How can work motivation among primary care physicians be assessed? Development and psychometric validation of the M-PCP scale: a cross-sectional study in the Girona Health Region, Spain.

Abstract

Work motivation is essential for well-being, performance and retention in general practice. Despite its relevance, no validated instrument is available to assess motivation specifically among primary care physicians (PCPs) or to inform targeted managerial action. To develop and validate the Motivation Scale for PCP (M-PCP), a theory-driven instrument designed to capture motivational processes relevant to general practice. The scale was developed using a structured, theory-based process grounded in Ford's Motivational Systems Theory. Items were generated from existing models, reviewed by experts and tested in a cross-sectional survey of PCPs in the Girona Health Region (Catalonia, Spain). Psychometric analyses included item discrimination, exploratory factor analysis and partial least squares structural equation modelling. After removing items with low discrimination or weak loadings, the final 37-item scale showed a clear two-factor structure: goals (continuous improvement, self-care and agency) and perceptions (emotions and contextual agency beliefs). Both constructs showed strong reliability and validity. The model fit was acceptable, and perceptions explained a moderate proportion of variance in goals. These findings indicate that the scale captures key motivational processes linked to daily clinical work. The M-PCP is a valid tool for assessing work motivation in general practice. By identifying goal-related, emotional and contextual motivational processes, it supports targeted strategies that may enhance clinical performance, continuity of care and physician well-being. Further research should examine its predictive value and applicability across health systems.