Objective: Barkley (2010) defined engagement as: “ . . . a process and a product that is experienced on a continuum and results from the synergistic interaction between motivation and active learning” (p. 8).
Reflection: During my time as a clinical practice educator in an acute hospital setting I was involved with the implementation of a health authority mandated, multiyear program called more OB (Managing Obstetrical Risk Efficiently) in a small, rural, maternity unit. This national program, designed by experts in the field of obstetrics, “is a comprehensive performance improvement program that creates a culture of patient safety in obstetrical units” (Global Salus Corporation, 2014 para. 1). The three year program involves reading educational material to ensure everyone is on the same page, team building activities, sponsored workshops, skills drills, simulation practice scenarios and frameworks for specific clinical situations and team debriefs (Global Salus Corporation, 2014). I was so excited! It was the dream program for a clinical educator; everything was already designed and ready to go. Staff nurses would even be paid for their time! All I had to do was follow the program as outlined by the program trainers and watch the unit flourish.
To celebrate the roll out, the core team and I organized a fun, team building event with food and entertainment. Hardly anyone showed up. Getting the staff to do the reading was like pulling teeth. We were told to create teams and offer coffee cards and gift certificates for dinners for those who completed their readings. There was major push back. I had a nursing union steward threaten to write us up for bullying. I was aghast. Why did this go so terribly wrong!
Interpretive: Barkley (2010) defined motivation as: “. . . a theoretical construct to explain the reason or reasons we engage in a particular behaviour. It is the feeling of interest or enthusiasm that makes someone want to do something” (p 9). It was obvious that the motivation to engage in this program was at a severe short fall.
Motivation can be understood as the product of expectancy and value (Barkley, 2010). Everyone enrolled in the moreOB program was already practicing obstetrics in a novice (the newly graduated perinatal nurse) or expert capacity. They knew they could be successful in learning the material; expectancy was therefore high. It then follows that the lack of motivation was attributable to the low perceived value of the program.
Value can be fostered through external and intrinsic rewards (Fluke, Peterson, Olson and Cathcart, 2015). The attempt to promote value via extrinsic rewards was a flop and was even being perceived as threatening. In the absence of intrinsic motivation the program did not hold value to the students of the program.
Barkley (2010) used the term of ‘evading’ (p 14) to describe students’ responses to situations of high success expectations and low task value perceptions. Student behaviours of minimal task completion and lack of engagement (Barkley 2010) match those seen with the staff.
Decisional: Engagement happens when the synergistic interaction between motivation and active learning takes place (Barkley 2010). Engagement of the students with the moreOB program faltered from the start as there was a perceived lack of value with the program. Relying on external rewards to kick start motivation was not the answer, creating intrinsic motivation was the route that should have been taken.
In their Motivation Tiers 1, 2 &3 Strategy Brief, Fluke et al. (2015) highlighted four conditions of the Motivational Framework for Culturally Responsive Teaching (p 4). They are as follows:
Inclusion: through interactions that build respect and connectedness
Staff did not feel included in the process. It was mandated education. Had the health authority allowed time for the staff to become familiar with the program before the launch date and allowed them to opt out if they so desired the staff might have felt more respected and connected with the program.
Attitude: Through choices and personally relevant curricula
The first year of the program was very heavy with a lot of readings, workshops, skills drills, tests, etc. I suggest that the program allow staff to choose what topics they want to learn and encourage more shared learning.
Competence: Through authentic ways that show students are effective
The program had a pre and post module year one test. Many nurses did quite poorly on the tests and although the results were confidential they felt quite devastated and frustrated that the tests were designed by physicians for physicians and not nurses.
I suggest that the program include exam questions that would be applicable for nurses and physicians.
Meaning: Through learning that challenges and engages students
I would suggest that the program focus the first year of learning on building internal motivation with its participants. This way it would create an environment where staff would feel motivated to take charge of their own learning in the years to follow.
By reviewing this case where a lack of engagement became a serious detriment to learning, I have gained an appreciation of the need for creating high value and expectancy with students so that the motivation to learn is present. For future courses and workshops that I will be teaching, I will ensure that the four conditions as discussed above are incorporated into the program’s delivery by: creating a sense of community through team building exercises and peer supported learning; having students determine what topics they want to focus on for the day; through the use of formative quiz techniques and case studies to help them assess their own competency; and by creating a safe environment that encourages students to challenge themselves.
Barkley, E. F. (2010). Student Engagement Techniques – A Handbook for College Faculty. San Francisco, CA: Jossey-Bass.
Fluke, S., Peterson, L., Olson, A., & Cathcart, A. (2015). Motivation Tiers 1, 2 &3 Strategy Brief, March, 2015 pdf document. Retrieved from http://k12engagement.unl.edu/strategy-briefs/Motivation%203-15-15_1.pdf
Global Salus Corporation. (2014). more OB Taking Care of Life. Retrieved from moreob.com