Shaping Tomorrow's Healthcare Professionals: A Study on Undergraduate Medical Educational Leaders' Role in a Danish...

Phenomenon: A career as an undergraduate medical educational leader presents significant challenges, shaped by the complexity of the role and the limited availability of structured career pathways. To strengthen recruitment and retention, medical educational organisations must better understand the responsibilities and incentives involved. Approach: This study, based on a larger project, presents unexpected and distinct perspectives on educational leaders working in both universities and hospitals. It draws on survey data collected from 56 mid-level leaders in a Danish context from December 2023 to February 2024. We conducted a secondary qualitative thematic analysis of open-ended survey responses, focusing on the relationship between two questions, one on tasks and responsibilities and the other on incentives. We incorporated statistical data into the analysis of tasks and responsibilities to triangulate the thematic analysis. Findings: The results yielded insights into the relationship between leaders' daily tasks and the incentives that motivate their engagement in educational leadership. It reflects participants' views on their responsibilities and the factors that encourage them to pursue and sustain these roles. The findings highlight educational leadership practices at three responsibility levels: the interactional micro level (teaching responsibilities), the organisational meso level (coordination and development of the educational environment), and the society macro level (fostering the students' professional growth to meet future societal health care responsibilities). Micro- and meso-level responsibilities dominated educational leaders' daily practices, while macro-level responsibilities were present primarily in the overall aim of educational activities. Incentives to pursue educational leadership were threefold: personal career considerations, orientations towards the organisation (department), and holistic incentives to "make a difference." Insights: Findings indicate that undergraduate mid-level medical education leaders primarily undertake micro- and meso-level tasks, whereas macro-level incentives strongly influence their motivation. This discrepancy underscores a gap between their desire to have a broader impact and the time they spend on administrative duties and teaching tasks. Opportunities for macro-level responsibilities could bolster these leaders' motivation. Building on theories from public service motivation and the sociology of professions, we propose the concept of professional intrinsic motivation to reflect this broader view. Future retention strategies should emphasise tasks, responsibilities, and opportunities that align with professional intrinsic motivation. Alongside this, understanding responsibilities across micro, meso, and macro levels can help develop a shared vocabulary, thereby improving recruitment and retention conversations.