A Motivational Profile of Nurses Pursuing Doctoral Education

A predicted shortage of nurses has been on the horizon for a number of years. The predicted shortage is related to the geographical distribution of nurses in some locales. An adequate pipeline of nurses is essential to meet the complex, chronic multiple conditions of Americans to ensure a safe and effective healthcare system. According to Snavely, current trends indicate stabilization in the nursing workforce, though a number of predicted factors will revive a critical shortage in the nursing workforce in years to come. In order to produce more nurses, additional educators are in demand, and doctoral education for nurses provides one possible means to achieve this goal.

orientations of nurses pursuing advanced degrees. Existing studies on motivation include drivers for RNs pursuing bachelors and master's degrees. The foundation for the present literature is based upon nursing research regarding the shortage of nurses, shortage of nursing faculty, and motivators for nurses pursuing advanced education.

Shortage of Nurses
A predicted shortage of nurses has been on the horizon for a number of years. The predicted shortage is related to the geographical distribution of nurses in some locales. An adequate pipeline of nurses is essential to meet the complex, chronic multiple conditions of Americans to ensure a safe and effective healthcare system. According to Snavely, current trends indicate stabilization in the nursing workforce, though a number of predicted factors will revive a critical shortage in the nursing workforce in years to come. In order to produce more nurses, additional educators are in demand, and doctoral education for nurses provides one possible means to achieve this goal.

Shortage of Nurses
The shortage of nursing faculty presents a significant threat within the US as a steady pipeline of nurses is needed to produce the amount of nurses necessary to sustain the delivery of healthcare services. In order to provide a steady pipeline of nurses prepared to work in the healthcare environment, RNs with bachelor's degrees (BSN) must return to school and pursue graduate study. The reality of a predicted nursing faculty shortage is exacerbated by the lack of PhD-prepared nurses. Nehls et al. further asserted that the problem is complicated by the fact that graduates from nursing PhD programs have a fairly short period of time to make significant contributions to the field. The average age of PhD-prepared nursing graduates is 46 years-over Abstract Background: Presently, less than 1% of the nursing workforce possesses a doctoral degree. Characteristics of nurses who seek doctoral education are poorly understood. This research describes the motivational orientation and factors of Registered Nurses (RN's) pursuing doctoral education. Results: Results of the study indicated that participants self-identified with the motivational orientation of intrinsic motivation-to know, a self-determined motivational orientation. Positive correlates included geographical locale, age and race.

Conclusion:
The innate benefits perceived by RN's as reflected in the intrinsically motivated orientation provides insight into potential innovative strategies to recruit and retain RN's seeking doctoral degrees.

Background of the Problem
The demand for nurses with advanced education within healthcare and community environments has stimulated the need for nurses prepared at the doctoral level. Moreover, recommendations from the Institute of Medicine include doubling the number of nurses prepared at the doctoral level in the United States (US) by 2020 in an effort to have adequate numbers of faculty to educate future nurses and conduct nursing research. In concert with the positive aspects of nursing research, nurses prepared at the doctoral level can provide a significant impact on the creation of nurses as leaders and equal collaborating members within the healthcare environment. Furthermore, characteristics of nurses who seek doctoral education are poorly understood, and this information is critical to planning long-term strategies for US nursing education.

Statement of the Problem
The collaborative knowledge and skill level of DNP and PhD prepared nurses provides a means to improve the gap between research and practice. According to Sarver, et al., nurses highly regard continuing professional education, but in order to achieve success, support from nursing leadership is paramount. However, no known studies to date examine the relationship of the motivational orientation of RN's specifically pursuing doctoral education. Hence, the purpose of this study was to describe the motivational orientation and factors of RNs pursuing doctoral education.

Theoretical Framework
The theoretical framework for this study was based on Self-Determination Theory (SDT) and the framework that RNs have varied motivational orientations and factors for pursuing doctoral education. The SDT provides a mechanism to explain human behavior and categorizes individual behaviors as intrinsically motivated, extrinsically motivated, or amotivated. Motivational orientations of RNs are proposed as either intrinsic, extrinsic, or amotivated.

Literature Review
Student motivation for pursuing advanced education is individualized and varied. The unique motivating factors which lead to the pursuit of advanced education are of interest to nurse educators in academia. A limited number of studies exist on the motivational a decade older than the mean age of all doctoral graduates. Also, Potempa et al. noted that current methods for nursing doctoral education do not prepare a sufficient number of graduates to replace retiring faculty or expand capacity.
In the study conducted by Shen et al. findings revealed that PhDand DNP-prepared RNs were the most employed in the field of nursing with PhD-prepared nurses working primarily in academic settings and DNP prepared nurses working in ambulatory care, academic settings, or hospitals. Also, Smeltzer et al. noted that the current mixture of faculty teaching in DNP and PhD programs has implications for the development of the scientific discipline of nursing.

Motivators for Advanced Education
The educational preparation of RNs has an impact on patient safety, outcomes, the nursing shortage, the faculty shortage, and the attitude and actions of nurses. Patient outcomes provide the primary motivation to encourage continued formal education. Byrne, et al. conducted a pilot study to identify internal motivators for RNs to pursue a BSN. Findings from the study indicated that respondents believed pursuing advanced education would provide career opportunities. Further findings indicated that nurses' self-perception was that their current level of education was sufficient. Similarly, in a study conducted by Warren and Mills [18], findings indicated that nurses expressed little desire to return to school. Moreover, lower intent to stay in the present job with lower levels of job satisfaction was a predictor of nurses pursuing a master's degree [4]. Likewise, Altmann [16] noted that the top barriers for not pursuing advanced education included older age, the lack of additional salary compensation, not a condition of employment, and not needed to provide quality patient care. While this study added to the body of knowledge regarding internal motivators for RNs to pursue a BSN degree, information is lacking on the motivators for RNs pursuing doctoral degrees. Further, recommendations from the study support the need for future research on how to overcome nurses' reluctance for further education. A study which identifies extrinsic and intrinsic motivators for nurses pursuing doctoral education is posited to provide a means to understand nurses' perspective on further education.

Human Subjects Protection
Permission to complete the study was granted by the Institutional Review Board (IRB) at The University of Southern Mississippi. The rights and confidentiality of participants was protected and the expressed voluntary nature of the study explained. The identity of participants was protected by granting participants a waiver of written documentation in the informed consent. Moreover, no Uniform Resource Locator (URL) information was collected.

Methodology
A non-experimental descriptive correlational design was utilized. A power analysis was performed to identify the needed sample size. A total of 250 completed questionnaires were needed for data analysis so the targeted sample size was 1,000 to ensure that a sufficient number of surveys were available for analysis. The final sample for data analysis included responses from 173 RNs enrolled in doctoral study. Schools awarding doctoral degrees in nursing were entered into a 2013 version of Excel spreadsheet. The programs for randomization Int  then were grouped and numbered on the spreadsheet by state and degree awarded (e.g., Ph.D., DNP, or both). As each organization was numbered, then the website random.org was utilized to randomize selection of participating institutions. The researcher then requested agreement to participate from each selected institution.
The Academic Motivation Scale (AMS) is a survey instrument developed to measure motivation toward education. The AMS includes ratings on a 7-point horizontal numeric scale with ranges from 1 (Does not correspond at all) to 7 (Corresponds exactly) in response to each item. The AMS, developed by Vallerand et al. [19] with modifications (electronic approval to revise obtained from Vallerand et al. [19]) specific to nursing, was used as the survey instrument to identify factors which might motivate RNs to pursue doctoral education. Findings of the study provided sufficient support of the factorial validity and reliability of the AMS with validation of its use in academic research on motivation [19]. Reliability of the instrument was validated using a Cronbach alpha for each subscale. The survey instrument included 11 items which provided a means to obtain demographic information, with 28 Likert-type items to collect information on the motivational orientation.

Data Analysis
The initial methods used included exporting the data from Qualtrics into SPSS Version 23. Data cleaning was utilized by reviewing collected data for missing items, normality, and outliers. The variables were then labeled and levels identified by the principal investigator for coding. For purposes of this study, binary logistic regression was used to describe the motivational orientation and factors for RNs pursuing doctoral education.

Findings
Findings of the study supported and further illustrated the limited body of research specific to the motivational orientation of RNs in pursuit of advanced education. One noteworthy similarity between this study and Richardson [20] was the identified motivational orientation of RNs as intrinsic motivation-to know. Findings further supported studies performed by Altmann [16] and Warren and Mills [18] which reflected nurses satisfied with their present employment (an extrinsic motivator) as having little desire to pursue further education. In essence, a positive correlation exists between an intrinsic motivational orientation and pursuing doctoral education. The factors of age, geographical locale, and race did provide the lowest significance. One potential explanation for the findings may be due to the small size which could impact the ability to detect significant differences. Further, the demographic factors of employment and SES for the sample were comparable with limited variation. One noticeable demographic finding included the large number of female-enrolled participants (n = 154) compared to participants (n = 19).

Implications for Nursing Education
Results of this research provided insight into the motivational orientation of RNs pursuing doctoral education. These results may provide guidance into the recruitment and attrition of this population. Therefore, it is recommended that colleges and schools of nursing can formulate recruitment methods with the intrinsically motivated orientation in mind.

Limitations
The purpose of the study was to describe the motivational orientation and factors of RNs pursuing doctoral study. In identifying the purpose, the necessity of further research was evident. Replication of this study would provide a means to validate findings from the study through similarities in identified outcomes. The sample size in the present study was small, which necessitates replication of the study to include a larger sampling pool. A second area of further research on this topic is to integrate a qualitative component.

Conclusion
The results of this study highlight the motivational orientation and select factors for RNs pursuing doctoral education. An encouraging finding of the study is the innate benefits perceived by RNs in the select programs as reflected in the intrinsically motivated orientation. Insight into the motivational orientation of RNs in pursuit of doctoral degrees is imperative as the commitment to lifelong education is an expectation for nursing professionals in the US and abroad.