Teaching and Learning in Nursing (2011) 6, 181–184

www.jtln.org

Academic success of nursing students: Does

motivation matter?
Stacy Rose MSN, RN, CRNP, CNE⁎
Kent State University, 456 16th Street, Conneaut, OH 44030, USA

KEYWORDS: Abstract
Intrinsic motivation; Schools of nursing around the world, including associate degree nursing (ADN) programs, continue to be
Extrinsic motivation; challenged by retention and recruitment issues. Many efforts have been made to address the variety of
Academic outcomes complex issues that nurse educators face to increase student retention and recruitment in nursing
programs. Fortunately, enrollment in many of the nursing programs is on the rise, as the economic
challenges in the United States continue to be unwavering. According to the National League for Nursing
Annual Nursing Data Review, ADN programs “account for majority of growth in admission and
enrollment” (2009). However, with an increase in enrollment comes an increase for the potential of
choosing a career in nursing not only for the desire to help others but also for the sake of having a career
with job “security.” The motivating forces for choosing a career in nursing, the changing demographics
of nursing students, and the students' motivation to learn can all provide challenges for nurse educators.
The one challenge that educators will face with an increase in enrollment is how to increase retention
among a very diverse student population. One avenue to consider is the students' motivation for learning
and how that could impact his or her retention. A review of the literature suggests that locus of control
(internal versus external motivation) can be one predicator of success in higher education (L. Perrot,
L. Deloney, J. Hastings, S. Savell, & M. Savidge, 2001). Furthermore, motivation has been positively
related to learning outcomes, and positive learning outcomes have been correlated with increased
retention in higher education.
© 2011 National Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.

1. Introduction inate individual difference that can be easily overlooked is

The retention of students in college programs has been an
ongoing issue for many universities, big and small alike, and
across many disciplines; nursing is not an exception. Nursing
student's retention and recruitment continue to be a
challenge for nurse educators and the “attrition of student
nurses is a major problem…” (Last & Fulbrook, 2003).
Academic success is strongly influenced by factors that can
differ significantly for every student; however, one predom-
* Corresponding author.
E-mail address: srrose@kent.edu
motivation. This is one area that faculty, administrators, and
advisors need to examine more closely prior to the student
entering, as well as when continuing with a nursing program
(Fortier, Vallerand, & Guay, 1995). Furthermore, there is
existing evidence that suggests that successful outcomes are
highly correlated to a person who has a strong match
between his or her motivation and interests and external
demands (Zysberg & Berry, 2005), such as the demands of
nursing school (Gottfried, 1990; Newton, Kelly, Kremser,
Jolly, & Billett, 2009).
Educators are always trying to discover ways to increase
retention among students in higher education, and the

1557-3087/$ – see front matter © 2011 National Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.
doi:10.1016/j.teln.2011.05.004
182
motivation aspect is one avenue that has been investigated
but may need to have more attention as motivation has been
positively related to learning outcomes, and positive learning
outcomes has been correlated with increased retention in
higher education (Jeffreys, 2007; Lotkowski, Robbins, &
Noeth, 2004).
Understanding what type of motivation our students use
throughout their nursing program can be beneficial to
educators in assisting the student through the challenges of
their nursing education. In addition, we must have a good
appreciation of the different motivational patterns that the
individual student may possess to understand the relationship
between various motivational patterns and the successful
completion of a nursing degree (Gambino, 2010).
Motivation is typically classified as either intrinsic or
extrinsic. Those students who are intrinsically motivated
view learning as opportunities to satisfy their own inquis-
itiveness and their own desire for knowledge. An example of
intrinsically motivated students might be those students who
report “I have always wanted to be a nurse because I want to
help others.” In comparison, extrinsically motivated students
strive to satisfy others, such as good grades to please a
parent, or work on tasks because they believe it will result in
a desired external reward such as earning money (Bengtsson,
& Ohlsson, 2010).
2. Literature review
Research has suggested that students do not choose a
nursing career for the same reasons that they once did, and it
is during the last century that we have seen nursing
transformed from a mission or “calling” to a profession
(Rognstad & Polit, 2002). Understanding what motivates
the student not only for learning but also for entering the
nursing profession may provide educators insight and
strategies for retaining those students (McLaughlin, Mou-
tray, & Moore, 2009). In addition, retention strategies
focusing on motivation should accommodate to the
nontraditional student as well as the traditional student as
nursing programs continue to enroll an ever changing
student population (Gambino, 2010).
The question of what motivates student behavior (and
more specifically what type of motivation) toward academic
achievement is one area that has been of interest and
controversy to educators in all levels of academia. Much of
the controversy has been prompted in part by research that
has demonstrated a negative correlation of extrinsic rewards
on students' intrinsic motivation to learn and their learning
outcomes (Deci, Koestner, & Ryan, 2001). In addition,
excessive use of and reliance on extrinsic motivators, such as
grades, has been singled out by some as a major threat to
personal engagement and creative expression among stu-
dents (Covington & Mueller, 2001). Because of the
pervasive use of external incentives, both to stimulate
achievement of certain learning standards and to promote
S. Rose
task completion, research findings in this area are integral for
application to instructional practice.
A study conducted by Walker et al. (2006) examined the
relationship among intrinsic motivation versus extrinsic
motivation to cognitive engagement in college students
(Walker, Greene, & Mansell, 2005). This study provides
further support for previous research showing that intrinsi-
cally motivated students are more likely to overcome
academic challenges, have stronger academic self concept,
express more creativity, and exhibit higher academic
performance (Mitchell 1992; Vallerand et al., 1992; Deci
& Ryan, 1994). To assist our nursing students with
difficulties and challenges in the students' learning process,
we need to better understand the individual motivational
patterns of the student to promote better learning outcomes.
Furthermore, students' motivation for learning is gener-
ally regarded as one of the most critical determinants of the
success and quality of any learning outcome (Mitchell,
1992). Researchers have shown that there is an overall
enhanced learning outcome resulting from intrinsic motiva-
tion, such as more interest, excitement, confidence, enhanced
performance, persistence, creativity, self-esteem, and general
well-being (Vansteenkiste, Lens, & Deci, 2006). Research
has demonstrated positive correlations between intrinsic
motivation and student's grades and standardized test scores
and a negative correlation between extrinsic motivation and
academic outcomes (Lepper, Corpus, & Iyengar, 2005).
Gambino (2010) conducted a study that offers insight into
the motivation for entry into the nursing profession, and
although students oftentimes are motivated to enter nursing
for the altruistic reasons of caring for another person and the
desire for human contact, there is also evidence that suggests
extrinsic motivation is a strong driving force for choosing
nursing as a career. Furthermore, Rognstad et al. (2004)
found that nursing students have a high degree of self-
centeredness and are not interested in becoming an
“ordinary” staff nurse. These students expressed desire for
a career with a high salary and possibilities for promotion,
which further supports the belief that nursing students may
be motivated by just as many extrinsic factors as intrinsic
factors. This desire to meet one's own needs is increasingly
more prevalent and reflective of students entering the nursing
programs, representing the generation of the “what's in it for
me” attitude (Solvoll et al., 2009).
As hypothesized in the Walker et al. (2005) study, there
was a positive correlation among intrinsic motivation, self
efficacy, and meaningful cognitive engagement and a
positive correlation between extrinsic motivation and
shallow cognitive engagement. A path analysis was
completed to further assess the predicted correlation between
the motivation variables and the cognitive engagement
variables. Meaningful cognitive engagement was positively
predicted by self efficacy, intrinsic motivation, and identi-
fication with academics; shallow cognitive engagement was
predicted by extrinsic motivation. Therefore, for those
students who are extrinsically motivated to enter nursing
Academic success of nursing students
only for “the money” or “job security,” according to some of
the research previously noted, those students may have a
more difficult time completing their nursing program.
It is difficult to discuss intrinsic motivation without
mentioning some of the historical and theoretical connec-
tions to the realm of academic motivation. One of the most
widely cited contemporary theories of intrinsic motivation is
the self-determination theory (SDT), developed by Edward
Deci and Richard Ryan. The SDT purports that people have
an innate motivation to internalize the regulation of
uninteresting activities through introjections and integration
(Deci, Eghrari, Patrick, & Leone, 1994; Wolters, 1998). In
addition, according to the SDT, humans have three innate
psychological needs: a need to feel competent, a need to feel
related, and a need to feel autonomous. Intrinsic motivation
develops out of the support of these needs. So the question
remains, can nursing students change their motivation to
learn, and how can nurse educators facilitate the process?
The following study by Vansteenkiste, Sheldon, and
Deci, (2004) examines the relationship of the SDT and
learning outcomes in that intrinsic (versus extrinsic goals)
and autonomy-supportive (versus controlling) conditions
would improve students' learning outcomes and perfor-
mance in the student (Vansteenkiste, Timmermans, Lens,
Soenens, & Broeck, 2008).
The environment, in general, can contain any mix of
elements that could be defined as autonomy supportive or
controlling. Even when the academic environment supports
autonomy and competence, if a person is simply not
interested in a particular learning activity, he or she will
not likely be intrinsically motivated for engagement and thus
may not be successful with regard to learning outcomes.
Education begins when the student wants to learn the skills
and acquire the knowledge being discussed. This can be
accomplished through application of a variety of active
teaching strategies (Bengtsson, & Ohlsson, 2010). Van-
steenkiste et al. (2004) hypothesized that when students'
learn concepts for intrinsic goals, there will be better learning
outcomes, such as better test performance, deeper proces-
sing, and greater persistence than when they learned for
extrinsic goals.
3. Implications
Intelligence is not the only predictor of academic
achievement, academic success, and retention for nursing
students. High motivation, especially the most self-deter-
mined types of motivation, and engagement in learning have
consistently led to increased levels of student success
(Vallerand, Pelletier, & Koestner, 2008; Vansteenkiste,
Sierens, Soenens, Luyckx, & Lens, 2009). The large amount
of literature supporting intrinsic motivation as a factor in
increasing learning outcomes cannot be ignored. It is evident
in review of the research that the most positive outcomes are
resultant from the self-determined types of motivation, such
183
as intrinsic motivation. In addition, the less self-determined
types of motivation, such as extrinsic motivation and
external rewards, are either unrelated or negatively related
to positive learning outcomes (Vallerand et al., 2008).
Vansteenkiste et al. (2004) hypothesized that when students'
learn concepts for intrinsic goals, there will be better learning
outcomes, such as better test performance, deeper proces-
sing, and greater persistence for completion of their degree,
than when they learned for extrinsic goals.
Recruitment and retention of nursing students can be
impacted by the individual student's motivation for learning
and his or her motivation for choosing nursing as a career.
Historically, nursing education in the United States tends to
focus on classroom learning strategies and psychomotor
skills rather than the individual student's motivation for
learning (Perrot, Deloney, Hastings, Savell, & Savidge,
2001). Associate degree nursing programs should consider
measuring motivation in their students as an adjunctive tool
to the basic entry qualifications/criteria to help identify the
student's motivation preferences for learning, as well as for
choosing nursing as a career in order to facilitate an
educational environment to enhance students' success for
completion of a nursing program. Nurse educators and
administrators have the ability to measure student motivation
upon entering the nursing program and throughout the
nursing program using a variety of valid instruments that can
determine the students' motivation preference (extrinsic and
intrinsic). Although it is not the scope of this article to
describe all of the available tools for measuring motivation,
the following instruments are examples of tools that have
been used to assess motivation: the Academic Motivation
Scale, the Inventory of School Motivation, Harackiewicz's
instrument, and Archer's instrument (Perrot et al., 2001).
4. Conclusion
There are many factors that impact retention rates for
nursing programs. Oftentimes, factors such as intelligence,
socioeconomic issues, and personal issues play a role in the
success of nursing students. It is essential, however, to
consider how a student's motivation preference plays a role
in his or her success for completion of a nursing program.
There are many factors that motivate individuals toward
their goal of completing a degree in nursing and toward
their goal to become a nurse. Nurse educators need to
identify the motivating factors that encourage positive
outcomes for students and thus help increase retention
among nursing students.
References
Bengtsson, B., & Ohlsson, B. (2010). The nursing and medical students
motivation to attain knowledge. Nurse Education Today, 30, 150−156.
184
Covington, M., & Mueller, K. (2001). Intrinsic versus extrinsic motivation:
An approach/avoidance reformulation. Educational Psychology Review,
13(2), 157−176.
Deci, E., Eghrari, H., Patrick, B., & Leone, D. (1994). Facilitating
internalization: The self determination theory perspective. Journal of
Personality, 62(1), 119−142.
Deci, E., Koestner, R., & Ryan, R. (2001). Extrinsic rewards and intrinsic
motivation in education: Reconsidered once again. Review of Educa-
tional Research, 71(1), 1−27.
Fortier, M., Vallerand, R., & Guay, F. (1995). Academic motivation and
school performance: Toward a structural model. Contemporary
Educational Psychology, 20, 257−274.
Gambino, K. (2010). Motivation for entry, occupational commitment and
intent to remain: A survey regarding registered nurse retention. Journal
of Advanced Nursing, 66(11), 2532−2541.
Gottfried, A. (1990). Academic intrinsic motivation in young elementary
school children. Journal of Educational Psychology, 82(3), 525−538.
Jeffreys, M. (2007). Tracking students through program entry, progression,
graduation, and licensure: Assessing undergraduate nursing student
retention and success. Nurse Education Today, 27, 406−419.
Last, L., & Fulbrook, P. (2003). Why do student nurses leave? Suggestions
from a Delphi study. Nurse Education Today, 23, 449−458.
Lepper, M., Corpus, J., & Iyengar, S. (2005). Intrinsic and extrinsic
motivational orientations in the classroom: Age differences and
academic correlates. Journal of Educational Psychology, 97(2),
184−196.
Lotkowski, V., Robbins, S., & Noeth, R. (2004). The role of academic and
non-academic factors in improving college retention. ACT Policy
Report, 3−20.
McLaughlin, K., Moutray, M., & Moore, C. (2009). Career motivation in
nursing students and the perceived influence of significant others.
Journal of Advanced Nursing, 66(2), 404−412.
Mitchell, J. (1992). Interrelationships and predictive efficacy for indices of
intrinsic, extrinsic, and self assessed motivation for learning. Journal of
Research and Development in Education, 25(3), 149−155.
Newton, J., Kelly, C., Kremser, A., Jolly, B., & Billett, S. (2009). The
motivations to nurse: An exploration of factors amongst undergraduate
students, registered nurses and nurse managers. Journal of Nursing
Management, 17, 392−400.
S. Rose
Perrot, L., Deloney, L., Hastings, J., Savell, S., & Savidge, M. (2001).
Measuring student motivation in health professions' colleges. Advances
in Health Sciences Education, 6, 193−203.
Rognstad, M., & Polit, C. (2002). Recruitment to and motivation for nursing
education and the nursing profession. Journal of Nursing Education, 41
(7), 321−325.
Rognstad, M., Aasland, O., & Granum, V. (2004). How do nursing students
regard their future career? Career preferences in the post-modern
society. Nurse Education Today, 43, 493−500.
Vallerand, R., Pelletier, L., & Koestner, R. (2008). Reflections on self-
determination theory. Canadian Psychology, 49(3), 257−262.
Vallerand, R., Pelletier, L., Blais, M., Briere, N., Senecal, C., & Vallieres, E.
(1992). The academic motivation scale: A measure of intrinsic, extrinsic,
and a motivation in education. Educational and Psychological
Measurement, 52, 1003−1017.
Vansteenkiste, M., Sheldon, K., & Deci, E. (2004). Motivating learning,
performance, and persistence: The synergistic effects of intrinsic goal
contents and autonomy supportive contexts. Personality Processes and
Individual Differences, 87(2), 246−260.
Vansteenkiste, M., Lens, W., & Deci, E. (2006). Intrinsic versus extrinsic
goal contents in self determination theory: Another look at the quality of
academic motivation. Educational Psychologist, 41(1), 19−31.
Vansteenkiste, M., Timmermans, T., Lens, W., Soenens, B., & Broeck, A.
(2008). Does extrinsic goal framing enhance extrinsic goal-oriented
individuals' learning and performance? An experimental test of the
match perspective versus self determination theory. Journal of
Educational Psychology, 100(2), 387−397.
Vansteenkiste, M., Sierens, E., Soenens, B., Luyckx, K., & Lens, W. (2009).
Motivational profiles from a self determination perspective: The quality
of motivation matters. Journal of Educational Psychology, 101(3),
671−688.
Walker, C., Greene, B., & Mansell, R. (2005). Identification with
academics, intrinsic/extrinsic motivation, and self-efficacy as predictors
of cognitive engagement. Learning and Individual Differences, 16,
1−12.
Wolters, C. (1998). Self-regulated learning and college students' regulation
of motivation. Journal of Educational Psychology, 90(2), 224−235.
Zysberg, L., & Berry, D. (2005). Gender and students' vocational choices in
entering the field of nursing. Nursing Outlook, 53, 193−198.