Abstract
BACKGROUND: Recent decades have witnessed a concerning global trend of declining engagement among physician scientists, with participation rates falling from 4.7% in the 1980s to approximately 1.5% today in the United States. The research highlights the declining engagement of physician scientists and the challenges young physicians face in participating in clinical research. OBJECTIVE: This study aims to examine the intrinsic motivation, attitudes, and practices of young physicians toward scientific research and its clinical value and identify factors that influence their engagement in research activities. METHODS: We developed a comprehensive questionnaire measuring intrinsic motivation (27 items; score range 27-135), attitudes (8 items; score range 8-40), and practices (7 items; score range 7-35) related to scientific research among physicians. Cronbach α coefficients for the 3 dimensions were 0.967, 0.916, and 0.937, respectively. A cross-sectional survey was conducted on young physicians from 12 hospitals in eastern provinces of China between May 2024 and October 2024. RESULTS: A total of 532 valid questionnaires were obtained. Among the respondents, 271 (50.9%) were female, and 317 (59.6%) had not led or been deeply involved in a research project. Most physicians (more than 80%) reported high intrinsic motivation and positive attitudes, but relatively fewer demonstrated active research practices. Key challenges identified included balancing research with clinical work (n=102, 19.2%) disagreed that research alleviates clinical monotony) and insufficient institutional support (n=329, 61.3%) reported inadequate research investment from their hospitals). The mean scores for intrinsic motivation, attitude, and practice were 108.79 (SD 11.91; possible range: 27-135), 32.23 (SD 4.27; possible range: 8-40), and 27.44 (SD 3.81; possible range: 7-35), respectively. Multivariate logistic regression showed that intrinsic motivation score (odds ratio [OR] 1.063, 95% CI 1.035-1.091), attitude score (OR 1.095, 95% CI 1.029-1.165), and good research atmosphere (OR 1.915, 95% CI 1.038-3.533) were independently associated with practice. Moreover, structural equation modeling analysis revealed that intrinsic motivation had a direct effect on attitude (β=0.854; P<.001), attitude directly affected practice (β=0.637; P<.001), and intrinsic motivation indirectly influenced practice through attitude (β=0.544; P<.001). CONCLUSIONS: Despite high levels of intrinsic motivation and positive attitudes toward research, young physicians face significant barriers to active research engagement. Our findings suggest that fostering a supportive research environment is a critical factor that can help translate motivation into practice. Young physicians exhibited positive intrinsic motivation and attitudes but relatively inactive practices toward scientific research and its clinical application. Institutional initiatives should focus on providing protected research time, formal mentorship programs, and adequate research infrastructure to leverage young physicians' existing motivation. Addressing the gap between motivation and practice could significantly contribute to reversing the declining trend of physician scientists and enhancing evidence-based medicine implementation.