Motivation in Undergraduate Nursing Students
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Motivation in Undergraduate Nursing Students
Motivation can be defined as what makes people tick and a driving force within
individuals by which they attempt to achieve some goal in order to achieve a need or expectation
(Murphy, 2006, p. 1132). There is a lot of emphasis placed on college students having
motivation to be successful, and also what role the educator has on this motivation. Students
also need to be engaged in their learning. Many feel that motivation is an essential requirement
in order for learning to occur. Some feel that having high motivation determines success. In the
nursing education arena, it is imperative that nursing instructors facilitate and propel students’
motivation in the classroom as well as in the clinical setting. Learning more about what
motivates undergraduate nursing students is what prompted the author to conduct an informal
phone survey of first and second year undergraduate nursing students to evaluate what motivated
them to learn, what class activities they participated in that demonstrated motivation, what
teaching strategies motivated them the most, and what personal characteristics they valued in
their nursing instructors (see appendix A for further details of the survey).
The informal phone survey was a convenience sampling of 15 undergraduate nursing
students that attend a private, Christian university in Southeastern Tennessee. The demographics
were as follows: 67% of the students were female, 33% were male, 67% were ages 18-25, 33%
were ages 26-35, 80% do not have any previous degrees in another field, and 20% of the sample
size already had a college degree prior to entry into the nursing program. The previous degrees
obtained were Biology, Speech Pathology, Psychology, and a Masters in Education. The
students were also asked if they had any prior work experience in a nursing-related job prior to
entry into the nursing program. The response was 27%, and these students either worked parttime or as needed, and the length of employment ranged from one to five years.
Motivation in Undergraduate Nursing Students
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Extrinsic and intrinsic motivators
The first survey question dealt with what motivates nursing students to learn. McKeachie
and Svinicki (2006) discuss intrinsic and extrinsic motivation. Extrinsic motivators are usually
rewards, recognition, and the approval of others. If students are intrinsically motivated, they are
usually learning because of the content or just for the pleasure of learning. Usually students will
have multiple reasons for their learning which causes them to have a variety of intrinsic and
extrinsic factors. There is also discussion of how performance goals and mastery goals fit in
with motivation. Performance goals are placing focus on performance and how one rates in
relation to others. Mastery goals are a desire to learn to understand and master the information.
In the phone survey, the students were given a variety of extrinsic and intrinsic
motivation choices to choose from and were asked to mark all that applied. The top five
motivators were to improve knowledge base (100%), grow academically (95%), grades (87%),
job security (87%), and parents and significant others (87%). These results show that these
students display both intrinsic and extrinsic motivators. This information was helpful in
understanding where the undergraduate students are coming from regarding their motivation and
how nursing educators can tailor their curriculum and advising to reflect these top areas. It
showed that all the students wanted to improve their knowledge base, but that their grades and
parental support are still very important to them.
As the author reflects upon her own academic journey, she has gone through many
phases of motivation. When reviewing the high school years, the author can clearly see that she
focused mainly upon performance and grades. Achieving the highest grades possible seemed to
be her only goal. When entering nursing school, her motivation changed slightly. She knew she
still wanted to obtain high grades, but she knew that she needed to retain the information to be
Motivation in Undergraduate Nursing Students
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able to apply it into her nursing practice. Once the author completed her AS in nursing, the BSN
component started to bring out a different side of her character. She was working full-time and
taking classes part-time. She still achieved high grades, but she enjoyed the classes and making
applications to her work setting. She felt like she was retaining more of the information she was
learning. After being out of the academic setting for almost 20 years, the author entered into
graduate school. The first semester found her entering into her performance only learning style;
however, once she entered into the role of a graduate teaching assistant, she enjoyed being able
to apply all the nursing graduate education material to her teaching of nursing students. She was
actually learning for pleasure. She was seeking additional information and not just learning the
material for a test or to make an A in the class. She found herself truly learning the material for
mastery of the skills.
Seeking academic assistance
Students can have high motivation but may also require academic assistance. They may
not be connecting with the theory component of the nursing classes or are having difficulty
applying the information into clinical situations on test material. Nursing faculty may have to be
open to a variety of ways to encourage students to ask for assistance. This information may need
to be reiterated many times during the course of study. It can also be very frustrating as an
educator when students don’t seek assistance. Several motivation learning theories can be
discussed which help to clarify why students do or do not seek assistance.
Bandura’s proposed Self-Efficacy Theory emphasizes the power of self-beliefs on
functioning, and it is defined as “beliefs in one’s capabilities to organize and execute the courses
of action required to manage prospective situations” (Lee, 2007, p. 469). Students who have a
high self-efficacy can handle a few disappointments and can learn from them. They don’t see
Motivation in Undergraduate Nursing Students
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themselves as total failures and will generally seek assistance to avoid further failures or
disappointments.
Maehr’s and Braskamp’s Personal Investment Theory is another social-cognitive theory
that focuses on how motivational resources are selected. Those selected have personal meaning
to the individual based on past experiences. It shows that individuals tend to have multiple goals
that they are hoping to accomplish (Ford, 1992). This theory is concerned with how students
choose to invest their energy, talents, and time in certain activities. It places focus on cultural
and social backgrounds and how this can cause differences in academic achievements. The
theory shows that there is diverse learning even between cultural groups. It emphasizes
subjective meaning based on a person’s belief system of self, goals, and pursuing these goals. It
also emphasizes that students may choose alternatives to meeting these goals (McInerney &
Etten, 2004).
Attribution Theory by Fritz Heider, Bernard Weiner, and Harold Kelley focuses on
events and behaviors. The basic principle states that a person’s perceptions of successes or
failures will determine how much effort they will apply to the situation or activity in the future.
This theory explains why students respond very differently to the same outcome. It further
outlines this into three aspects of causality. They are locus, which can be internal or external,
stability, and controllability. The locus component affects a person’s pride and self-esteem that is
developed after a certain event. A person’s stability affects their future expectations, and the
controllability can influence their future (Dembo, 2004; General Historical Overview, n.d.).
It is also important for nursing faculty to focus on retention of their nursing students who
are already enrolled in the program. Hopkins (2008) states that early predication of students’
success is important when planning and implementing interventions to assist in academic
Motivation in Undergraduate Nursing Students
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achievements. He states that colleges can create an atmosphere that provides support programs
for at-risk students. In addition, Hopkins states that students who are successful in their first
semester of college usually graduate from college.
In a qualitative study of 12 nursing students who explored their undergraduate
experience, four major themes were identified. These themes were the following: nursing
students frequently had difficulties meeting demands of college life, frequently felt
overwhelmed, felt unprepared, and needed respect and support from the nursing faculty. Their
answers to open-ended questioning gave insight into the challenges, stress, and satisfaction that
are experienced by nursing students. Nursing faculty can play a pivotal role in helping make the
undergraduate nursing experience a positive one and promote the profession (Magnussen &
Amundson, 2003).
The second question on the informal survey was designed to identify what activities
nursing students participated in most when seeking academic assistance or preparing for their
nursing classes. The top five activities were: took classroom content into the clinical setting
(100%), read information prior to class (80%), interacted with the instructor during class (80%),
asked question during class time (80), and asked questions via email (67%). The students also
stated that going to the schools tutoring program and making an appointment with the instructor
were beneficial as well.
This survey information shows how motivational theories and retention programs are
essential to the success of a nursing program. Nursing faculty must continually communicate
their availability to students. They must display a genuine interest in the students and engage in
dialogue with them. Nurse educators must also display that they are committed to the success of
their students and want them to further themselves in the field of nursing.
Motivation in Undergraduate Nursing Students
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Teaching strategies
Generation X students, those born between 1961 and 1981, and Millennial students, those
born between 1982 and 2002, are the majority of students that the nursing faculty are currently
educating. These groups of students bring many interesting challenges to the academic world.
They have been raised in a media-rich environment, have been the center of attention, have a
high self-esteem, and arrive into the college setting with many ideas of what they want to
contribute to their field of study. They don’t tolerate just being lectured to, they expect a mediarich teaching environment, and don’t always connect with nursing faculty who haven’t kept up
with the times. They expect their nursing instructors to give them frequent feedback and let
them have a balanced college life. Educating these students can be very challenging because
they want a variety of teaching strategies utilized in their education (Wieck, 2003). Halawah
(2006) stated that students are motivated when their teachers show genuine interest in them.
These teachers use new and interesting ways to instruct and use a variety of teaching strategies.
Students get involved and engaged in their learning by actively participating.
When students actively participate, they become more deeply engaged in the content of
the material. This allows them to find meaning in the material, respond to the information better,
organize the material, and process the information for learning. It is important to incorporate
many different active learning approaches to allow students to better facilitate learning. Students
will hopefully internalize the material when they have actively participated in the teaching
strategies (Caputi & Engelmann, 2005).
Malcolm Knowles developed the Theory of Adult Learning, otherwise known as
andragogy. Andragogy is defined as the art and science of helping adults learn. It is a very
complex theory, but it can be summarized into five main points. The first point is that adults
Motivation in Undergraduate Nursing Students
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need to know why they are learning something. They need to know how this new information is
going to directly affect them. Secondly, adults have so many life experiences that can be brought
into their learning. All these different experiences greatly enrich their learning. Thirdly, adults
need to utilize a hands-on approach to learning, not just memorization. The fourth key point is
that adults want and need to apply the new information immediately. They are not able to retain
the information as well if this does not occur. The last key point is that adult learners are
internally motivated. These key points are essential to review when designing educational
programs and teaching strategies for adults (Merriam, Caffarella & Baumgartner, 2007; Smith,
2002).
Identifying what teaching strategies these undergraduate nursing students most
appreciated in relation to motivation was question number three. The results identified the top
five teaching strategies that the students connected with the most as simulation (93%),
demonstrations/visual aids (87%), storytelling (87%), interactive discussions (80%), and quizzes
(80%). As the author soon begins her role as a nurse educator, this is significant information that
she can use as she plans her courses. The literature clearly provides evidence that using a variety
of teaching strategies and incorporating these top five strategies would be important in designing
the author’s lesson plans. It is also important to incorporate the key components of adult
learning theories. The author could stress the importance of implementing simulation into every
semester of nursing. Simulation could also be incorporated into the classroom lecture setting.
When the author develops her courses, it would be imperative to evaluate every assignment to
make sure it blends with the adult learning theory. The assignments need to be meaningful and
not seen as busy work. The assignments also need to show students how the information can be
applied to real nursing situations.
Motivation in Undergraduate Nursing Students
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Personal characteristics of nursing instructors
Due to the nursing shortage, nursing faculty must develop new ways to make nursing
appealing to college students. One way is to hire nursing faculty that display personal
characteristics that appeal to students. Wieck (2003) conducted a study of 176 nursing students
that looked at what personal characteristics they were looking for in nursing instructors. The top
five characteristics that were outlined in this study were the following: instructors who were
approachable, who communicated well, who were professional, were supportive, and
demonstrated understanding.
Tang, Chou, and Chiang (2005) conducted a study that consisted of 214 nursing students
from two different nursing schools that focused on identifying what characteristics are present in
effective clinical instructors. The major component discovered was that teachers’ attitudes
toward students are the critical difference between effective and ineffective teachers. Students in
this study also felt that if they had a good relationship with their instructors, they would be more
successful.
These studies prompted the last question of the survey which asked, “What top three
personal characteristics do student nurses value in their nursing instructors?” The top three
characteristics were approachable (73%), knowledgeable (53%), and good communicator (33%).
This informal survey was consistent with what is found in the literature. This information is
important to incorporate into the nurse educator role. Students must feel that their instructors
have respect for them, are approachable, are role models, have excellent clinical knowledge, and
provide adequate channels of communication.
The author has had the privilege of teaching clinical nursing to over 80 students. Each of
them comes to the clinical setting with a variety of skills and motivation. She has come to
Motivation in Undergraduate Nursing Students
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understand that the clinical instructor can have a great impact on the motivation of the students
and keeping the motivation going. She has found that she is able to have very motivated groups
by implementing just a few techniques. She begins the clinical experience by having the
students complete a questionnaire. This questionnaire focuses on identifying what the student
expects to accomplish during the clinical rotation, what concerns they have, and how they learn
best. She considers herself a role model, and she expects the students to display a high standard
of nursing care to their patients and perform at a high standard in their clinical paperwork and
projects. She then holds the students accountable to these high standards. She also enjoys
getting to know the students personally and displays a caring approach toward them. It is
important to understand that they have lives beyond just what is seen in the clinical setting. She
has spent a lot of time developing quality clinical assignments which create a variety of
opportunities and challenges for them. She expects the students to improve over the quarter and
celebrates their successes with them.
Nurse educators and clinical instructors have great opportunities to give back to the
profession of nursing by educating nursing students. They can work with these students in their
motivation and achievements. They can help them move beyond just learning for rewards or
grades and learn for the enjoyment of the experience and move from novice to expert in the
nursing field. They can teach them by using a variety of teaching strategies and educate them on
appropriate ways to seek academic assistance by understanding and utilizing a variety of learning
and motivational theories which provide a framework for guidance. The nurse educator must
also be a role model in professional behavior and display characteristics that appeal to nursing
students.
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References
Caputi, L., & Engelmann, L. (2005). Teaching nursing: The art and science (Vol. 1). Glen Ellyn,
Illinois: College of DuPage Press.
Dembo, M. H. (2004). Motivation and learning strategies for college success: A selfmanagement approach (2nd ed.). Mahwah, New Jersey: Lawrence Erlbaum Associates,
Inc.
Ford, M. E. (1992). Motivating humans: Goals, emotions and personal agency beliefs. Newbury
Park, CA: Sage Publication.
Hopkins, T. H. (2008). Early identification of at-risk nursing students: A student support model.
Journal of Nursing Education, 47(6), 254-259.
https://www.msu.edu/~dwong/StudentWorkArchive/CEP900F01-RIP/WebberMotivationOverview.htm
Halawah, I. (2006). The effect of motivation, family environment, and student characteristics on
academic achievement. Journal of Instructional Psychology, 33(2), 91-99.
Lee, C. J. (2007). Academic help seeking: Theory and strategies for nursing faculty. Journal of
Nursing Education, 46(10), 468-475.
Magnussen, L., & Amundson, M. J. (2003). Undergraduate nursing student experience. Nursing
and Health Sciences, 5, 261-267.
McInerney, D. M., & Etten, S. V. (2004). Big theories revisited. United States: Information Age
Publishing.
McKeachie, W. J., & Svinicki, M. (2006). Teaching tips: Strategies, research, and theory for
college and university teachers (12th ed.). Boston: Houghton Mifflin Company.
Murphy, F. (2006). Motivation in nurse education practice: A case study approach. British
Motivation in Undergraduate Nursing Students
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Journal of Nursing, 15(20), 1132-1135.
Smith, M. K. (2002) Malcolm Knowles, informal adult education, self-direction and andragogy.
Retrieved on May 15, 2009, from www.infed.org/thinkers/et-knowl.htm
Tang, F. I., Chou, S., & Chiang, H. (2005). Students’ perceptions of effective and ineffective
clinical instructors. Journal of Nursing Education, 44(4), 187-192.
Wieck, K. L. (2003). Faculty for the millennium: Changes needed to attract the emerging
workforce into nursing. Journal of Nursing Education, 42(4), 151-158.
Motivation in Undergraduate Nursing Students
Appendix A
Undergraduate Nursing Student Survey Results
June 2009
Demographics:
Male: 33%
Age:
Female: 67%
18-25: 67%
26-35: 33%
36+: 0%
Any previous degrees: Y: 20% N: 80%
Biology, Masters in Education, AS Speech Pathology, Psychology
Before starting the nursing program, were you employed in a nursing-related job?
Yes: 27%
No: 73%
If yes: Part-time: 3 Full-Time: 0 As needed: 1
Length of employment:
1 years – 3
5 years – 1
Survey:
1.
What motivates you to learn?
**Mark all that apply.
73%
87%
67%
87%
53%
93%
87%
100%
73%
Just for fun
Grades
Recognition
Parents/significant other
Approval of others
Grow academically
Job security
Improve knowledge base
Monetary value
Comments:
None
2.
What activities did you participate in during your last nursing class?
**Mark all that apply.
20%
80%
Sat on the front row
Interacted with the instructor during class
12
Motivation in Undergraduate Nursing Students
53%
80%
67%
100%
60%
80%
53%
Made an appointment with the instructor to discuss and review progress
Asked questions during class time
Asked questions via email
Took classroom content to the clinical setting
Refined notes after class
Read information prior to class
Other: ASAP tutoring
Comments
Sat on 2nd row – 3
One studied 20 minutes every day in preparation for nursing test
One student made note cards
3.
What teaching strategies motivated you to learn more?
**Mark all that apply.
60%
80%
67%
87%
73%
67%
53%
93%
80%
47%
87%
7%
Lecture
Interactive discussion
Video clips
Demonstrations/visual aids
Case studies
Small group discussion
Games
Simulation
Quizzes
Concept mapping
Storytelling
Other: supplements
Comments:
None
4.
What personal characteristics do you value in your nursing instructors?
**Mark your top three.
28% Integrity
27% Concern for others
27% Sense of humor
73% Approachable
0% Other:_____________
Comments:
None
27% Enthusiasm
0% Fairness
0% Influential
0% Flexible
20% Patience
20% Dedication
53% Knowledgeable
33% Good communicator
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