Motivation of Pharmacy Services Elective and BS Pharmacy Students

Motivation is a key aspect affecting performance, in all cases. Generally, by the age of 15-17 students begin to think about the future; then their vocational goals, career exploration and preparation become motivators (Karns and Myers-Walls, 1996). “Research on motivational theories and studies of students’ learning” (Brophy 1998, Pintrich and Schunk 1996) reveals that self-efficacy; the individual’s goals toward tasks, task value and the learning environment dominate students’ learning motivation. Booth et al., (1984) sought to determine the motivation of applicants for places in a school of pharmacy, looking at factors influencing choice such as: sources of influence, school characteristics, and other career alternatives.

Some authors have measured the comparative influence of extrinsic and intrinsic motivators behind choice of university course in medicine and pharmacy in Australia (Greenhalgh T et al. 2004). According to Roller L. (2004) Extrinsic factors are those associated with work conditions and rewards such as: income and status, the potential for self-employment or part time work.

The intrinsic factors are: liking science, liking people, intellectual satisfaction, being socially useful.

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According to Dr. R. Franken (2006), motivation is the arousal, direction, and persistence of behavior. One of the major concepts in psychology is that of motivation. It would be difficult indeed to overstate its importance when one observes the extent to which it is an integral part of our efforts to achieve a valid psychology of learning, of perception of thinking and of social behavior of all forms, whether normal or abnormal and finally in the sophisticated, professional attempts at social control as, for example, in education and in psychotherapy.

Motives are variously conceived as intervening variables with associated stimuli, as central nervous states, as sensitizing factors, as symbolic processes, as stimuli or responses. (Bunch, M., 1958) A review of learning motivation studies revealed the diversity and variety of motivation factors, such as self-perceptions of ability, effort, intrinsic goal orientation, task value, self-efficacy, test anxiety, self-regulated learning, task orientation and learning strategies (Garcia 1995, Garcia and Pintrich 1995, Nolen and Haladyna 1989, Pintrich and Blumenfeld 1985).

These studies, on the one hand, highlighted the diversity of the learning motivation and, on the other hand, showed how researchers’ interests influenced the approach taken to aspects of motivation. Burlage HM (1963) conducted a study of 385 first-year students in a 5-year pharmacy program found that the motivating influences for choosing pharmacy as a major included a desire to earn a high salary, an interest in chemistry, and a desire to help. Pratt R. (1965) survey comparing 1,569 health science majors (eg, dental hygiene, dentistry, medicine, nursing, pharmacy, and public health), including 422 freshmen and senior pharmacy students, found that the pharmacy students, regardless of age, were more likely than other students to choose the major for practical reasons, such as: expectation of economic security, expectation of advancement in position and social prestige, and opportunity to fulfill one’s financial needs immediately.

About 250 pharmacy students found the top factors for choosing pharmacy were: desire a career in the health field, desire to help people, opportunity to earn a high salary, job security, and respected occupation. The top 5 individuals who influenced the students’ decision in choosing the career were pharmacists, mother, father, other relatives, and personal friends. (Rascati K.L., 1989) 2.2 Cross sectional Survey According to Setia (2016), cross-sectional study design is a type of observational study design. In a cross-sectional study, the investigator measures the outcome and the exposures in the study participants at the same time and the participants in the study will be based on the formulated inclusion and exclusion criteria set by the researchers. In this type of study, the researchers record the information about their subjects without manipulating the study environment. Also, according to Hemed (2015), cross-sectional studies can be helpful in determining how many people are affected by a condition and whether the frequency of the occurrence varies across groups or population characteristics.

A study conducted by James, et. al. (2017) in a study entitled “Was Pharmacy Their Preferred Choice? Assessing Pharmacy Students’ Motivation to Study Pharmacy, Attitudes and Future Career Intentions in Sierra Leone”, stated that there is limited number of students entering the profession, therefore an understanding of the factors that influence the choice of pharmacy as a career is needed to attract highly motivated and skilled individuals into the profession. Their aim was to assess pharmacy students’ motivation to study pharmacy, their attitude and future career intentions in Sierra Leone. They have utilized a cross-sectional questionnaire based on the students and the data collected was treated using descriptive statistics, chi-square and Fischer exact two-tailed tests.

The results showed that Close to a quarter of pharmacy students surveyed chose pharmacy as their preferred major. Motivation for choosing pharmacy was assessed based on three domains (education, personal and career-related factors). Students cited a subject teacher at school ̸ College as the most education-related influence, while friends and family members was the major personal-related factor. Also, students considered the desire for self-employment in a healthcare related job, and excellent career opportunities as the major career-related factors that influenced their choice of pharmacy as a preferred major. Pharmacy students demonstrated a positive attitude toward the profession and considered drug manufacturing and hospital pharmacy as the most desirable future career options. A study conducted by Katz et. al. (2010) entitled “Students’ Needs, Teachers’ Support, and Motivation for Doing Homework: A Cross Sectional Study”, the researchers used the self-determination theory as a framework for the cross-sectional study of the elementary and junior high school students’ autonomous motivation for homework. The focus was on the role of teachers’ support of students’ psychological needs in students’ motivation for homework in the two school systems, and investigated the contribution of a supplement between teachers’ support and students’ expressed level of psychological needs to independent motivation for homework. The results showed the teachers support interceded the difference in independent motivation for homework between students in the two school systems.

Furthermore, the results suggested that students with different level of expressed needs may distinguish different levels of teachers’ support, and that teachers’ support might be more important for students who express higher level of needs, perceived teachers’ support of psychological needs was important for students’ adaptive motivation for homework, irrespective of their expressed level of needs. In another study conducted by Shraim (2015), entitled “Community pharmacists’ knowledge, practices and beliefs about complementary and alternative medicine in Palestine: a cross-sectional study”, the main objective of this study was to assess the knowledge, beliefs, and practices of community pharmacists in Palestine about CAM since the utilization of Complementary and Alternative Medicine (CAM) is dramatically increasing among patients. A total of 284 community pharmacists were surveyed, however, 281 were included in the analysis as they met inclusion criteria. Out of the 281, 149 of the participants were males and the rest were females. About 40% of the participants were between 20 to 29 years old. Pharmacists frequently recommended CAM. Exercises and food supplements were the most commonly recommended. Vitamin B12 was the most frequently prescribed supplement in the last year. The median knowledge score was 5 out of 8 and the median beliefs about CAM score was 4.0 out of 7.0.

The CAM recommendations by pharmacists appear to be commonplace. Results showed that pharmacists still need more education and training about CAM in order to be more qualified to provide better pharmaceutical care and improve their patient’s outcome 2.2 Interpretative Phenomenological Analysis According to Brocki &Weardon (2006), Interpretative Phenomenological Analysis is an approach to qualitative research that is well-established in the British psychology. It aims to understand what an experience is like from a participants’ perspective, with a regard to a given phenomenon in a given context. IPA is a particularly useful methodology for examining topics which are complex, ambiguous and emotionally laden (Smith & Osborn, 2009). IPA draws upon the fundamental principles of phenomenology, hermeneutics, and idiography. Phenomenology can be defined as the study of the phenomena; how things appear and how things were experienced from a first person point of view (Smith, 2011). It is a study regarding conscious experience as experienced personally from a subjective or first-person point of view. Hermeneutics (from the Greek word ‘to interpret’ or ‘to make clear’) comprehend the mind-set of a person and language which mediates one’s experiences of the world, in order to translate his or her message (Freeman, 2008).

Idiography refers to an in-depth analysis of single cases and examining individual perspectives of study participants, in their unique contexts. The principle of idiography is based on the investigation of every single case before producing a general statement. The analytical process in IPA is often described in terms of a double hermeneutic or dual interpretation process. Firstly, the participants relay their experience from their own point of view and secondly, the researcher tries to decipher that importance - comprehend the members' significance making (Smith & Osborn, 2008). A study conducted by Smith & Osborn (1998) entitled “The personal experience of chronic benign lower back pain: An interpretative phenomenological analysis”, the researchers have seen chronic back pain as a major health problem and their aim is to explore the patients’ personal experiences of their pain.

They have also stated that pain is a prime exemplar of such a phenomenon: elusive, involving complex psycho-somatic interactions and difficult to articulate, hence they utilized the Interpretative Phenomenological Analysis as a method for an in-depth study of the semi-structured interviews that were carried out to nine women pain patients. The verbatim transcripts of the interviews were used as the data and from there, four emerged themes were produced namely: searching for an explanation, comparing this self with other selves, not being believed and withdrawing from others. 2.5 Phenomenology on Motivation to Pursue a Profession In a study conducted by Mugot (2009) entitled “Students Awareness and Motivation in the Choice of Library and Information Science (LIS as a Career): Basis for Promotional Strategies”, the researchers wanted to determine the level of interest and motivation of 4th year students of integrated school and night high school of La Salle, Ozamiz City, SY 2008-2009 towards the LIS profession. The result shows from the 156 integrated school students and 23 LSU-night schoolers that majority of them will choose the said career if personal influence is involved. Also, majority of them find it boring, not interesting, a silent type of work and they've already had plans to take in college. The study led to a realization that the best way to promote this profession is through career assessment programs followed by seminars and talks as well as television advertisements and the least is newsletters.

Therefore, the promotion of librarianship profession depends on how aware students in this career. In the study entitled “Nursing students’ perceptions toward the nursing profession from clinical practicum in a baccalaureate nursing program - A qualitative study” by Tseng, H et al. (2012), a phenomenology approach is helpful in evaluating perceptions and motivation of the senior nursing students. The findings of the study not only help in the further understanding of the profession but also provide recruitment and training to newly graduated nurses.Wouter et al (2017) had a study entitled “Motivation of Dutch high school students from various backgrounds for applying to study medicine: A qualitative study”. The objective of the research was to explore students’ motivation for applying to study medicine and the factors that influence this. They used semi structured one on one interviews with the students. The result of the study showed that the main reasons for pursuing a medical career pertained to autonomous motivation (interest in science and helping people) but controlled motivation (e.g. parental pressure, prestige) was also mentioned. Experience in healthcare and patients positively influenced students’ autonomous motivation and served as a reality check for students’ expectations.

The results concluded that medical schools should be aware of this and must create opportunities to acquire health care experiences. High schools could incorporate internships as part of their study counseling programs and offer tailor-made guidance to each individual student. 2.6 Phenomenology on Motivation to Pursue Pharmacy In phenomenology, getting the lived experiences helps in assessing the needs of a group. A phenomenological study by Firmin, M. et al. (2014) entitled “A Qualitative Analysis of Students’ Perceptions of Pursuing Pharmacy as a Potential Vocation” was conducted where 36 students were interviewed. Statements were tape-recorded and transcribed for analysis. Based on the information obtained, the reasons of the students were: they see themselves as a Pharmacist in the future (Personal “Fit”), most of students described themselves as “scientifically-minded” or said they enjoy math and science (Affinity for Science and Health Care), the students have previously interacted with the pharmacist and the pharmacy field (Interaction with the Field), Participants spoke of these in terms of future anticipated life expenses, such as supporting a family and paying off school debt, and were relieved to know they potentially would be working in a well-paying profession and were of secondary importance to students (External Benefits), Other Influencing People like parents, relatives, etc. were also significant.

Synthesis Several researches like the one written by Cavaco et al (2003) discussed the ideologies on how motivation helps in improving or changing a state. In the study of Cavaco et al (2003), understanding the motivation and self- efficacy perception of pharmacy students will then help in the improvement of the goal orientation preferences of the students, which is harmonious to what the researchers conducted through a qualitative phenomenological method in assessing motivation. The researchers believe that this study “Motivation of Pharmacy Services Elective and BS Pharmacy students at the University of Makati in pursuing Pharmacy as a Future Profession” is similar with the study entitled “Was Pharmacy Their Preferred Choice? Assessing Pharmacy Students’ Motivation to Study Pharmacy, Attitudes and Future Career Intentions in Sierra Leone” by James PB et al. (2017), in which perception of students was derived to get the motivation of Pharmacy students in choosing pharmacy. The study by Burlage HM (1963) and Pratt R.; (1965) show similarities with the research because it determined motivations of pharmacy students in the pharmacy or health profession. It also determined the type of motivation the students have.

This research is in one tenacity with the study of Keshishian (2009), Chettiar (2003) and James PB et al., (2017) which is designed to determine the motivation of pharmacy students in choosing pharmacy as a future profession. However, this study is unlike the abovementioned studies as it is a study on a specific phenomenon where it takes its locale in University of Makati. Unlike in the study of James PB et al., (2017) where they used only study questionnaires to know the motivation, interview and study questionnaires were injected to the co researchers in this study One difference, however, is that it only used a study questionnaire to extract results with the supplementation of a focus group discussion. The researchers made use of the Interpretative Phenomenological Analysis as a tool to come up with superordinate and emergent themes. There are only a few phenomenological method types of literatures and studies in the country about motivation of pharmacy students according to wide-ranging researches. The study is unique for there are neither current published local researches nor studies regarding the subject matter that included Pharmacy Services Elective students aside from the BS Pharmacy students as co-researchers. Also, the study is unique in terms of its treatment of the data. It uses interpretative phenomenological analysis as a tool for formulating themes from the focus group discussion. There are no local researches that made use of this method in the qualitative sector.