Strategies to promote academic motivation in nursing students: A qualitative study.

BACKGROUND: Academic motivation is highly important in nursing education. Providing high-quality nursing care requires students who have motivation to acquire information and skills. However, nursing students lose their motivation gradually during their program. Thus, the present study is aimed at elaborating on the strategies to improve academic motivation in nursing students.
MATERIALS AND METHODS: A qualitative study was conducted in Saveh University of Medical Sciences. The data were collected through focus groups and individual semi-structured interviews with forty nursing students, professors, and lecturers of nursing and midwifery school. The participants were selected through purposeful sampling method. This method is used for the selection of people who have had experience with or are part of the culture or phenomenon of interest. Data analysis was done as a continuous process through conventional qualitative content analysis.
RESULTS: The strategies to promote academic motivation of nursing students were categorized into four main categories including strategies pertinent to professors (empowering and motivating to improve the quality of teaching), strategies pertinent to students (creating positive attitude toward nursing, empowering, and encouraging academic achievement), strategies pertinent to clinical education (improvement of the quality of clinical training and optimization of the academic and clinical relationships), and strategies pertinent to faculty (providing extracurricular activities, proper curriculum programming, and educational and welfare facilities).
CONCLUSIONS: The strategies to improve academic motivation are available in different areas including professors, students, faculty, and clinical education. In general, improving the quality of education and creating positive attitude in nursing students increase their academic motivation.

Introduction

By definition, motivation is a process that stimulates and energizes physical and mental activities toward a specific goal.[1] Academic motivation is the driving force of academic studies,[2] and it is considered as an effective factor that determines whether or not students complete their program at school or college.[3] The importance of academic motivation lies with the fact that motivated students demonstrate more interest in dealing with learning activities and realizing achievements in educational environments.[14]

Motivation is one of the most complicated challenges in the way of today's teachers.[5] One of the common problems of educational systems is the low academic motivation in students, which leads to considerable educational, cultural, and economic losses to the state.[6]

Academic motivation is highly important in nursing training as providing quality nursing services needs students with enough motivation to receive a considerable amount of information and skills and undergo a continuous education process.[7] A positive and significant relationship between academic motivation and professional commitment in nursing students has been reported.[8] Moreover, nursing students with high motivation tend to suffer less academic depression and enjoy higher self-confidence.[91011]

Academic motivations and its causes vary between students and during the program. Changes in educational motivation might be due to clinical experiences and professional challenges from the aspect of students.[12] Studies have shown that, despite the fact that nursing students start the program with high motivation, their motivation declines throughout the program.[27131415]

Lack of academic motivation in students leads to deceleration of academic achievements.[1316] Since nursing profession deals with people's lives, the loss of motivation might have a destructive effect on the public health as well, which results in considerable capital losses.[6]

Taking into account the importance of academic motivation in nursing students and the challenges, this study is an attempt to elaborate on the strategies to improve academic motivation in nursing students.

Materials and Methods

The study was conducted as a qualitative analysis following content analysis approach. This study is part of an action research to design and implement a program to improve academic motivation in nursing students in Saveh University of Medical Sciences. Action research is a research paradigm that covers a range of research methods so that a group of researchers and participants cooperate to determine potential problems and feasible interventions.[17]

The study participants constituted forty members including 34 nursing students and 6 nursing professors and lecturers of Nursing and Midwifery School. To enrich the data, different participants (students at different levels and with different grade point average, age, and gender and professors and lecturers with different work experience) were selected based on purposeful sampling method. This method is used for the selection of people who have had experience with or are part of the culture or phenomenon of interest. In purposeful sampling, the goal for qualitative researchers is to develop a rich or dense description of the culture or phenomenon. The reason for choosing this sampling method was that it ensures rich data in qualitative studies.[18]

The data were collected through five focus groups with students and six individual semi-structured interviews with nursing professors and lecturers. Since the professors and lecturers did not have same free time, they were individually interviewed. The number of participants in the focus groups ranged from 6 to 8. Each focus group interviews lasted 90–120 min, and individual interviews took 45–60 min. The interviews were arranged in the most convenient time for the participants in council meeting room of the school. Each interview would be started with briefing the participants about the objectives and that their comments will remain confidential. Moreover, they gave their consent to participate in the study and voice recording. To start, the interviewer would bring in an open and general question; for instance, in the case of students, questions would be like “how does it feel being a nursing student?” followed by more specific questions throughout the interview. The more specific questions would be like “how do you evaluate your motivation to and interest in studying?” “what makes you lose your motivation for studying?” “what makes you feel more motivated to and interested in studying?” “what makes you study better?” and “what do you recommend to improve academic motivation in nursing students?”

The question that would be ask from the nursing professors and lecturers were “how do you evaluate academic motivation in nursing students?” “from your point of view, what factors affect academic motivation in students?” and “as a nursing professor (lecturer), what solutions do you propose to improve academic motivations in nursing students?”

Data gathering was continued until data saturation. Data analyses were conducted simultaneously with data gathering so that immediately (1 week afterward at most) after an interview, the content would be transcribed verbatim for encoding and analyzing. Data analysis was done based on conventional qualitative content analysis. To this end, the audio files and transcribed texts of the interviews were listened and read for several times to achieve a general perspective of the participants’ comments. Afterward, the interviews were reviewed for encoding. Throughout the reviewing, the primary codes were extracted and categorized based on the similarities and differences so that categories and subcategories were extracted.

To ensure reliability and validity of the data, Guba and Lincoln's criteria including credibility, dependability, transferability, and confirmability were used.[19]

The approaches to improve credibility in this study were creating long-term engagement with the participants and data, member check, and data triangulation. To carry out member check, all the proposed solutions and items in each interview would be summarized by the author and checked by the participants. Moreover, the transcribed and encoded interviews would be provided to the participants for confirmation and changes were made if necessary. Triangulation of the data would be conducted through interviewing different participants including students at different levels, professors, and lecturers with different work experiences.

To ensure confirmability of the data, all the interviews, codes, and categories were provided to an independent researcher to examine the codes and categories.

At so dependability of the data, all the stages and processes of the study were recorded in detail to make the study process traceable for reviewers.

With regard to transferability of the findings, the participants’ comments were presented without alterations. Moreover, demographic characteristics of the participants were reported for further examination by readers.

Results

Characteristics of the participants are presented in Table 1. Based on qualitative content analysis, 363 primary codes were extracted, which were then decreased into four main categories and 10 subcategories based on overlapping and combining the codes based on similarities and differences. Categories, subcategories, and codes are summarized in Table 2. The four main categories are explained in what follows.

Table 1

Characteristics of the study participants

Variables	Classification	Frequency (%)
Students (n=34)
Age	18−20	12 (35.3)
	21−24	16 (47)
	25−30	4 (11.8)
	31−35	2 (5.9)
Gender	Female	18 (53)
	Male	16 (47)
Education level (years)	1	8 (23.5)
	2	9 (26.5)
	3	9 (26.5)
	4	8 (23.5)
Being native	Yes	16 (47)
	No	18 (53)
Average score	18−20	8 (23.5)
	16−17.99	18 (53)
	14−16.99	7 (20.6)
	12−13.99	1 (2.9)
Teachers (n=6)
Age	28−30	2 (33.3)
	31−33	2 (33.3)
	39−40	2 (33.3)
Gender	Female	3 (50)
	Male	3 (50)
Academic degree	MS	4 (66.6)
	PhD	2 (33.3)
Scientific degree	Lecturer	4 (66.6)
	Assistant professor	2 (33.3)
Teaching experience (years)	1−5	2 (33.3)
	6−10	3 (50)
	10−15	1 (16.6)

Table 2

Categories, subcategories, and codes of strategies to promote academic motivation in nursing students

Categories	Subcategories	Codes (solutions to improve academic motivation)
Strategies pertinent to professors	Empowering professors	Holding workshops on effective relationships with students
		Holding workshops on student-centered teaching methods
		Holding workshops on the improvement of academic motivation
	Motiving professors for improving the quality of teaching	Appreciating hard working and motivated teachers
		Establishing a teaching quality improvement committee
		Providing a checklist to improve the quality of teaching to teachers
Strategies pertinent to students	Creating positive attitude toward nursing	Holding seminars on the role and position of nurses in the society
		Recognizing and honoring successful nurses
		Holding introduction meeting about nursing profession, especially for newcomers
		Holding sessions for answering questions of students about the profession
	Empowering students	Holding educational workshops as required for nursing students
		Providing more support for students by consultant professors
	Encouraging academic achievement in students	Recognizing top students (one to five) in the school journal
		Honoring top students in the presence of officials and other students
		Granting privileges for top students to attend festivals and other events
		Granting privileges to top students to receive loan, book coupon, and attending extracurricular programs
Strategies pertinent to clinical training	Improving quality of clinical education	Holding workshops for trainers about the principles of clinical training
		Preparing a checklist of the solutions to improve the quality of clinical training for trainers
		Using the same teacher for theoretical and training courses
		Providing educational and welfare facilities at clinical environment
	Optimization of the academic and clinical relationships	Holding coordination meeting with clinical nursing managers
		Holding workshop on establishing effective relationship with students for nurses
Strategies pertinent to faculty	Holding extracurricular activities for students	Holding physical training classes for students
		Holding cultural, pilgrimage, and leisure tours
		Holding briefing meeting for students to introduce extracurricular activities such as festivals and student competitions
	Effective curriculum planning	Planning free time after clinical training hours
		Assigning more hours and credits for specialized and applied courses and cutting the hours of general courses
		Limiting specialized courses to morning hours and beginning of the week
		Holding training courses along or immediately after theoretical courses
		Assigning fewer credits and general courses to students in their first semester to let them familiarize themselves with the new environment
		Paying more attention to recommendations of students about curriculum planning
	Providing educational and welfare facilities in faculty	Providing proper educational facilities such as well-equipped laboratory
		Improving facilities at study hall
		Providing sport facilities in faculty

Strategies pertinent to professors

The majority of the participants believed that the professors had the most important role in boosting or decreasing academic motivation in students. As a leader and role model for students, professors play a key role in educating and altering the attitudes of students. This makes professors a key influencer in the improvement of academic motivation of students.

Empowering professors

The participants believed that empowering professors, through holding educational workshops, in the areas of teaching and creating effective relationship with students, would lead to improvement of teaching performance and motivation of students. “Improving awareness and skills of professors and lecturers in using proper teaching methods can be effective in motivating students. Some professors might not be familiar with student-centered teaching methods. Holding workshops in this area can be helpful” (Nursing assistant professor).

Motivating professors to improve the quality of teaching

Quality of teaching is one of the key factors in academic motivation of students. According to the participants, one of the approaches to improve the quality of teaching is to motivate and incentivize professors. “Sometimes the lecturer might lack the motivation. As a faculty member, I can easily lose my motivation when I see that my hard work to improve learning performance of students in not recognized by the faculty” (Nursing lecturer).

Strategies pertinent to students

Creating academic motivations is not possible without focusing on these factors. Thereby, part of the strategies for promoting academic motivation has to be done with students.

Creating positive attitudes toward nursing in students

According to the participants, one of the reasons for lack of motivation in nursing students was lack of interest and negative attitude to the profession. One reason for this might be lack of knowledge about nursing and its role in the society. In light of this, it is helpful to hold familiarization seminars and meetings to introduce the profession to the students and clarify their ambiguities. “One reason for lack of interest in studying is that the students are not interested in their major. I think if the students are convinced that their role is not less than that of physicians and that their job is a valuable one, they will have more motivation and interest” (Student).

Empowering students

As noted by the participants, empowering students by holding educational workshops, focusing on educational condition of students, and supporting students to overcome educational challenges were effective in academic motivation. “Paying attention to educational performance of students will improve their motivations. Consulting professors should support students and be prepared to reward improvement in educational performance of students or examine the causes of probable decline in educational performance. If possible, they should solve student's problem” (Student).

Encouraging academic achievement

One of the approaches that can have a notable effect on academic motivation of students was appreciating academic achievement of hard-working students. The participants complained that their hard works in the school were not recognized by the officials. “I think there must be a difference between the student who gains better grades and those who fail. However, the school even does not bother to announce the name of top students” (Students).

Strategies pertinent to clinical education

The majority of the participating students noted that their academic motivation and interest in nursing have altered after entering clinical training stage. Nursing is a clinical profession, and one-half of the trainings take place at clinical environment. Therefore, the clinical environment is effective in the motivation or demotivation of students.

Improvement of clinical training quality

The participants believed that improvement of clinical education quality through employing scientific principles in trainings, empowering clinical trainers, recruiting experienced trainers, and providing educational facilities and a decent training environment would lead to academic motivation of students. “I think using experienced trainers in clinical training is a great academic motivation for students. Students will be more interested in clinical work when they have knowledgeable and experienced trainers” (Lecturer).

Optimization of the academic and clinical relationships

The quality of relationships at clinical setting was effective on academic performance of students. The participants believed that the improper way by which some nurses treat students and lack of coordination between education and clinical relationships disturb clinical education of students and decrease academic motivation in them. “Nurses and personnel in hospitals do not know how to treat students or what to expect from students. They expect everything from students, even doing noneducational services” (Student).

Strategies pertinent to the faculty

Planning extracurricular activities for students

The participants believed that holding extracurricular activities such as sports events, cultural works, and leisure activities along with educational activities was effective in the academic motivation of students. In some cases, however, the students were not aware of such activities and this calls for better public informing services. “Extra-curricular activities open the minds of students and make them better study and ensure good physical and mental health in them” (Student).

Proper curriculum programming

Some of the participants noted that they were not satisfied by the curriculum planning of their school and proposed solutions for improvement. “One of the factors that decrease educational motivation is squeezed timetable of the courses. After spending the whole morning in the hospital, we do not have the energy to spend the afternoon in classroom let alone paying attention to professor and learning” (Student).

Provision of educational and welfare facilities

The participants believed that lack of educational and welfare facilities at the school had negative effect on students’ academic motivation. Therefore, some highlighted the necessity of providing educational and welfare facilities at the school. “Students will learn better if they enjoy a more decent educational environment at the school. For instance, having equipped labs to hold parasitology class in it so that students could watch actual parasites by microscope is surely effective in improving their motivation” (Student).

Discussion

The strategies to improve academic motivation are available in different areas including professors, students, clinical education, and faculty. Part of the strategies was extracted directly from the participants’ comments, and another part was determined based on the problems highlighted by the participants.

Part of the motivational strategies was focused on professors. Several studies have noted the role of professors in creating academic motivation in students.[1520212223]

Empowering professors through holding educational workshops can have a positive effect on the awareness and skills of professors in establishing proper relationship with students and motivating them. Communication and teaching skills determine if a teacher is successful in his/her work or not. These skills play a notable role in motivating students.[2124] Consistent with the findings of the present study, Ghadami et al. emphasized on the importance of improving communication skills of professors and recommended holding workshops in this area.[25] Incentivizing professors to improve the quality of teaching along with empowering them may lead to the improvement of academic motivation in nursing students. Schiefele reported that teachers can motivate students through implementing better class managements and utilizing proper teaching methods.[26]

According to the participants, creating positive attitude and interest in nursing was effective in academic motivation of students. Many authors have noted the relationship between interest in the field of study and academic motivation in nursing students.[2728] Negative thoughts about the major, which is mostly rooted in lack of information, and the effect of peers and friends who are not aware of nursing profession are among the demotivating factors in nursing students.[15]

Empowering students through holding educational workshops that they need and paying more attention to their education performance were among the strategies pertinent to students. Consistently, Aghajari et al. reported that holding life skill workshops for nursing students was effective in their learning motivation.[29] Empowering students increases self-efficacy in them. Studies have reported a positive and significant relationship between self-efficacy and academic motivation in nursing students.[103031]

Encouraging educational achievement in students was another motivating strategy. Recognizing top students improves self-confidence and interest in studying in them. Consistently, Jones based on his motivational model reported that one of the factors that motivates students is to pay attention to the educational achievement.[4]

The strategies pertinent to clinical education were another main category. Nursing is a clinical profession so that clinical education is a key and inseparable part of nursing education with notable role in the development of professional skills in students.[32] According to the participants, improvement of clinical, educational quality affected the motivation of nursing students. Consistently, Jasemi et al. reported that improving the quality of clinical education through recruiting capable trainers with good communicational skills could motivate students.[33] The participants believed that improvement of the relationships between students and personnel and nurses, in particular, was another effective factor. Consistently, Hanifi et al. showed that the quality of communication and the way nurses interact with students were effective in academic motivation of nursing students.[34]

Another main category was the strategies pertinent to the faculty. Some authors have highlighted the direct effect of educational system on academic motivation of students.[35] According to the participants, efficient curriculum planning is an effective factor to motivating students. Consistently, Najafi Kalyani highlighted that ineffective curriculum planning was one of the factors that decreased motivation in students.[36] Moreover, one reason for nursing students’ dropout during the early stage of the program, in particular, was the heavy load of classes.[37] Given these, it is essential for the curriculum planners and teachers to take learning interests and capabilities of students into account in planning and teaching.[27] Provision of educational and welfare facilities was another solution for motivating students. Consistently, Hamjah et al. noted that providing students’ financial aid and learning facilities was effective in students’ motivation.[38] Emotions such as pleasure, interest, and happiness which are achieved through appropriate educational and welfare facilities will enhance the student's motivation and increase academic and educational activities.[39]

The results of this study can be used as a guide for officials, planners, professors, and lecturers to design academic motivation-boosting programs. Moreover, each one of the strategies mentioned here can be further examined through experimental studies.

Conclusion

The strategies to improve academic motivation are available in different areas including professors, students, faculty, and clinical education. The findings of this study can be used as a guideline for officials, planners, and professors of nursing to design academic motivation improvement programs for nursing students.

Financial support and sponsorship

The article has been derived from a PhD thesis. The study was financially supported and granted by Iran University of Medical Sciences Grant No. 96-02-28-31534.

Conflicts of interest

There are no conflicts of interest.