May 3, 2013

Motivating the Unmotivated

by Kristin Ho, Pharm.D., PGY1 Pharmacy Practice Resident, Walter Reed National Military Medical Center

Over the past year, I’ve served as a co-preceptor for students who are completing advanced pharmacy practice experiences.  I find it is much easier to interact with students who are motivated and want to complete the rotation at our institution.  It’s challenging when students lack motivation and my inexperience as a preceptor doesn’t make it any easier!  But I’m not alone.  According to a survey conducted at the University of California, San Francisco School of Pharmacy, many preceptors don’t feel very confidence in their ability to identify and manage the unmotivated student.  A majority of the survey respondents (61.5%) stated they had difficulty determining the reason why a student was unmotivated and 69.1% wanted more training on how to engage and motivate students.1

What is motivation?

Motivation is "a student’s willingness, need, desire, and compulsion to participate in, and be successful in, the learning process."2 There are two forms of motivation: intrinsic and extrinsic. Intrinsic motivation comes from an internal desire – formulated from both cognitive and emotional processes in the brain – to perform a task.  In other words, the student perceives the task to be "in and of itself" to be rewarding.  Extrinsic motivation is driven by external factors unrelated to the task.  Under these circumstances, the task is performed to gain some reward or avoid a punishment that is associated with, but not intrinsically a part of, the task.3 Intrinsically motivated students tend to do better because they are eager and willing to learn without inducement. Conversely, extrinsically motivated students must be encouraged, persuaded, cajoled, or, in extreme cases, coerced to perform the task.

Whether the lack of motivation is attributed to intrinsic or extrinsic factors, it is important to identify the reasons why students are unmotivated in order to appropriately address the problem.  Some reasons why students are not motivated and clues that can help you to identify students are: 4

Student engages in negative self-talk about abilities and/or by makes faulty attributions to explain poor performance
Lack of confidence
Student procrastinates, verbal complains, frequent seeks teacher’s help, and other avoidant behaviors
Effort needed to complete work seems too much or unrealistic
Student requires praise or rewards as a ‘pay-off’ in order to apply greater effort 
Fails to see a pay-off in doing the assigned work
Student display indifferent or hostile behavior toward instructor or preceptor
Negative relationship with instructor or preceptor

How to motivate unmotivated students?

If the students’ lack of motivation stems from fear of failure, preceptors should encourage students to focus on their improvements and help them evaluate their progress by encouraging them to critique their own work. This method, called attribution retraining, helps the student look for the explanations for their successes and failures. The goal of attribution retraining is assisting students in concentrating on the tasks rather than being distracted by their fear of failure.  Preceptors and instructors can help the student identify alternative methods or approaches to a problem instead of giving up; and attributing the student’s failures to ineffective strategies rather than a lack of ability.5  For example, a student may attribute poor clinical judgments to an inherent lack of ability. If the student believes he/she cannot succeed during the rotation, there is less motivation to strive for success. If a student perceives writing SOAP notes as being too difficult, the preceptor should use attribution retraining by encouraging the student to practice with hypothetical case studies so the task becomes easier when the student encounters real patients.

Positive or negative feedback influences motivation.  When a preceptor praises a student, this extrinsic motivator boosts self-confidence. Preceptors should acknowledge sincere efforts even when the student’s performance is less than stellar. If the student’s performance is weak, providing feedback for improvement as well as assure that he/she can improve and succeed over time. Before the preceptor provides feedback, ask the students to reflect on their perceived strengths and weaknesses to determine whether the students’ self-assessment is accurate. If the preceptor and student are in agreement, the preceptor can affirm the strengths and provide encouragement. This should be followed by a discussion of perceived weaknesses.  This will give the preceptor some insight into what the student identifies as areas that need improvement and facilitates goal setting for future performance.6

Most importantly, preceptors should display enthusiasm in teaching and a personal interest in the student to build a positive relationship. This can be achieved by tailoring the rotation to the student’s interest. Students are naturally more motivated to succeed when their interests are considered in the rotation plan. Therefore, constructing approaches to help the student realize how each learning activity relates to his or her personal and professional goals can improve motivation. For example, if a student has accepted a community pharmacy position and has no interest in acute care, it might be helpful to include more patient counseling during the rotation.  This learning activity would provide the student with more one-on-one patient interactions and boost confidence when speaking to patients.

Motivation is a powerful force. As preceptors and instructors, it can be challenging to motivate unmotivated students. However, identifying students who are unmotivated by paying attention to clues and addressing the problem with an appropriate method to encourage motivation is a valuable teaching tool. This resonates with me!  One of my preceptors reminds me that it’s easy to teach the intrinsically motivated students, but the truly great preceptor is one who can increase the unmotivated student’s desire to learn  … and achieve the intended learning outcomes.

1.  Mitra A, Robin CL, Peter AJ, et al. Development needs of volunteer pharmacy practice preceptors. Am J Pharm Educ 2011;75: Article 10.
2.  Bomia L, Beluzo L, Demeester D, et al. The impact of teaching strategies on intrinsic motivation. Educ Resour Inf Cent. 1997. ED418925
3.  Ryan RM, Deci EL. Intrinsic and Extrinsic Motivations:  Classic Definitions and New Directions.  Contemp Educ Psychol. 2000; 25 :54-67.
4. Wright, J. Six reasons why students are unmotivated (and what teachers can do). Intervention Central [Internet]. 2011. Accessed April 11, 2013.
5.  Lumsden LS. Student motivation to learn. Educ Resour Inf Cent. 1994. ED370200
6.  Orsmond P, Merry S, Reiling K. Biology students’ utilization of tutors’ formative feedback: a qualitative interview study. Assess Eval Higher Educ. 2005; 30:369-86.

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