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Applying the ARCS Model of Motivational Design to Pharmaceutical Education

Supakit Wongwiwatthananukit
Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand

Nicholas G. Popovich1
School of Pharmacy and Pharmacal Sciences, Purdue University, Heine Pharmacy Building, West Lafayette IN 47907-1330
Instruction, even when designed and based on sound instructional principles, oftentimes does not stimulate students motivation to learn. The result may be that students may not be motivated to pursue lifelong learning and use the knowledge and skills learned to deliver pharmaceutical care. The purpose of this article is to provide an overview of the Attention, Relevance, Confidence, and Satisfaction (ARCS) Model developed in education and demonstrate a systematic approach of motivational design with practical application that can be incorporated into a pharmaceutical educators instruction (e.g., tool box). It is intended to help the educator identify components of instruction that either increase or decrease student motivation to learn. It also provides motivational strategies which an educator can incorporate into the instruction plan to make it responsive to the interests and needs of students. Using motivational design to create motivational strategies and then incorporating these into the instruction can result in complementary enhancement of student learning and achievement.

In the yeast of every student body there is a ferment of idealism and emotional virility waiting for the proper climate to burst forth into the stuff of which good education is made. In every good teacher there must be a vigor, vitality, and an exuberance permeating everything he does in the classroom. The result will be people learningnot just being taught. There must be a motivation from within to learn, and it must be planted or nurtured as the case may be. If it can be done on an individual basis, fine, but if larger classes prevent this, there is no reason for dismay; rapport with students need have nothing to do with numbers. It isn t necessary to coddle students; most need only guidance and opportunity; and some, a motivating force. The force may be you.... Melvin R. Gibson, 1959 (1) The term motivation is derived from the Latin verb movere, which means to set into motion(2). Motivation is something that gets a person going, keeps the person moving, and helps the person to get the accomplished jobs. Conversely, a demotivated person does not have the motive nor desire that moves him/her toward action (e.g., learning). Keller(3) noted that an educator cannot really motivate anybody. However, it is possible to create or change the learning conditions/environment so that individual students can motivate themselves. It is possible that an educator can teach, and teach well, without having the students learn. Students may reluctantly learn things that do not mean anything to them. They may only memorize the content and memory erase it after an examination or a course. They also may choose not to use or apply what they
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have learned, and may actually dislike it. There is no doubt that such students do not always have the motivation to learn. As Stephen Yelon(4) describes in his book Powerful Principles of Instruction, four common attributes of excellent educators are: (i) caring about the subject matter that they teach; (ii) caring about their students learning and believing that their students have the ability to learn; (iii) caring about the job of teaching and enjoying the process of analyzing, planning, creating, delivering, and improving their instruction; and (iv) applying what they know about motivation, learning, and transfer to make their instruction effective. Motivation is one component of the set of principles that excellent educators apply to their instruction to help students understand the importance of a content area so they will want to continue to learn and use and apply what they have learned. Motivation is an important quality that affects students success in learning and performance. Students who are motivated to learn tend to engage in activities they believe will help them learn. They are likely to attend to the educators instruction and mentally organize and rehearse the material to commit it to memory. They also take meaningful notes to facilitate subsequent studying, periodically check their level of comprehension, and request help/guidance when they realize they do not understand the material. These activities improve the quality of student learning(2). However, Keller(3) noted that overmotivation can also be a problem. Students who are overmotivated may claim or believe that they already know the content (i.e., overconfidence) and tend to pay little attention in class,
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Corresponding author Am. J. Pharm. Educ., 64, 188-196(2000); received 1/19/00; accepted 4/5/00.

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Fig. 1. A model of motivation, performance, and instructional influence, describing a connection of personal and environmental inputs on effortperformance-consequences (5). Figure reproduced with permission of the Association for Educational Communication and Technology, Bloomington, Indiana.

may become a disruptive influence to other enrolled students, and may make more mistakes/errors and lose efficiency as a consequence. In contrast, students who are not motivated to learn do not put forth their best effort to learn. They may be inattentive during the instruction and may not organize or rehearse the material to be learned. Note taking may be done haphazardly, if at all. They may not monitor their level of understanding or even ask for assistance when they do not understand what is being taught. These habits limit students potential for learning and skill development and result in low levels of productivity(2,3). Although the importance of motivation as a positive influence on learning is acknowledged in the literature(2,5,6), there is less attention toward incorporating motivation into instructional plans to improve the motivational appeal of courses. In education, one particular model developed by Keller(3,7,8), the Attention, Relevance, Confidence, and Satisfaction (ARCS) Model, focuses on creating, stimulating, and maintaining motivational strategies used for instructional design. This model emphasizes strategies and motivational design that an instructional designer or educator can include in the instructional design/plan process. The motivational strategies can be used in influencing students motivation to learn and in solving problems associated with learning motivation by allowing educators to create a motivating learning environment. Studies evaluating this model in application have provided evidence to support the validity of the four basic constructs and their positive effects on student attitude and performance(9,10). The pharmacy profession, in the past four decades, has evolved from a traditional product orientation to a patientfocused orientation and has adopted the practice paradigm of pharmaceutical care(11). Pharmaceutical care is the responsible provision of drug therapy for the purpose of achieving def

inite outcomes that improve a patients quality of life. These outcomes are: (i) cure of a disease; (ii) elimination or reduction of a patients symptomatology; (iii) arresting or slowing of a disease process; or (iv) preventing a disease or symptomatology. By practicing pharmaceutical care, pharmacists have the potential to reduce the occurrence of drug misadventures described by Manasse(12,13). Such misadventures cause poor health outcomes for patients and cost an estimated tens of billions of dollars annually. Johnson and Bootman(14) have argued that by preventing avoidable drug misadventures, pharmacists may cut the associated costs in half, which in 1994 were estimated to cost the U.S. health care system over $70 billion dollars per year. Subsequently, this has been confirmed through numerous studies which have documented the positive impact on patient care that pharmacists can have(15). With this evolution, the American Association of College of Pharmacys (AACP) Commission to Implement Change in Pharmaceutical Education has recognized the increased role that schools/colleges of pharmacy must take in their responsibility as the resource for new practitioners for the profession. The graduates must be capable of entering practice with at least a minimal level of competence and with the skills needed to continue to increase competence. New practitioners need appropriate education and skill development opportunities to prepare them to provide medications and services within the framework of practicing pharmaceutical care. The Commission has laid out a carefully crafted strategic plan to advance the profession through education. The Commissions Background Papers I(16) and II(17) encouraged the concept of pharmaceutical care as the mission of pharmacy practice. Further, it proposed a curricular direction within schools/colleges that focuses on student achievement of ability-based outcome goals and on the educational processes necessary to ful
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fill pharmaceutical educations mission in the preparation of its students to enter practice and deliver pharmaceutical care. To perform this function, pharmaceutical education must facilitate student acquisition of the relevant knowledge base, skills, attitudes, ethics, and values. It stresses the importance of student acquisition of performance-based competencies that underlie a professional person and contributing citizen. The Commission also laid out one of the general competencies/outcomes that graduates must have - motivation for continued learning. It emphasizes that the curriculum must instill in students a spirit of intellectual inquiry and curiosity and a motivation for learning and must equip students to learn throughout their professional lives. The Commission views most students who enter health professional schools, including pharmacy, as dependent learners. They enter with a perception that it is the educators responsibility to teach students while de-emphasizing, if not ignoring, their responsibility of students to learn on their own. Students come to pharmacy schools adept at memorizing facts, and the teaching methods at most schools focus on this ability. This method of learning is diametrically opposed to the way the pharmacist is asked to practice. Specifically, the responsibility to learn must reside with the pharmacist. Therefore, schools must do a better job of preparing students for the realities of practice through the shifting of the educational process to a balance between the educator and the students. Methods for achieving this process must involve students as active learners through activities, including among others, problem solving, cooperative learning, developmental discussions, simulations, questions, early practice experience, laboratories, recitations, reading assignments, problem sets, presentations, writing, and role playing. For pharmacy educators to prepare competent future practitioners who will contribute a positive influence to society, they must know how to design courses of instruction that foster students active learning effectively and efficiently. Further, they must also know how to make the instruction more appealing to motivate and inspire students to learn. Improving the motivational appeal of courses can result in complementary gains in students successes in learning, in developing the goal to pursue life-long learning, and in using the knowledge and skills they have learned to deliver pharmaceutical care. This paper describes how to understand the motivation to learn in terms of the background of the ARCS Model, the models four major categories, their subcategories and motivational strategies, and how to use and design them into a course, instruction, or lesson. It intends to help pharmaceutical educators think about motivation in terms of four specific areas of influence on the motivation to learn, and to assist them generate, select, and design motivational strategies into their instruction. The ARCS Model has been used and applied in specific kinds of instructional settings such as computer-based instruction 18), textual material(19), and instructor-led lecture formal(10). This paper focuses primarily on instructor-led courses. THE ARCS MODEL The Attention, Relevance, Confidence, and Satisfaction (ARCS) Model of Motivational Design (a.k.a., Kellers ARCS Model of Motivation, The ARCS Model, Kellers Model) was developed in the early 1980s by John Keller(3,6-8,20). The model was systematically derived from his theory of motivation, performance, and instructional influence developed in the

late 1970s(5,6). Kellers theoretical model of motivation, performance, and instructional influence is a macro theory that describes a network of the relationships of personal and environmental characteristics on effort, performance, and consequences (Figure 1). More specifically, in a motivational context, it assumes that effort is a consequence of motives or values, and of expectancy for success. Reinforcement serves to confirm or deny expectations. This theory is based upon a synthesis of many areas of research that pertain to human motivation, and its purpose is to help answer questions about how to design motivational strategies into instruction that will stimulate or sustain learners motivation to learn. In other words, the purpose of this theory is to identify major categories of variables of individual behavior and of instructional design that are related to individual effort (motivation) and performance. The theory integrates a large number of specific motivational concepts: not only expectancy-value theory, attribution theory, self-efficacy theory, learned helplessness, social learning theory, environmental theories, humanistic theories, aspects of attitude theory, and decision theory, but also the effect of reinforcement on motivation as well as cognitive evaluation and equity theory as the foundation of the theory to explain individual motivational tendencies. As illustrated in Figure 1, motives or values are subdivided into two major categories called attention (A) and relevance (R). Expectancy is referred to as a category called confidence (C). The influence of consequences and cognitive evaluation are the effect of a category called reinforcing value or satisfaction (S) of instruction on motivation (effort). The theory of motivation, performance, and instructional influence also distinguishes between three types of influence of instructional design (i.e., motivational design and management, learning design and management, reinforcement-contingency design and management). The assumption is that any instructional event, whether it is an educator in a classroom or a module on a microcomputer, will have these three influences; and the task of instructional design is to understand and control them. The ARCS model is a systematic means of improving the motivational appeal of instructional materials, of educator behavior, and of the way in which lessons or modules and courses are designed(20). It helps an educator to identify the component of instruction that either increases or decreases student motivation to learn and also provides motivational strategies which an educator can use to make instruction responsive to the interests and needs of students. This model was created because of the lack of guidance that presently exists for improving the motivational quality of instruction. There have been many writings about how to design instruction that will be effective if students want to learn, but there is relatively little that demonstrates to an educator how to make the instruction more appealing. Four major categories (i.e., attention, relevance, confidence, satisfaction) influence a students motivation to learn(3,6-8,20). These are as follows: Attention (A) refers to the extent to which the students curiosity is aroused or gained and sustained over time; Relevance (R) refers to the students perception that the instruction is related to personal/career needs or goals; Confidence (C) refers to the students perceived likelihood of

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achieving success through personal efforts and control; Satisfaction (S) refers to reinforcing accomplishment with rewards from the instruction, which can include internal and external factors. According to the ARCS model, these four major categories have to be met for students to become and remain motivated(7). Keller(7) views the task of motivating students as a sequential learning process. First, an educator must gain a students attention before any learning activities can commence. The motivational goal is to achieve and sustain student circumspection. An educator must establish motivational strategies that can sustain the students consideration to produce a satisfactory level of attention throughout the instruction. After getting the students attention and starting to present the material, the student might be wondering why do I have to learn this thing? (i.e., relevance). Before the student can be motivated to learn, he/she must believe that the instruction is related to his/her personal goals/career and will meet their specific needs. Even with attentive students who envision personal relevance in the instruction, an educator might still have less than appropriately motivated students due to the confidence level of the student. A student who underestimates his/her expectation of success in learning might have fears/doubts about the subject and this could limit his/her potential of learning and skill development. If he/she undertakes a task, he/she will probably suffer from unnecessary anxiety and self-doubt that can increase the possibility of task failure. In contrast, a student who estimates his/her confidence in the subject to be learned at a level far beyond his/her actual knowledge and skill level may overlook important detail and skills in the instruction. He/she can suffer from mastering the desired objectives of the instruction. Finally, an educator must establish a sense of satisfaction in order for the student to have a continuing motivation to learn. He/she should make learning pleasing so that students are comfortable with what they have learned, and continue to make learning satisfying/enriching so that students keep learning and applying what they have learned. He/she must give students the opportunities to hone the skills learned. The ARCS model includes three subcategories of motivational characteristics for each of four major categories, the motivational strategies that stimulate or sustain each motivational element, and the associated process questions for each subcategory(3,7,19). The associated process questions are the questions that an educator must ask him-or herself as he/she is designing or preparing to teach a course. All of the motivational strategies in the model are derived from research findings and practice opportunities that have resulted in successfully motivated learners. The model provides a basis for prescribing motivational strategies or solving motivational problems to meet the individual motivational requirements of the situation, which eventually results in improving instruction so that it is appealing as well as effective and efficient. The four major categories, their subcategories and definitions, their associated process questions, and corresponding motivational strategies for stimulating motivation are summarized in the Appendix. The ARCS model helps an educator identify the component of instruction that either increases or decreases a students motivation to learn, and provide motivational strategies which an educator can use to make instruction responsive to the interests and needs of students. It also provides four major distinct

categories of motivational variables that help synthesize/create research foci. For example, the educator can pursue applied research projects according to the specific motivational category (i.e., attention, relevance, confidence, and satisfaction) and treat it as an independent variable (e.g., what motivational category facilitates increased student performance). The ARCS model is limited in its lack of specific, prescriptive strategies(6). It allows the educator to create and develop a variety of motivational strategies. The goal is to increase student motivation. How the educator achieves this may be different with each circumstance. For example, a group of students may present a different motivational profile and, therefore, require a different combination of motivational strategies. In addition, the ARCS model requires experience and judgement, and quite likely some trial-and-error from the educator(9). The educator must understand the need to create a unique solution for each unique problem to achieve the desired goal of instruction. Decisions about the effectiveness of any motivational strategies are affected by many factors, not just motivational ones. Student gain scores and other achievement measures will not always reflect the role of motivation. To judge motivational consequences, there is a need to use direct measures such as instruments of persistence, intensity of effort, emotion and attitude(9). THE USE OF THE ARCS MODEL IN INSTRUCTIONAL DESIGN The ARCS Model describes the motivation to learn in terms of four major categories and their subcategories (see Appendix). For each of these, there are general process questions for the educator to answer and motivational strategies to apply. By themselves the categories do not guide an educator in how many and what types of motivational strategies to use or how to design them into the instruction. Thus, motivational design, i.e., the use of the ARCS Model in an instructional design will help answer these questions. The goal of motivational design is to make the instruction appealing(3). There are four steps in applying the ARCS Model in practical fashion to instructional design, which is referred to as the process of motivational design(3,22). The steps follow a general systematic problem solving and design process, beginning with an extensive student analysis which forms the basis for identifying motivational objectives. These objectives guide the design and subsequent development and implementation of motivational strategies. These steps are as follows: Step 1: Analyze the student and develop a motivational profile based on ARCS. This step provides a means for identifying gaps in the students entry level motivation. The techniques used in conducting this step can range from a best guess estimate based on the educators personal experience with previous similar students to a judgement based on the collection and analysis of formal data from conducting focus interviews with members of the target population by using a questionnaire, or from other informed persons (e.g., faculty who have taught the students previously). The result of this step is the gathering of information which determines whether the students will be below, at, or above the appropriate level in each motivational category. This is needed for formulating the motivational objectives of the instruction. Educators should be wary of taking students selfdescriptions at face value, however, given students well

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known desire/intention to please educators with their responses. Misjudgment of the students motivational categories in the direction of overestimation or underestimation can result in undesirable outcomes as mentioned earlier in this manuscript (i.e., The ARCS Model). Step 2: Define motivational objectives based on the student profile and develop motivational measures. The motivational objectives should be written from the student perspective. These should specify the performance or attitude that the educator desires to observe relative to the four ARCS motivational categories. The objectives can be cognitive, affective, or psychomotor skills. For example, a psychomotor motivational objective for attention that might be written is Within the assigned recitation group for the chronic renal failure case in the pharmacotherapeutic course, each pharmacy student will demonstrate a higher degree of attention through participation in the group discussion to solve the drug-related problems in the case. A cognitive motivational objective for relevance that might be generated is By the end of the oral analgesic drugs lecture, pharmacy students will be able to describe two benefits of learning this content area in relation to their career goals. A cognitive motivational objective for confidence would be When given a homework case study assignment for smoking cessation products, pharmacy students will indicate a higher degree of confidence in their ability to select an appropriate smoking cessation product for the patient who desires to quit smoking. An example of an affective motivational objective for satisfaction is Pharmacy students will rate their satisfaction as highest with pharmacokinetics instruction as a result of opportunities provided to apply what was learned (e.g., adjusting the digoxin dose to a 45-year-old white male with congestive heart failure in a patient-simulation laboratory). After writing motivational objectives, methods for evaluating the motivational strategy(ies) used should be developed to determine whether the motivational objectives have been met. The techniques used in evaluating the strategy(ies) can include direct observation of specified behaviors (such as choice of tasks, effort expended, and persistence); judgements by observers of students on characteristics indicative of motivation; interviews or conversations between two or more students; and self-report questionnaires. Keller(3) suggested that self-report measures can be very helpful when an educator wants to focus on a particular area of concern. These measures should be consistent with the objectives. An example of a selfreport measure to evaluate students confidence might be achieved by asking students to assess their level of confidence (e.g., none, low, moderate, high) to select a smoking cessation product for a patient given certain patient variables/parameters. Step 3: Design a motivational strategy for each motivational objective and integrate it into the instruction. Keller(3) described three phases in this step: generation, selection, and integration. The generation phase deals with Kellers ARCS categories. These categories and their subcategories of motivational strategies serve as a guide to generating motivational interventions (see Appendix). In this phase, an educator should generate a list of potential motivational strategies for each of the objectives. Keller(3) suggested that it is generally best for an educator to use a brainstorming approach and an open, creative frame of mind to generate a broad range of strategy ideas. An example of gaining students attention is
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provided in the following fictitious scenario. Dr. Martin teaches the second-professional year pharmacology course. In the past, he normally began his lecture with an opening introductory statement such as, Today we are going to study drugs used to treat Alzheimers disease. As he talked, he noticed that some students were reading newspapers while others were doing work for other classes. Some were falling asleep. He realized that his past approach to educating students did not capture any student attention. When he engaged them with questions, he was impatient and provided answers to the students right away. So, he decided that he would present an unsolved case at the beginning of his discourse and ask questions of the students but not answer them. Thus, the next time he taught this topic he started by asking the students, Is there a cure for Alzheimers disease? What are the causes of Alzheimers disease? Are there any drugs that can cure it? Are the drugs, food supplements, and herbs such as estrogen, vitamin E, ginkgo biloba, a cure? Are there any drugs that can make Alzheimers disease worse? These are the issues I would like us to focus today. His observation was that his students were more enthusiastic and interested than normal, paid more attention during class and tried to seek more information after posing his questions by participating in debate and raising questions about content that needed additional clarification. Another example of making students satisfied and adding relevance to the instruction is in an integrated laboratory session whose goal is to teach second-professional-year students how to properly use an asthma inhaler. These students already had gained general knowledge of asthma drug therapy from a prior lecture session. They feel competent in identifying and solving drug-related problems but wanted to improve their skills in counseling patients who use inhalers. Dr. John began his introductory remarks by sharing a pleasant experience with a former pharmacy student whom he taught. This pharmacist shared that she worked in an out-patient clinic and applied the skills which she learned in the laboratory to properly instruct and counsel a patient with asthma who uses an inhaler. She shared what a great reward it was to her to use it in the realworld when providing pharmaceutical care to a patient. Dr. Johns students indicate that he makes learning enjoyable because he demonstrates to them the relevance of their knowledge and skills that they have obtained in the real world. An example of gaining students confidence is provided by Dr. Andy, a professor who teaches a Nonprescription Medicines course to third-professional-year pharmacy students. For content and effort on homework assignments, he gives separate scores or grades as well as positive and accurate feedback. Homework assignments are given in case or scenario formats (e.g., laxative products, cough and cold products) that provide the student with challenging situations, some more ambiguous than others, but that mirror the real world. These ensure the student is actively involved in learning by encouraging him/her to use class notes and literature references to solve the presented problem. His goal is to help his students experience that the effort they put into the assignment is linked to its overall quality. He also recognizes that there still may be differences in student knowledge and skill. Nevertheless, he continues to encourage students who try hard by giving them high marks for effort, although they may need more work on their problem-solving skills, content, grammar, and overall writing skills. He uses this confidence boosting strategy in terms of success opportunities to support or enhance students belief in themselves and their competence. He gives them personal responsibility and accountability opportunities to help

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them realize that their success is based on effort and abilities. Before producing an effective integration of motivational strategies into the instruction, Keller(8) provided five guidelines that are helpful to critically reviewing the potential strategies and selecting the ones to be used. He indicated that strategies: (i) should not take up too much time; (ii) should not detract from the learning objectives; (iii) should fall within the time and money constraints of the development and implementation phases of the instruction; (iv) should be acceptable to the students; and (v) should be compatible with the instructional methodology, including the educators style. The motivational strategies included in the model are proven, but their effectiveness, and the exact way in which they are implemented depends in part on the personality of the educator and the type of atmosphere that he or she wants (e.g., formal versus informal) to create. Therefore, the final selection of strategies for a given instructional event is based, in large part, on the judgement and perhaps even some trial-and-error work of the educator rather than an objective criteria. The last phase of Step 3 is integration. This is the phase that adapts motivational strategies selected to the specific learning environment and then incorporates them into the instructional plan. Step 4: Develop, try out and revise the selected strategy as necessary. In this step, the motivational materials are prepared in conjunction with the individual materials and are subjected to formative evaluation based on the motivational criterion measures developed in the second step. Small group try-outs or pilot tests involve testing the motivational strategies along with instructional materials on content experts (e.g., faculty, pharmacists) and representatives of the target population (e.g., focus groups) to determine the appeal of the instruction and the feasibility of the motivational activities. The importance of this step is that motivation should be separated from other aspects of the instruction(3). The educator should attempt to be sensitive to the effects the instruction is having (i.e., desired or undesired). Then, if the strategies are, for example, failing to produce their intended results, they can be revised and replaced. PRACTICAL APPLICATIONS The ARCS model provides a systematic means of improving the motivational appeal of the instruction. It is one of the tools that the educators can use to help their students become and stay motivated. The motivational design process bridges the gap between the students and the learning outcomes by incorporating motivational strategies that match the motivational needs of the particular class or students. The following hypothetical case is used to illustrate how students low confidence levels can be improved by using the ARCS model in identifying and solving motivational problems in the classroom. Case Pharmacotherapeutic, clinical reasoning is an elective two-credit course, meeting once a week for two hours. The course is offered for the first time to third-professional-year pharmacy students to foster pharmacotherapeutic reasoning skill development as experienced in actual clinical practice and to improve the integration of students knowledge, skills, and attitudes into patient care before they participate in the Advanced Pharmacy Practice Experience (i.e., clinical clerk-

ships). The course encompasses several major areas of drug therapy (e.g., cardiovascular diseases, infectious diseases, respiratory diseases). There are 30 students enrolled in this course. Anonymous self-report questionnaires ask each student to describe his/her motivation to learn in the four main categories of the ARCS Model and are administered to the students two weeks before the class begins. Students are urged to respond candidly and honestly, informed that there are no right or wrong answers, and that all responses are strictly confidential. This self-report measure will not affect the students grades or performance for the course. It is the intention of the educator to get information from students for the purpose of designing this course to meet students needs. Step 1: Student analysis. Attention(A) High. Students are very interested in taking this class with the hope that this course will help them to improve their clinical reasoning skills. Relevance(R) High. Students understand the relevance of this course in its application to next years Advanced Pharmacy Practice Experience and their individual pharmacy career goals (i.e., providing pharmaceutical care). Confidence(C) Low to Moderate. Students beliefs in their ability to employ sound clinical reasoning in identifying and solving drug-related problems is low to moderate. Most of the students share that they do not have much experience in clinical situations and fear being too disorganized and lacking knowledge and skills to solve patient problems. However, most of them realize that confidence in the ability to use cognitive skills is an important quality for them to practice successfully when they enroll in the Advanced Pharmacy Practice Experience next year and when they ultimately enter practice. Satisfaction(S) High. Students find the course useful and expect it will enable them to become effective practitioners. They expect that this course will give them opportunities to use/apply their knowledge and skills in realistic situations such as patient simulations, or actual clinical case scenarios. Step 2: Define motivational objectives based on the student profile. 1. During the course of instruction, students will demonstrate greater confidence in their ability to solve the problems and employ sound clinical reasoning as the educator continues to illustrate the process of clinical reasoning using the patient case scenario examples. During the practice phase of the instruction and homework assignments of the course, students will demonstrate greater confidence in being able to successfully solve actual case scenario problems through sound clinical reasoning. This can be further developed by increasing the difficulty of the problems as the semester move forward. Along with submitted homework assignments, students will demonstrate increased level of confidence in their ability to solve patient problems. The educator will pro
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vide constructive feedback to help them develop reasonable perceptions of their competence and foster the belief that competence in clinical reasoning is a changeable, controllable aspect of their development. 4. Within the last three recitation/discussion meetings, each student will demonstrate greater confidence in his/her ability to solve patient problems with sound clinical reasoning, when given the opportunity to create his/her own case scenarios and then presenting them to fellow classmates. Step 3: Design a motivational strategy for each motivational objective and integrate it into instruction. 1. Carefully plan presentation of the process of clinical reasoning based on the case examples to assist in building a positive expectation for success among students. (Strategy C.1) Plan to develop case scenario homework assignments and in-class practice exercises that provide the student with challenging situations, some more ambiguous than others, that mirror the real world. The assignments and exercises will be purposely sequenced from simple to difficult. This will help the students learning experience and enhance the students beliefs in their competence. (Strategy C.2) Plan to create criteria for evaluating and grading homework assignments which are fair, valid and reliable. This will help students clearly experience success based on their effort and abilities. (Strategy C.3) Create opportunities for students development of case scenarios that allow them to use their acquired knowledge and skills in demonstrating their competence. (Strategy C.3)

(AACP) President Melvin R. Gibson(1) shared that even in the largest of classes, educators always have the opportunity to help plant motivational seeds to learn and nurture seeds development through their instruction. Using motivational design in creating motivational strategies helps pharmacy students understand the importance of a lesson or instruction. Motivational design and strategies should be embraced by every pharmaceutical educator to enhance student learning and achievement and skill development.
References (1) Gibson, M.R., Editorial, Am. J. Pharm. Educ., 23, 286-287(1959). (2) Pintrich, P.R. and Schunk, D.H., Motivation in education: Theory, research, and applications. Merrill, Englewood Cliffs NJ (1996). (3) Keller, J.M.,. The systematic process of motivational design, Performance and Instruction. J., 1-8 (November/December 1987) . (4) Yelon, S.L., Powerful Principles of Instruction. Longman, White Plains NY (1996). (5) Keller, J.M., Motivation and instructional design: A theoretical perspective, J. Instruct. Develop., 2(4), 26-34(1979). (6) Keller, J.M., Motivation design of instruction, in Instructional-Design Theories and Models: An Overview of Their Current Status, (edit., Reigeluth, C.M.), Lawrence Erlbaum Associates, Hillsdale NJ (1983) pp. 383-434. (7) Keller, J.M., Strategies for stimulating the motivation to learn, Performance and Instruction. J., 1-7 (October 1987). (8) Keller, J.M., Development and use of the ARCS model of motivational design,J. Instruct. Develop., 10(3), 2-10(1987). (9) Keller, J.M., The use of the ARCS model of motivation in teacher training, in Aspects of Educational Technology Volume XVII: Staff Development and Career Updating, (edit.,Shaw, K.), Nichols, New York NY(1984)pp.140-145. (10) Visser, J. and Keller, J.M., The clinical use of motivational message: An inquiry into the validity of the ARCS model of motivational design, Instruct. Science., 19, 467-599(1990). (11) Hepler, C.D. and Strand, L.M., Opportunities and responsibilities in pharmaceutical care, Am. J. Hosp. Pharm., 47, 533-543(1990). (12) Manasse, H.R., Medication use in an imperfect world: Drug misadventuring as an issue of public health policy, Part I, ibid .., 46 , 929944(1989). (13) Manasse, H.R., Medication use in an imperfect world: Drug misadventuring as an issue of public health policy, part II, ibid .., 46 , 11411152(1989). (14) Johnson, J.A. and Bootman, J.L., Drug-related morbidity and mortality, a cost-of-illness model, Arch. Intern. Med., 155, 1949-1956(1995). (15) Burson, C.S., The value of pharmaceutical care services, Pharmacists Letter, 15, 67 (detail number 151201)(1999). (16) Commission to Implement Change in Pharmaceutical Education, Background paper I: What is the mission of pharmaceutical education?, Am. J. Pharm. Educ., 57, 374-376(1993). (17) Commission to Implement Change in Pharmaceutical Education, Background paper II: Entry-level, curricular outcomes, curricular content and educational process, ibid.., 57, 377-384(1993). (18) Keller, J.M. and Suzuki, K., Use of the ARCS motivation model in courseware design, in Instructional Designs for Microcomputer Courseware, (edit., Jonassen, D.H.) Lawrence Erlbaum Associates, Hillsdale NJ (1988) pp. 401-434. (19) Keller, J.M. and Kopp, T.W., An application of the ARCS model of motivational design, in Instructional Theories in Action: Lessons Illustrating Selected Theories and Models., (edit., Reigeluth CM), Lawrence Erlbaum Associates, Hillsdale NJ (1987) pp. 289-320. (20) Keller, J.M., Development and use of the ARCS model of motivational design. (Reports Research/Technical 143). East Lansing, MI: National Center for Research on Teacher Learning. (ERIC Document Reproduction Service No. ED 313 001)(1983). (21) Keller, J.M., ARCS Model modifications - January 20, 1991, in Foundations of Instructional Design Theory (EDCI674) Course Manual, Department of Curriculum and Instruction, Purdue University, West Lafayette IN (1998). (22) Driscoll, M.P., Psychology of learning for instruction. Allyn & Bacon, Boston MA (1994).

2.

3.

4.

Step 4: Develop, try out and revise the selected strategy as necessary. Because this is the first time the course has been offered, these motivational strategies will be used as a try-out test. Motivational measures developed based on the ARCS Model will be used to evaluate the effectiveness of the strategies. If there are any strategies that fail to produce the intended results, they will be revised and replaced for the future class. This step should be implemented as soon as possible after the course ends when thoughts/ideas are still fresh in ones mind. CONCLUSION This paper has attempted to provide an overview of the ARCS Model and a systematic approach of motivational design that can be incorporated into ones instruction. Pharmaceutical educators should think about motivation in terms of four major categories of influence on the motivation to learn, their subcategories and motivational strategies. In the pharmaceutical care era, teaching pharmacy students is a challenging and rewarding experience. Pharmaceutical educators can teach, and teach well, and still students might not learn if their hearts are not in what we want them to learn. The result is that they may not use and apply the knowledge and skills they have learned to provide pharmaceutical care, nor contribute a positive influence to society, nor pursue the goal of life-long learning. As quoted earlier, the 1984 Distinguished Pharmacy Educator and the 1979-1980 American Association of College of Pharmacy

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APPENDIX. MOTIVATIONAL CATEGORIES, SUBCATEGORIES, ASSOCIATED PROCESS QUESTIONS, AND MOTIVATIONAL STRATEGIES FOR STIMULATING MOTIVATION AS SUGGESTED BY THE ARCS MODEL
Categories/Subcategories Attention (A) A. 1. Perceptual arousal (i.e., capturing student interest) What can I do to capture students interest create curiosity by using novel approaches, injecting personal and/or emotional material using animation, inverse, flash, sound and other audio and/or visual capabilities of the audiovisual instruments using unusual, humor, contradictory, or bizarre content to stimulate attention avoiding dysfunctional attention getting effects such as a flashing word that distracts the students concentration stimulate information-seeking behavior by presenting an unsolved case, posing or having the student generate questions or provide problem solving opportunities that nurture active thinking challenges maintain student attention by varying the elements of instruction (e.g., presentation style, using concrete analogies, human interest examples or unexpected events) provide clear statements or examples that present the objectives and utility of the instruction, and either present goals for their accomplishment or have the student define them use teaching strategies that match the motivational profile of the students make instruction responsive to student motives and values by providing personal achievement opportunities or self-study, cooperative activities, leadership responsibilities, and exposure to positive role models make the materials and concepts familiar by providing or using concrete language, examples, concepts, and analogies that are related to the students educational level experience and values learn and use the students names; request for experiences and ideas from the students gain the students trust and positive expectations by explaining the prerequisite knowledge, skills, or attitudes that will help him/her succed at the task clearly present or state the instructional goals, objectives, and the overall structure of the lesson/course explain the evaluation criteria and provide opportunities for practice with feedback without penalty tell the student how many items are going to be in a test or drill, and whether it will be timed, this helps the student anticipate performance requirements include statements about the likelihood of success with given amounts of effort and ability; teach students how to develop a plan of work that will result in goal accomplishment help students set realistic goals provide many, varied, and challenging experiences which increase learning success as the course moves forward organize materials and practice exercises on an increasing level of difficulty - that is structure the materials to provide a conquerable challenge, over the course life match learning requirements to prerequisite knowledge and skills to prevent excessive challence and anxiety for the less capable students, or boredom for the more capable ones provide a pretest at the beginning of the instructional sequence. There may be a wide variation in students entry level of knowledge Process questions Motivational strategies

A.2. Inquiry arousal (i.e.., stimulating student inquiry) A.3. Variability (i.e.., maintaining student attention) Relevance (R) R.1. Goal orientation (i.e.., meeting student needs/goals) R.2. Motive matching (i.e.., matching student interests and learning styles)

How can I stimulate an attitude of inquiry? How can I maintain students attention?

How can I best meet my students needs/goals? (DoI know their needs?) How and when can I provide my students with appropriate choices, responsibilities, and influences? (How and when can I link my instruction to the learning styles and personal interests of the students?) How can I tie the instruction to the students experiences

R.3. Familiarity (i.e.., creating links to student experiences)

Confidence (C) C.1. Learning requirements How can I assist in building a (i.e., developing a positive positive expectation for success? expectation for success)

C.2. Success opportunities How will the learning experience (i.e.., supporting or support enhance the students beliefs in their or enhancing students belie competience? in his/her competence)

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Categories/Subcategories

Process questions

Motivational strategies to help the student establish a personally meaningful level of challenge and develop confidence and self-esteem, control difficulty level by adding a time-limit, varying the speed of the stimulus and response, or varying the complexity of the situation after students have achieved some degree of mastery of a skill or knowledge areal, they are more likely to be stimulated by competition and other sources of uncertainty. Insert random events as a means to reinforce knowledge and skills and not ultimately override the influences of skill performance during practice or application provide student feedback for acceptable responses as well as constructive feedback for those responses that do not meet criteria

C.3. Personal responsibility (i.e.., establishing students effort and ability as his/her basis for success

How will the students clearly know allow students opportunity to become increasingly independent in their success is based on their efforts learning and practicing a skill and abilities? have students learn new skills under low risk conditions, and continue practice performance of well-learned tasks under realistic conditions help students understand that the pursuit of excellence does not mean that anything short of perfection is a failure. Allow them to feel good about genuine accomplishment provide attributional feedback that connects student success to personal effort and ability rather than through pure luck or ease of task when appropriate encourage student opportunities to verbalize appropriate attributions for success and failures How can I provide meaningful opportunities for students to use their newly acquired knowledge skills? (How can I encourage and support their intrinsic enjoyment of the learning experience?) provide problems, simulations, or work samples that allow students to realize they can solve real world problems provide students positive recognition by giving opportunities to help others who have not yet mastered a task acknowledge student actions or characteristics that are necessary for success, continue these acknowledgements of any risks or challenges that are lmet nurture student motivation by informing students about areas of related interest or application of concepts and how students might continue to pursue to their interest in the topic use verbal praise, real or symbolic rewards, and incentives, or allow students to showcase the results of their effort (show and tell) to reward their success after instruction avoid diluting the motivational benefits of feedback (i.e.., providing too much praise for a rather simple task) but use this frequently when students are trying to master a new skill use extrinsic rewards for correct responses and do not chastise students for wrong answers, help students understand mistakes as learning opportunities use extrinsic rewards judiciously so that the rewards do not become more interesting than the instruction itself use reinforcement intermittently as students become more competent at a task and progress with the instruction make performance requirements consistent with stated expectations objectives, and/or standards and provide consistent measurement standards for all students tasks, tests, and accomplishments

Satisfaction (S) S.1. Natural consequences (i.e.., intrinsic reinforcement)

S.2. Positive consequences (i.e.., extrinsic rewards)

What will provide rewarding consequences to the students successes?

S.3. Equity (i.e.., demonstrating fair treatment among students)

How can I build student perception of fair treatment (How can I assist the students in anchoring a positive feeling about their accomplishment?)

Adapted from references 3,8,7,18,19,21

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