Publication date: Feb 01, 2026
Understanding why faculty engage in medical education is critical because it illuminates how to sustain faculty motivation and engagement. This study uses self-determination theory (SDT) and practice theory to examine how faculty perceptions of their own competence, autonomy and relatedness evolve as external perceptions of skills, meaning and practice also change. We used longitudinal qualitative research to conduct a case study of nine faculty at one institution in the United States from AY2019-2020 through AY2023-24. Each faculty member was interviewed annually. Eight completed all interviews; one faculty left the study after the second year. After using reflexive thematic analysis to inductively code transcripts, we used theory to deductively code data. As societal and institutional perceptions of competence, autonomy and relatedness changed over the 4 years of the study, faculty perspectives of these factors changed. As expertise in social determinants of health gained importance, faculty with this experience grew more confident about their teaching skills, while those with less lost confidence. All faculty experienced greater autonomy over drawing boundaries around personal lives with the advent of the COVID-19 pandemic, but only the women faculty reflected on this during interviews. All experienced a loss of relatedness but found ways to connect virtually with each other and with students. Examining faculty engagement and motivation through SDT and practice theory with a longitudinal approach allowed us to understand how faculty perspectives about their roles as educators change over time and in relation to evolving contexts.

Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 pandemic |