Self-Determination Theory

Cognitive Evaluation Theory explains how external events can affect someone’s intrinsic motivation by their influence on their perceptions of autonomy and competence. The theory proposes that all external events have not only a controlling aspect but also an informational aspect, and both affect motivation in different ways. These external events can either enhance or go against intrinsic motivation, depending on how the person perceives them. If one sees them as controlling, then they limit the psychological need for autonomy, undermining intrinsic motivation. On the other hand, if the external factors are seen as informational, then one sees them as providing feedback and can build feelings of autonomy and competence, enhancing intrinsic motivation. There are three propositions of this theory, including perceived locus of causality, perceived competence, and functional significance. When external events create an internal perceived locus of causality, intrinsic motivation increases, but when they cause an external perceived locus of causality, extrinsic motivation is promoted. External events that increase one’s feelings of competence enhance intrinsic motivation, while those that reduce it once again undermine intrinsic motivation. All external events can be interpreted as informational, enhancing intrinsic motivation; controlling, undermining intrinsic motivation; or amotivating, decreasing both intrinsic and extrinsic motivation. Meredith’s intrinsic motivation was supported by her perceptions of competence, autonomy, and positive relationships from her environment.

When Meredith is provided with the opportunity to take initiative and when she succeeds in challenging situations, her feelings of competence are supported. For example, when the attendings, such as Derek Shepard, trust her to make critical decisions during surgery, they are providing her with informational feedback that affirms her skills. Her best friend, Cristina, who shows genuine respect for Meredith’s talent, reinforces Meredith’s sense of effectiveness. These aspects of her environment strengthen her confidence and allow her intrinsic motivation to grow since she feels capable and can see that her hard work is paying off. On the other hand, when Meredith’s mother calls her ordinary, she feels controlled, and this criticism reduces her perceived competence and, in turn, her intrinsic motivation. 

Meredith’s growth from being an intern to being a resident allows her to gain control over her decisions in both her professional and personal life. At the beginning of the show, the strict hospital hierarchy and her complicated relationship with Derek reduce her sense of autonomy and make her feel like her actions truly depend on others. This undermines her intrinsic motivation. When her mentors Bailey and Webber start treating her as an independent surgeon as she becomes a resident, she shifts to having a more internal perceived locus of causality. She has the chance to operate in a manner more true to herself, giving her a genuine interest in what she is doing rather than putting more pressure on her. As these external factors from her environment shift, her engagement and intrinsic motivation for medicine and her relationships increase. 

The sense of belonging in the hospital’s social setting Meredith seeks has a strong effect on her intrinsic motivation as well. When her friendships with the other interns, Cristina, George, Izzie, and Alex blossom, she feels relatedness in her environment and has the confidence to take risks and learn from her mistakes. This provides Meredith with psychological security and encourages her to stay engaged and resilient even when she faces setbacks. When she feels this support and validation from positive relationships, her sense of connection increases as does her motivation.