Exploring the Factors Affecting the Motivation for Learning from the Perspective of Public Health Students: A Qualitative Study

Highlights

• Public health students have different needs in order to preserve and increase motivation for learning.
• The family, university, and student play pivotal roles in the motivation for learning; and the attitude of society, authorities and policymakers towards the health status is of special significance.

Abstract

Objective. Despite the significant role of motivation in achieving success among public health students, students often do not demonstrate adequate motivation for learning and education. This study was performed to determine factors affecting the motivation for learning from the perspective of public health students via content analysis approach. Methods. This qualitative study was conducted at Kurdistan University of Medical Sciences in Sanandaj, Iran in 2017. 15 students were included in the study by using purposive sampling. Data were collected through personal interviews, group discussions, and field notes, and they were analyzed through conventional content analysis. Several parameters were taken into account to support the accuracy and the strength of the data: acceptability, confirmability, and transferability. Results. Five categories were derived from the data analysis, including “University Policy”, “Health Status”, “Teacher’s Role”, “Student-Related Factors” and “University Facilities”. Attention to the health status and its priority in the opinion of people, authorities, and educational system were the most important factors involved in the students’ motivation for learning. Conclusions. To increase motivation for learning, students have diverse needs that should be met. Attention to the components of motivation for learning not only enhances academic achievement but also promotes the formation of health behaviors in the society.

Introduction

The main mission of the university, the most important center of education and research in every country [1], is training the necessary expert manpower, promoting and developing knowledge, expanding research, and providing favorable grounds for the development of the country [2].

Students, the future human resource of the community, need motivation to achieve academic success and to provide quality services [3,4,5]. Motivation is defined as the desire of a person to perform activities. Lack of motivation causes pessimism, anxiety, and failure in learning [6,7]. Students, as a vulnerable group, may experience changes in motivation for learning due to various reasons such as separation from family and experiencing new social communications [5,8]. Students and health personnel urgently need motivation for cooperating with people and other organizations, undertaking health-related responsibilities, recognizing the problems, and planning and implementing the programs. They need to be motivated enough to learn and acquire the skills related to their major [9,10].

Despite the important role of motivation for learning among public health students, studies have shown that this group of students does not possess sufficient motivation for learning and education, and further, that they experience depression more often than students of other health sciences and medical majors [1,11]. Several domestic and international studies have attributed students’ motivation for learning to factors such as providing feedback, students’ encouragement, educational methods, teacher’s behavior [6], major, environmental factors, and educational facilities of universities [12,13]. However, these studies have been carried out using a quantitative approach and have not investigated the students’ perspectives, especially public health students, about the components of motivation for learning. The researchers in this study attempted to identify factors affecting the motivation for learning from the point of view of public health students. The identification of factors affecting an event in the opinion of the people who have experienced it through a qualitative approach is a necessary step for designing interventions and preventive programs [14].

In general, a number of factors instigated this study, including the significance of motivation in students’ learning [6], the effect of social, environmental and personal factors in creating motivation, and failure to recognize these factors from the students’ point of view [15,16]. In addition, the low motivation of public health students for learning [12], prevalence of depression among public health students [11,13], the role of motivation among public health experts in dealing with people [9,10] and the significance of qualitative studies in enhancing the insight to the understanding of the human experiences [17] further encouraged us to investigate the factors influencing the motivation for learning from the point of view of public health students.

Materials and Methods

Using conventional content analysis, this study explored the factors affecting the motivation for learning from the perspective of public health students in Kurdistan University of Medical Sciences in Sanandaj, Iran in 2017. 15 students were chosen and interviewed using purposive sampling. Inclusion criteria were being a public health student at Kurdistan University of Medical Sciences and willingness to participate in the study. An exclusion criterion was freshman status in public health (first-semester student in public health).

Data were collected through personal and semi-structured group interviews and note-taking during and after the interview. The first author, who had been trained to conduct interviews, collected the students’ comprehensive information and experiences about the components influencing the motivation for learning following permission from the research council of Kurdistan University of Medical Sciences. The main items included “Please express your experiences about success in learning in the courses during your education” and “Please express your experiences about the challenges and barriers in learning during schooling”. Based on the responses, follow-up questions were asked. At the end of each interview, a summary was written. The mean durations of group and individual interviews were 49 minutes and 32 minutes, respectively. The interviews were conducted in a quiet classroom or counseling room at the university. The data collection ceased when data saturation occurred, that is, no new information emerged [18]. The data were obtained via five individual interviews, two group discussions (two five-member groups), and field notes, and were analyzed simultaneously. Five-member groups were selected based on the inclusion and exclusion criteria. Focus group interview was used to generate information on common views and achieve the comprehensive understanding of the participants' experiences. The seven stages of the interview, including thematizing, designing, interviewing, transcribing, analyzing, verifying and reporting were taken into consideration [19].

Data analysis was carried out through conventional content analysis [20]. First, the interviews were transcribed and studied several times for general insight. The meaning units were determined and the relevant codes were extracted and included in subcategories according to similarity, fitness, and matching. The subcategories were also converted to categories, and themes were finally determined. The highest variations of samples were found for age, gender, semester, family income, and motivation for the learning score (the motivation for the learning questionnaire has 35 five-point items with a cutting point of 87.5) [21]. With the maximum variation sampling, we tried to include all the extremes in the population. When using a maximum variation sampling method, the researchers selected a small number of units or cases that maximize the diversity relevant to the research question.

MAXQDA (version 10) software was used to facilitate data analysis during the process of going back and forth, listing and classifying, repeated comparison of different data, and retrieval of quotations [22]. For the sake of accuracy and strength of the data, the acceptability of the data along with a review of the accuracy of the statements expressed by the participants in the manuscripts, long-term involvement of researcher with the data, establishing a good communication with participants, and gaining their confidence in the researcher were ensured. The confirmation of findings was done by reviewers in the sense that some parts of the interviews, codes, and themes were reviewed by specialists and analyzed by experts. The credibility of the results was ensured by immediate transcription, accurate record of the procedures, integration of the data collection methods, and integration of time and place [20,23]. The present study was approved by the research council of Kurdistan University of Medical Sciences. After going through all legal procedures, taking permission, and signing the informed consent by the participants, the objectives of the study were explained to them. Confidentiality of the obtained data was also assured.

Results

A total of 7 men and 8 women participated in the study. The demographic characteristics of the respondents are presented in Table 1. The data analysis yielded 589 primary codes, which were reduced to 84 codes after integrating them in terms of similarity and matching, 24 subcategories and 5 major categories, including “university policy”, “health status”, “teacher’s role”, “student–related factors” and “university facilities”. Table 2 shows the categories, subcategories, and comments of participants on the factors affecting their motivation for learning.

University policy

The University policy was classified into seven subcategories (Table 2). Students stated that financial and spiritual support, freedom, and security should be in line with the increase of their motivation. One student (participant₁₁) said: “The University can give needy students book coupons or loans … . Counseling can also be very helpful. Several students who wanted to quit university became interested in their major after counseling”. Another student (participant₁₃) stated: “Walking comfortably in the campus and having some kind of psychological security is very good”. The student stated that when the university assigns responsibilities to students and students feel they are involved in the university affairs, they make more effort. The participants mentioned that the university can make families familiar with the student’s problems and related solutions by holding meetings. One student (participant₉) said: “When students enter a new environment like the university, they may face a series of problems due to being away from their families.”

Participants declared that practical training is important because it helps students develop skills and abilities that support professional studies and prepare them for their future careers. The students stated that establishing financial associations and holding recreational programs would increase their motivation. One student (participant₆) said: “When I attend cultural and art communities, I don’t feel bored and I feel like being useful”. Another student (participant₉) mentioned that “Every human has his/her own potential and capacity in any situation…. When you are preoccupied with your lessons, you get disappointed. Organizing a recreational camp or a concert is very helpful”. It can be inferred from the students’ comments that the university would achieve its objectives and missions if it provides a favorable ground not only for education but also for students’ motivation. An interesting finding of this study was that students tended to be independent, i.e., not dependent on their families, but in practice they wanted a mutual interaction between their families and the university. However, they reported there was no relationship between their families and the university, which affected their motivation for learning.

Health status

The health status category was divided into two subcategories (Table 2). Students often complained about the negative attitude of society towards health. The students mentioned that people ignore the efforts of the health personnel and consider the work of the treatment staff more valuable. One student (participant₁₄) said: “When you say your major is public health, people ask you what the benefit of your major is. People prefer treatment….”.

The participants stated that job security in the future was their main concern during education and the most influential factor involved in the motivation for learning. One student (participant1) stated that “Job prospect should be in the public sector, which is not actually true. Public health has no position in the private sector either; in general, it has no job guarantee. There is a real discrimination between this major and other majors; even the equipment and resources in this major are limited”. It can be inferred from the participants’ comments that the absence of job security will cause an unemployment crisis, change the attitude towards health majors, and bring about undesirable psychological consequences among health sciences students.

Table 1. Characteristics of study participants

Table 1. Characteristics of study participants

The teacher’s role

The teacher’s role was organized into five categories (Table 2). The students reported that teachers have a constructive role in their education, and their passion, love, and skills have a significant impact on their motivation for learning. One student (participant₁₄) said: “Some teachers make use of various teaching methods; for example, they make students participate in conferences and ask them questions, which enhances their learning”. The students said that the teacher’s behavior and ability in teaching make students more motivated. One student (participant₁₂) stated that “The information provided by the teachers, the teachers’ mastery, and skills in teaching provide students with motivation. Therefore, the students will want to become similar to their teacher someday”. The student declared that the teacher’s physical health is an important factor affecting the motivation for learning. One student (participant₁₁) said: “A teacher who talks well, has no hearing nor speaking problems, and is physically sound gives you energy”.

As for the teacher’s psychological health, another student (participant3) mentioned: “You know, I think a teacher who controls his/her emotions has concentration skills, is hopeful and happy, and can transfer his/her happiness to students, thereby helping students concentrate more on learning”. It is inferred from the students’ statements that the behavior and activities of teachers affect their learning directly and indirectly, and their attributes, behaviors, attitudes, and beliefs are transferred to the students. The students frequently emphasized the effect of the teachers’ role and behavior on their life and destiny.

Student-related factors

This category was organized into seven subcategories (Table 2). Students stated that they were interested in their major because it was related to human health and was useful to them, their family, and society. Moreover, they mentioned that the student’s communication skills, creativity, interests, and effort definitely affect their success and motivation. One student (participant₁₃) stated that “The more you make a stronger connection with the teachers, the more advice you can get from them… When you make friends with more motivated and studious students, you pay more attention to your lessons because you want to be at the same level with them”. Most of the students declared that family and physical and mental health can be very effective in one’s life and academic achievement. One student (participant₁) said: “If you stutter, you lose your self-confidence… You always think others make fun of you… It really affects your learning”. Another student (participant₁₁) mentioned: “When I am stressed or anxious about something, I can no longer concentrate on my lessons. Do not bother someone who is suffering from a mental disorder”. Some students did not realize the importance of participating in extracurricular activities outside Academia during their time at their university, while others emphasized it. One student (participant₅) said: “Being involved in non-academic activities such as cultural and political activities enlightens students more and more, thus affecting learning”. The students considered their personal characteristics to be very important in learning and asserted that the best and the most enduring learning would occur when personal factors were compatible with the learning conditions. The students were also pleased with the university measures and activities which influence their motivation for learning.

Table 2. Categories, subcategories and codes regarding the factors affecting the motivation for learning

Table 2. Categories, subcategories and codes regarding the factors affecting the motivation for learning

University facilities

The university facilities consisted of three subcategories (Table 2). The students considered educational facilities the main component of education and viewed their quality very important to student-teacher communication. One student (participant7) stated: “Supplementary materials create variety in the classroom; one feels less tired and learns the materials better”. Another student (participant₆) mentioned: “The light and the color of the classroom, even the exterior view, and the facilities of the faculty are not appropriate, take a look at other faculties such as medicine. You like to stay in its campus, while our faculty has no green places and proper exterior view”. Regarding the university amenities, one student (participant₈) said: “The fact that you have no concern for food and commuting and a series of recreational equipment exists within the university increases your concentration on the lessons”. In the opinion of participants, the use of up-to-date educational equipment in a proper educational environment created an appealing space that promoted the quality and persistence of education and affected the depth and speed of the motivation for learning.

Discussions

Dramatic advances in the current world are the outcome of learning. Motivation is one of the requirements of learning, a factor involved in its maintenance and continuity. Meanwhile, the motivation for learning among students, especially public health students, is of great significance to preserve and promote heath in the society [9,10].

This study is the first qualitative study that attempted to explain the factors affecting the motivation for learning from the perspective of public health students. The findings showed that university policy, health status, teacher’s role, student-related factors, and university facilities were pivotal factors involved in their motivation for learning. In their study, Nabavi and Asgarian reported that the motivation for learning was a phenomenon influenced by the environment and factors such as psychological characteristics, personal desires, interest in the major, educational equipment, and surrounding stimulants [24].

Also, Amini et al. showed that the internal factors affecting the motivation for learning among students in the clinical years were student’s competence and talent for clinical learning, student’s interest in the major, and student’s personal characteristics, whereas the external factors included teacher’s interest in teaching, occupational and social status of the graduates and encouragement [25]. The study of Karimpour Azar et al. indicated that supplying standard facilities in the university such as high-speed internet and library access influenced the public health students’ motivation for learning [12].

Moreover, the results of Bakhshandeh Bavarsad et al. showed the significance of the teacher’s attitude towards students’ motivation, which is in line with the results of the present study [26]. Ghadirzadeh et al. reported the students’ personal qualifications, the teacher’s teaching method, and course content were factors affecting the students’ motivation for learning [27]. Ur-Rahman et al. found that students’ achievements during education and their satisfaction with this period affected their motivation for learning [28].

In addition, in their qualitative study, Fallahi et al. reported that student’s self-esteem, spiritual and physical health, and life skills, as well as the teacher’s behavior, were important factors involved in inducing motivation among students [5]. According to the self-determination theory by Ryan and Deci, social relations and a sense of belonging, personal competence, and satisfaction with life affect an individual’s motivation [29]. Cheng and Jang showed that meeting the basic psychological needs leads to intrinsic motivation, which would be followed by satisfaction with education [30].

Domestic and international studies have attributed students’ motivation for learning to the teacher’s behavior and teaching [6], university equipment, and environmental factors [12], but few studies have explored the status and value of the public health major as well as the university policy for inducing motivation among public health students. The attitude of the society towards health and the importance of the health majors in the educational system, which can guarantee the health of people and prevent illnesses, were the main factors affecting the public health students’ motivation for learning. Allocating enough budget to the health sector, constructing and equipping the health centers, understanding the importance of health by the public, getting the public health major recognized, and the attention of authorities—especially the authorities of Ministry of Health and Medical Education—to the public health major can promote students’ motivation for learning and help ensure healthcare services to people. Despite the significance of health and its role in the productivity of community, treatment of health issues is still given priority over prevention, which may lead to adverse consequences such as reduced motivation among the students of health-related majors, job burnout of healthcare trainers, and ineffectiveness of the health education programs.

Conclusions

The absence of public health students, who were unwilling to participate in the study, the absence of students of other majors from various universities, and the lack of generalizability of study findings to other students were limitations of this study. However, the results showed that public health students have different needs in order to preserve and increase motivation for learning. The support of their family, university, and authorities, as well as planning for more success of students, not only promotes the psychological health of students but also plays a role in their occupational and social performance. The family, the university, and the student play a pivotal role in the motivation for learning, and the attitude of the society, authorities, and policymakers towards the health status is of special significance.

The findings of this qualitative study complement those of quantitative studies on factors affecting the motivation for learning among students and may be beneficial to teachers and higher education managers, families, and educational institutions and universities. Motivation plays a critical role in the cognitive, behavioral, and affective aspects of students. Hence, conducting further studies on the overall knowledge of factors influencing the motivation for learning among students of various majors and designing educational programs related to the promotion of the psychological health of students can enhance their active participation in the learning process.