Sustaining a national surgical educator workforce: a mixed-methods evaluation of faculty motivation and longitudinal...

To evaluate motivational drivers, qualitative experiences, and longitudinal retention patterns among faculty teaching the UK Urology Simulation Boot Camp, and to identify factors influencing the sustainability of the teaching workforce.

A convergent mixed-methods design combined (1) quantitative analysis of validated motivation domains (Intrinsic Motivation, Task Value, Self-Efficacy, Extrinsic Motivation, Effort/Cost), and (2) thematic analysis of free-text responses, with (3) a longitudinal retention analysis (2015-2025) using a unified "years-since-entry" approach to examine continuity of faculty participation over time. Non-parametric tests (Friedman, Wilcoxon, Kruskal-Wallis, Spearman correlations) assessed domain differences and associations with retention behaviour.

124 faculty participated. Intrinsic motivation (mean 4.56 ± 0.55), task value (4.18 ± 0.58) and self-efficacy (4.41 ± 0.60) scored highly; extrinsic motivation was moderate (3.89 ± 0.75) and effort/cost lowest (3.05 ± 0.90). Domain differences were significant (Friedman χ²(4)=190.6, p<0.001). Retention category analysis showed only intrinsic motivation differed (p=0.009). Years of participation weakly correlated with intrinsic motivation (ρ=0.23, p=0.010) but not with other domains. Qualitative findings reinforced strong intrinsic and relational motivations, with workload, rota burden and lack of protected time as key constraints. Unified retention analysis revealed an early two-year attrition window, after which participation stabilised for 5-8 years or more.

Faculty teaching is driven predominantly by intrinsic enjoyment, educational purpose and professional fulfilment; attrition arises primarily from structural pressures rather than motivational decline. Programme sustainability depends on reducing early-phase barriers, strengthening institutional recognition, and supporting new faculty during the highest-risk period.