is important for supporting physician wellbeing and therefore patient care, the authors used self-determination theory's (SDT) framework. According to SDT, different types of motivation exist, ranging from controlled to autonomous, that lend to differences in engagement, performance, and wellbeing.

"Grabbing" Autonomy When the Learning Environment Doesn't Support it: An Evidence-based Guide for Medical Learners.

According to self-determination theory (SDT), environments which support the basic psychological needs for autonomy, competence, and relatedness will facilitate autonomous motivation, learning, and wellness. On the other hand, environments which introduce external controls and power dynamics into the equation will do the opposite. Educational studies support these principles, yet most have focused on learners' need satisfaction as a passive process (e.

Towards an autonomy-supportive model of wellness in Canadian medical education.

Purpose: Learner distress is a huge problem in medicine today, and medical institutions have been called upon to help solve this issue. Unfortunately, the majority have responded not by addressing the system and culture that have long plagued the profession, but by creating individual-focused "wellness" interventions (IFWs). As a result, medical learners are routinely being forced to undergo training on resilience, mindfulness, and burnout.

Moving the Field Forward: Using Self-Determination Theory to Transform the Learning Environment in Medical Education.

The learning environment (LE) is known to be the main determinant of physician distress, yet most wellness interventions continue to focus on the learner. Additionally, few wellness interventions that focus on the LE have derived from well-established theory. These limitations represent major barriers in our progress toward improving the LE and supporting medical learner wellness in an evidence-based, humanistic, and scalable way.

Highly Parallel Tissue Grafting for Combinatorial In Vivo Screening.

Material- and cell-based technologies such as engineered tissues hold great promise as human therapies. Yet, the development of many of these technologies becomes stalled at the stage of pre-clinical animal studies due to the tedious and low-throughput nature of implantation experiments. We introduce a 'plug and play' screening array platform called Highly Parallel Tissue Grafting (HPTG).

Left ventricular assist device inflow obstruction.

Inflow cannula obstruction is a rare complication of left ventricular assist device implantation. In this report, we present a case of inflow obstruction that was successfully treated with left ventricle myectomy and mitral valvectomy. Transesophageal echocardiogram was essential in diagnosing this condition.

Anomalous left anterior descending coronary artery arising from the right coronary artery: a case report.

Congenital anomalous coronary artery origins are rare, with a prevalence of 0.24-1.6%.

Redo heart transplant without allogeneic blood transfusion.

Allogeneic blood transfusion in cardiac surgery is associated with increased morbidity, mortality, and health care costs. We report a successful case of third-time redo sternotomy second-time redo heart transplantation without allogeneic blood transfusion owing to the multiple blood conservation strategies used throughout the perioperative period.

Inference after latent variable estimation for single-cell RNA sequencing data.

In the analysis of single-cell RNA sequencing data, researchers often characterize the variation between cells by estimating a latent variable, such as cell type or pseudotime, representing some aspect of the cell's state. They then test each gene for association with the estimated latent variable. If the same data are used for both of these steps, then standard methods for computing p-values in the second step will fail to achieve statistical guarantees such as Type 1 error control.