Learner Motivational Strategies In Nursing Education
Whats Are Motivational Strategies
Finding the spark that motivates the learner to learn is challenging to the educator. The question remains, how does an educator motivate a seemingly unmotivated individual or help a motivated person to remain motivated? As noted earlier, incentives viewed as appeals or inducements to motivation can be either intrinsically or extrinsically generated. Incentives and motivation are both stimuli to action. Bandura (1986), for example, associate’s motivation with incentives.
He notes, however, that intrinsic (internal) motivation, although highly appealing, inclusive. Only rarely does motivation occur without extrinsic (external) influence. Green and Kreuter (1999) note that “strictly speaking we can appeal to people’s motives, but we cannot motivate them” (p. 30). Extrinsic incentives are used for motivational strategics in the educational situation.
Cognitive Evaluation of Motivation In Nursing Education
Cognitive evaluation theory (Ryan & Deci, 2000) posits that knowing how to foster motivation is essential because educators can- not rely on intrinsic motivation to promote learning. They note, however, that autonomy and competence are intrinsic motivators that can be enhanced by selected teaching strategies.
One contemporary nursing educational strategy suggested that a way to promote motivation is concept mapping, which enables the learner to integrate previous learning with newly acquired knowledge through diagrammatic “mapping.” As a motivational technique, concept mapping facilitates the acquisition of complex new knowledge through visual links that acknowledge previous learning.
Learner interest is sustained by perceived competence and autonomy. Concept mapping, as a less instructor regulated learning activity, promotes interest and value on behalf of the learner. A review of the health professions” literature indicates that students and faculty find concept mapping to be a valuable learning exercise (Hunter Revell, 2012; Taylor & Littleton-Kearney, 2011; Torre et al., 2007; Wilkes. Cooper, Lewin, & Batts, 1999).
Motivational strategies for the nurse as educator are extrinsically generated using specific incentives. The critical question for the nurse as educator to ask is, “Which specific behavior, un- der which circumstances, in which time frame. may be desired by this learner?”.When a variable is absent or reduced, incentive strategizing is likely to move the individual away from the desired outcome.
When considering strategies to improve learner motivation, Maslow’s (1943) hierarchy of needs also can be taken into consideration. An appeal can be made to the innate need for the learner to succeed, known as achievement motivation (Atkinson, 1964).
In an educational setting, clear communication, including clarification of directions and expectations, is critical. Organization of material in a way that makes information meaningful to the learner, environmental manipulation. positive verbal feedback, and provision of opportunities for success are motivational strategies proposed by Haggard (1989). Reducing or eliminating barriers to achieve goals is an important aspect of maintaining motivation.
Attention, Relevance, Confidence, and Satisfaction Model In Nursing Education
One model developed by Keller (1987). known as the attention, relevance, confidence, and satisfaction (ARCS) model, focuses on creating and maintaining motivational strategies that can be used for designing instruction. This model emphasizes strategies that the educator can apply to effect changes in the learner by creating a motivating learning environment:
Attention introduces opposing positions, case studies, and variable instructional presentations.
Relevance capitalizes on the learners’ experiences, usefulness, needs, and personal choices.
Confidence deals with learning requirements, level of difficulty, expectations, attributions, and sense of accomplishment.
Satisfaction pertains to timely use of a new skill, use of rewards, praise, and self evaluation. In motivational strategizing, it would also be beneficial to consider Damrosch’s (1991) proposal that client health beliefs, personal vulner ability, efficacy of proposed change, and ability to effect the change are important in-patient education efforts.
Beliefs are a major construct proposed by Wright et al. (1996) as the heart of healing in families. Facilitating beliefs can promote a desired change, whereas constraining beliefs can restrict options. Challenging constraining beliefs and promoting facilitating beliefs are, therefore, offered as motivational strategies.
An understanding of the individual’s mental representations or beliefs also is foundational to the commonsense model in the representational approach to patient education (Leventhal & Diefenbach, 1991), Beliefs constitute an under acknowledged and understudied phenomenon that needs to be further developed in the education literature in terms of motivational strategics.
Motivational Interviewing as Motivational Strategy in Nursing Education
Motivational Interviewing (MI) is an other motivational strategy the nurse educator can use with learners (Droppa & Lee, 2014). It is a client centered, directive counseling method in which clients’ intrinsic motivation to change is enhanced by exploring and resolving their ambivalence toward behavior change (Miller & Rollnick, 2013).
The purpose of MI is strengthening the motivation of an individual to change. MI is a useful collaborative communication technique that facilitates engagement of patients in changing health behaviors (Howard & Williams, 2016).
Collaborative conversations are arranged in MI in a way that facilitates an individual talking one-self into changing (Miller & Rollnick, 2013). Dart (2011) states that “motivational interviewing fits perfectly into the nursing profession” (p. 23) and represents a caring, respectful tool with which to promote behavior change.
MI is a rapidly diffusing, empirically supported approach to health behavior change (Antiss, 2009). Both as an assessment strategy and as an intervention, MI supports client self- esteem and self-efficacy though emphasis on the client’s own reasons and values for change (Miller, 2004).
According to Miller (2010), the theoretical underpinnings of MI include Festinger’s (1957) cognitive dissonance theory, Bem’s (1967) self-perception theory, and Bandura’s (19776) self efficacy theory.
Carl Rogers’s (1951) work on non directive counseling and the FRAMES set of data about the effective components of brief interventions for change (Bien, Miller, & Tonigan, 1993) also provide foundational relevancy for this counseling method (Miller, 2010), as does self determination theory (Markland, Ryan, Tobin, & Rollnick, 2005).
The MI approach integrates well with two health behavior models discussed later in this chapter: the transtheoretical model of change (Prochaska & DiClemente, 1982) and the therapeutic alliance model (Barofsky, 1978). MI was initially used in substance abuse treatment with adults, where it was developed as a reaction to the confrontational methods used in that field in the 1970s and 1980s.
In this counseling approach, the nurse as educator avoids telling a patient what he or she needs to do. Rather, the interview is a collaborative venture between nurse and patient whereby a positive atmosphere is created through a partner-like relationship. The nurse guides rather than directs the patient.
This approach stands in contrast to the classic relationship of expert provider and passive recipient (Miller, 2004) that is often seen in the traditional medical model. With MI, the learner has more autonomy and the nurse is less of an authority figure.
Nurses can ask patients useful questions that guide the direction of this counseling approach, such as what changes are most important to them, how confident they are in being able to make changes.
What do they see as the benefits or drawbacks in making changes in their lives, and how might their lives be different if they carried through with one or more of changes (Rollnick, Butler,Kinnersley, Gregory, & Marsh, 2010)? According to Miller and Rollnick (2013), the spirit of MI includes collaboration (as opposed to confrontation), evocation (as opposed to education), and autonomy (as opposed to authority).
Because change is ultimately the patient’s responsibility, this approach encourages motivation for change to come from within rather than being imposed from the outside. Overall, MI is a form of patient empowerment, with the goal of helping patients gain control over the most important lifestyle management decisions affecting their well being (Soderlund, Nilsen, & Kristensson, 2008).
It consists of two phases: in the first phase, the nurse helps the patient enhance intrinsic motivation for change; in the second phase, commitment to change is strengthened (Miller, 2010, Miller & Rollick, 2013).
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