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It's not my fault: Understanding nursing students' causal attributions in Pathophysiology
Nurse Education Today 33 (2013) 828–833
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Nurse Education Today journal homepage: www.elsevier.com/nedt
It's not my fault: Understanding nursing students' causal attributions in Pathophysiology Karee E. Dunn a,⁎, Cara Osborne b, Glenda C. Rakes c a b c
248 Graduate Education Bldg., University of Arkansas, Fayetteville, AR 72701, United States 111-A Ozark Hall, University of Arkansas, Fayetteville, AR 72701, United States 205-F Gooch Hall, University of Tennessee, Martin, Martin, TN 38238, United States
a r t i c l e
i n f o
Article history: Accepted 20 February 2012 Keywords: Nurse education Causal attributions
s u m m a r y Pathophysiology is a difficult subject matter for many nursing students. This course is also critical for safe clinical practice. However, little research has explored what variables may influence nursing students' success in this course. This study is the first in a forthcoming series that seeks to better understand how to facilitate student success in Pathophysiology. In this study, students' causal attributions for successes and failures were explored as these attributions greatly influence future academic motivation and behavior. Students were asked to respond to two open-ended questions in order to better understand what causal attributions students were making for their successes and failures in Pathophysiology. Seventy-five Bachelor of Science in Nursing students who were enrolled in Pathophysiology returned their responses (92.6% response rate). Content analysis was utilized to determine whether students were making internal or external causal attributions for their successes and failures. Additionally, responses were evaluated in order to identify common themes shared by respondents. The majority of respondents (84%) attributed their academic successes in Pathophysiology in part to internal causes, and the majority of respondents (68%) attributed their academic failures, in part, to external causes. In this study the majority of students attributed their successes to controllable, unstable causes—primarily effort. Research indicates that attributing success to effort may reflect that students' confidence in their abilities is suffering, and that attributing failures to external causes, such as task difficulty, are also detrimental to performance and learning (Siegle et al., 2009). The results of this study are further presented and discussed. © 2012 Elsevier Ltd. All rights reserved.
Introduction
Attribution Theory
Undoubtedly, one of the challenges nursing faculty face is teaching Pathophysiology. Although not all nursing students agree, the majority of nursing students perceive Pathophysiology as one of the most difficult and least interesting courses in the nursing curriculum (Elberson et al., 2001). While this course may not be students' favorite in nursing school, it is critical for safe practice in the clinical setting (Salamonson and Lantz, 2005). Often times when students consider learning tasks to be difficult, unpleasant, and/or boring, the students attribute their learning outcomes to factors that are outside of their control (Miller and Ross, 1975). This is unfortunate because these types of causal attributions negatively impact motivation and future academic behaviors (Doctor, 2004; Russell and Phelps, 2009; Weiner, 1994, 2010). The purpose of this study was to explore the causal attributions undergraduate nursing students make for both their successes and failures in Pathophysiology.
A central assumption of attribution theory is that students attempt to devise the causal determinants of their behavioral outcomes (Weiner, 1986, 2010). These attributions in turn impact future academic choices and behaviors (Weiner, 1989, 1994, 2000, 2010). In short, student attributions can significantly impact learning and academic success (Siegle et al., 2009; Struthers et al., 1996). Weiner's attribution theory is sequential and begins with an individual designating an outcome to be a success or a failure (Graham and Williams, 2009). Then, the learner experiences happiness or sadness with regard to their interpretation of the outcome. Finally, the individual attempts to understand why the outcome occurred. Individuals may attribute these perceived successes or failures to ability, effort, context, luck, or mood (Hamilton and Akhter, 2002; Lefcourt et al., 1979). These perceived causal determinants of outcomes fall within three dimensions—locus (i.e., internal or external), stability, and control (Weiner, 1994, 2000; Weiner and Graham, 1989). For example, luck is external (locus), unstable (stability), and uncontrollable (controllability). The first dimension is locus, the location of the cause, which may be internal or external to the person. Of the dimensions, locus of
⁎ Corresponding author. E-mail address: [email protected] (K.E. Dunn). 0260-6917/$ – see front matter © 2012 Elsevier Ltd. All rights reserved. doi:10.1016/j.nedt.2012.02.012
K.E. Dunn et al. / Nurse Education Today 33 (2013) 828–833
control is one of the most influential for student success. An internal locus of control is associated with more successful academic outcomes where as an external locus of control is more strongly associated with negative academic outcomes (Carr et al., 1991; LebedinaManzoni, 2004; Phillips and Gully, 1997; Russell and Phelps, 2009). The second dimension is stability, which reflects whether the cause of the outcome is perceived as being the same across time or different depending upon the context. Stability is associated with expectations for the future. If failure is associated with something stable such as the difficulty of material in a particular course, a student may believe they will fail and are less likely to be motivated to try harder. The final dimension, controllability, reflects the degree to which the individual believes they controlled the cause of the outcome. Controllability is related to emotions. If one experiences failure and believes the causes were controllable, he or she may feel angry. These attributions impact how individuals affectively, cognitively, and behaviorally respond in future situations (Weiner, 1994). Thus, understanding students' explanation for both academic successes and academic failures may be important to future academic success (Graham and Williams, 2009). Individuals tend to claim responsibility for their successes, attributing such behavior to internal factors, but blame failures on external reasons (Miller and Ross, 1975). This pattern of explanation allows learners to rationalize failures and to view themselves in a more positive light, regardless of what the outcome of a particular behavior might be. Unless the pattern of attributing failures on external influences is interrupted, the cycle is continued to the detriment of learning. Some research indicates attribution training that focuses on effort and strategies, rather than ability, can motivate students to work harder and perform more successfully on academic tasks in the future. Attributional tendencies have been shown to change after a single training presentation (Menec et al., 1994; Schunk, 2005; Wilson and Linville, 1982; 1985). In light of Pathophysiology's difficult nature (Elberson et al., 2001) and the evidence that suggests the highly malleable nature of student attributions (Doctor, 2004), understanding nursing students' causal attributions in Pathophysiology may provide nursing faculty with a means of improving student performance, and subsequently, teachers experience of teaching Pathophysiology. The greatest impediments to learning caused by attributions arise when students attribute failures to external, stable, and uncontrollable causes (Weiner, 2000). Such attributions are likely to lead to low motivation and a sense of helplessness. Ideally, a nursing instructor would want Pathophysiology students to feel in control of their learning because such attributions lead to increased effort, strategy use, persistence, and selection of more challenging academic tasks (Schunk, 2000; Weiner, 1994). Moreover, nursing faculty would want Pathophysiology students to attribute failures to unstable variables such as effort. Students who attribute failures to internal, controllable, unstable variables have more confidence in their abilities and are more likely to succeed (Weiner, 2000; Graham and Williams, 2009). While psychological literature and educational literature have extensively explored the topic of attribution theory, there is limited research on this topic in nursing (Wood et al., 2009). In the one article found on attributions in nursing students, Wood et al. (2009) found that nursing students in a medical-surgery theory made lower grades if they attributed their academic outcomes to caus.es outside of their control. The existing psychological and educational research indicates that student attributions related to academic outcomes significantly impact their academic achievement (Siegle et al., 2009; Struthers et al., 1996). In light of the limited research on the role causal attributions play in nurse education, it is important to understand what variables influence nursing students' attributions in order to help nursing students develop attributions that support success in the academically rigorous nursing curriculum. Such understanding is of particular import for a course as difficult as Pathophysiology (Elberson et al.,
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2001) that so significantly impacts in-service nurses' clinical practice (Salamonson and Lantz, 2005). Therefore, this study sought to better understand nursing students' causal attributions for both successes and failures in Pathophysiology. Because of the strength of the influence of students' locus of control on academic success, this study primarily focused on respondents' description of causes as internal or external (Carr et al., 1991; Lebedina-Manzoni, 2004; Phillips and Gully, 1997; Russell and Phelps, 2009). A secondary focus was to identify the prevalence of the following causal attribution pattern for academic failures—external, stable, and uncontrollable. Methodology Participants The sample in this study consisted of 81 fully admitted nurse education undergraduate students enrolled in Pathophysiology. The Midwestern university's nursing program from which the sample was taken is fully accredited. Of those surveyed, only 75 returned their responses to the two open-ended questions. Respondents ranged in age from 20 to 47 (M = 26). Eighty-eight percent of the respondents were female (n = 66) and 12% were male (n = 9). Procedures and Research Questions Approval to use human subjects and to conduct this study was granted by the university's Institutional Review Board. The researchers provided participants with a two item open-ended survey and explained that participation was voluntary and anonymous. Prior to participating in this study, students were required to submit a signed informed consent form. The surveys are given as part of course requirements in order to enhance students learning experiences. The researchers asked participants to respond to the following two open-response items: 1. When you do well in this class (quizzes, tests, etc.), to what do you attribute that success? 2. If you do not do as well as you like on assignments in this class (quizzes, tests, etc.), how would you explain the cause of that performance? Two of the researchers examined responses to these open-ended questions in order to explore the following three guiding research questions: 1. How many students attributed successes, at least in part, to internal causes? 2. How many students attributed failures, at least in part, to external causes? 3. What common themes were presented among students' responses to the two open-ended questions? The third researcher, who taught the course, did not review openended responses as students sometimes reported their names along with their responses. Thus, only two of the authors reviewed responses to protect students' anonymity. The teacher–author never saw the students' responses as a non-teacher-author collected the responses from students. Data Analysis Content analysis was used to identify the emergent themes of participants' responses to the two open-ended questions. It is important to note that many students reported more than one causal attribution for each item. Content analysis has been defined as “any qualitative data reduction and sense-making effort that takes a volume of qualitative material and attempts to identify core consistencies and meanings” (Patton, 2002, p.453). Two of the authors separately examined participants' responses.
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Because the identification of causes as internal or external has such a powerful influence on student learning and achievement (Carr et al., 1991; Lebedina-Manzoni, 2004; Phillips and Gully, 1997; Russell and Phelps, 2009), student responses to questions were first evaluated for internal and external attributions. These causal attributions were then evaluated for common themes. Subsequently, responses were analyzed to identify external, stable, and uncontrollable causal attributions as such attributions are detrimental to academic success (Weiner, 2000; Graham and Williams, 2009). The findings of these analyses are presented below. Results The two authors who evaluated the responses to the first question agreed on 96.7% of the categorizations. The authors then discussed the reasons for their different analyses. Upon further discussion, the authors reached an agreement upon the remaining items. With regard to the responses to the second question, the authors agreed on 100% of the categorizations. Attributions for Success Fifty-one respondents (68%) indicated that they attribute their academic successes to internal causes. Twelve respondents (16%) indicated that they attribute their academic successes to external causes. Twelve respondents (16%) indicated that they attribute their academic successes to a mix of internal and external causes. Therefore, 63 of 75 respondents (84%) attribute their academic successes, at least in part, to internal causes (see Fig. 1). The two authors agreed upon 11 themes that manifested in students responses to what causal attributions they make for their academic successes. The internal causal attribution themes that emerged were— effort, study habits, understanding, class attendance, ability, interest, and intelligence. An example of a response coded as effort was: “I worked hard and earned that grade.” An example of a response coded as study habits was: “I broke the material in to small units that made sense to me before I studied.” An example of a response coded as understanding was: “I simply understood the material.” An example of a response coded as class attendance: “I wouldn't have done so well, if I hadn't gone to hear class lectures.” An example of a response coded as ability was: “I've got really good critical thinking abilities.” An example of a response coded as interest was: “I do better when I really enjoy what I study. That interest helps motivate me to study.” An example of a response coded as intelligence was: “Honestly, I do good because I'm smart.” The external causal attribution themes that emerged were—professor, luck, program time demands, and test design. An example of a response coded as professor was: “The [professor] has explained things clearly.” An example of a response coded as luck was: “Being a good guesser.” An example a response coded as program time demands was: “Breaks in
other classes help me get adequate hours of study time.” An example of a response coded as test design was: “The test questions were fair.” The frequency of each type of response was reported in Table 1. Attributions for Failures Twenty-six respondents (32%) indicated that they attribute their academic failures to internal causes. Thirty-one respondents (41%) indicated that they attribute their academic failures to external causes. Eighteen respondents (27%) indicated that they attribute their academic failures to a mix of internal and external causes. Therefore, 49 of 75 respondents (68%) attribute their academic failures, at least in part, to external causes (see Fig. 2). Twenty-six respondents (35%) attributed failures to external, stable, and uncontrollable causes. Of those 26 respondents who attributed failures to external, stable, and uncontrollable causes, 85% reported purely external attributions for failures (not mixed attributions, see Fig. 3). An example of a student attribution comment coded as external, stable, and uncontrollable was: “There are too many classes that have papers, homework, quizzes, and tests on the same days and week. Therefore, it is hard to get all the studying in we need to keep up…It gets to be VERY overwhelming.” The two authors agreed upon nine themes that manifested in students responses to what causal attributions they make for their academic successes. The internal causal attribution themes that emerged were—effort, understanding, study habits, ability, and interest. An example of a response coded as effort was: “Laziness.” An example of a response coded as understanding was: “I didn't understand as well as I should have.” An example of a response coded as study habits was: “I have really bad study habits.” An example of a response coded as ability was: “My general inabilities.” An example of a response coded as interest was: “I am not interested.” The external causal attribution themes that emerged were—professor, program time demands, test design, and outside stress. An example of a response coded as professor was: “The professor goes too fast.” An example of a response coded as program time demands was: “We are expected to do too much in all our nursing courses.” An example of a response coded as test design was: “The test doesn't cover what I expected.” An example of a response coded as outside stress was: “I need to quit my job.” The frequency of each type of response was reported in Table 2. Discussion If entered in the Google search engine, the statement “I earned an A.” returned 54,600 hits. When the statement “I earned an F.” was entered, the search returned only 2,860 hits as compared to “He gave me an F.” that resulted 75,700 hits. Clearly this is merely anecdotal evidence, but this informal search supports and serves to drive home the point that while many students are willing to take full Table 1 Frequency of attributions for success (n = 75).
16%
16% EXTERNAL
68%
INTERNAL MIXED
Fig. 1. Causal attributions for academic successes in Pathophysiology.
Internal attributions
f
%
1. Effort 2. Study habits 3. Understanding 4. Class attendance 5. Ability 6. Interest 7. Intelligence Internal total External attributions 8. Professor 9. Luck 10 Program time demands 11. Test design External total
47 19 9 9 3 3 2 92 f 10 9 9 1 29
38.8 15.7 7.4 7.4 2.5 2.5 1.7 76 % 8.3 7.4 7.4 0.9 24
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Table 2 Frequency of attributions for failure (n = 75).
27% 41%
EXTERNAL INTERNAL
32%
MIXED
Fig. 2. Causal attributions for academic failures in Pathophysiology.
responsibility for their academic successes, the majority are not as willing to take responsibility for their academic failures. The results of this study align with this anecdotal evidence. The majority of this study's respondents (68%) indicated that they attributed their academic successes in Pathophysiology to internal causes. This number grows substantially if students who provided at least partial credit to internal causes for their successes (84%) were included. An example of such a mixed response was “I've done pretty well so far because I work really hard. I also have a lot of working knowledge from other courses that help with this one, but I don't think I'd be doing as well if the teacher didn't care if we understand this stuff.” Although a number of students reported internal attributions for academic failures, the majority attributed their academic shortcomings at least in part to external causes (68%). This attributional style was more salient than the positive finding that some students attributed part of their failures to internal causes (39%), as the attributional tendency to associate academic failures with external causes is related to decreased academic achievement (Yailagh et al., 2009). An example of such a mixed response was “My study habits are pretty bad, but I do fine in other classes. I think the biggest issue is that the we are not told what will be on the tests.” In other words, the current findings supported both Miller and Ross' (1975) position and the anecdotal evidence above. Students believed they earned their success, and believed their failures were imposed upon them. When examined more closely, the analysis of these students' causal attributions for their successes and failures in Pathophysiology revealed interesting patterns with powerful implications for Pathophysiology instructors. The determination of a casual attribution for academic success as internal alone is insufficient to determine if a student holds productive or detrimental interpretations of their learning experience. In this study the majority of students attributed their successes to controllable, unstable causes—primarily effort. While on the surface this may seem ideal, research reveals that such attributions may indicate that students' confidence in their abilities are suffering (Dweck, 2000). Essentially, these students may be questioning their ability and competence in this course because they must exert greater
15%
85%
PURELY EXTERNAL MIXED
Fig. 3. External compared to mixed attributions for external, stable, and uncontrollable attributions.
Internal attributions
f
%
1. Effort 2. Understanding 3. Study habits 4. Ability 5. Interest Internal total External Attributions 6. Professor 7. Program time demands 8. Test design 9. Outside stress External total
30 11 7 3 3 54 f 33 26 23 3 85
21.6 5.0 7.8 2.2 2.2 38.8 % 23.6 18.6 16.4 2.2 61.2
amounts of effort (Hong et al., 1999). Only a small number of students attributed successes to causes such as ability (n = 3) or intelligence (n = 2). Attributions to ability or intelligence are actually more beneficial to student self-efficacy (Siegle and McCoach, 2007). These findings are not surprising as the sample is primarily female, and females are more likely to attribute successes to effort than to ability (McClure et al., 2011; Rimm, 1991). However, addressing these attributions presents a challenge as providing students with praise for their ability may actually increase student fear of failure, decrease efficacy, and result in students avoiding challenging tasks because they desire to preserve the belief in their abilities (Kamins and Dweck, 1999). Moreover, these students may become more performance-oriented rather than mastery-oriented (Siegle et al., 2009). Thus, future research should investigate means of increasing Pathophysiology ability-oriented attributions for success. A second theme that emerged and may be of great concern to those teaching Pathophysiology was the attribution of failure to external, stable, and uncontrollable causes. Such attributions may be detrimental to future motivation and result in a sense of learned helplessness (Weiner, 2000). The most common of these attributions related to the impact of the demands of the program on students' time. An example of one of these attributions was “Its impossible to get enough studying in because we have WAY too much to do in ALL our courses to ever dedicate enough time to be really successful in Patho.” If students believe that the demands of the program make it “impossible” for them to succeed, they will be less motivated to do what is needed to succeed. In other words, they may be developing a sense of learned helplessness. It will be important to retrain these attributional tendencies to help students feel in control of their learning because students who feel in control of their learning are more likely to increase effort, strategy use, persistence, and selection of more challenging academic tasks (Schunk, 2000; Weiner, 1994). The goal of attribution retraining is to help students develop attributional patterns in which failures are associated with internal attributions that are controllable and unstable such as effort in order to alter maladaptive behavior (Cheong et al., 2005; Hall et al., 2004; Wilson et al., 2002). Evidence exists to support that single training sessions can powerfully impact student attributions (Wilson and Linville, 1982; 1985). For example, Menec et al. (1994) found that when low achieving college students in an introductory psychology course viewed an eightminute attribution training video, their test scores improved. Furthermore, simply providing feedback that failures are caused by lack-luster effort levels lead to significant increases in performance (Schunk, 2005; Toland and Boyle, 2008). Much of the empirical research regarding the impact of attribution retraining has been garnered from research on low achieving, at-risk, or learning disabled children or college students (e.g., Cox and Yang, 2012; Perry et al., 1993). Hall (2004) applied two types of attribution retraining to groups of college students defined as high achievers and low achievers. One employed cognitive strategies in which students were taught to
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understand their thinking processes (meta-cognitive strategies). The second employed affective strategies in which students were taught to understand their emotional reactions to successes and failures. Both types of attribution retraining strategies benefited both groups of college students. Weiner (2010) notes that while the research regarding the malleable nature of students' attributions and the impact of attribution changes on achievement-related outcomes is encouraging, further research is needed to confirm and elaborate upon this conclusion. Based upon the existing literature, it is recommended that future research explore the impact of brief attribution retraining that focuses on connecting academic difficulties to unstable and controllable causes in lieu of the external and uncontrollable factors to which students in this study attributed academic shortcomings. Moreover, it is recommended that cognitive strategies that focus on metacognitive training in order to help nursing students be more aware of their attributional thinking and errors in Pathophysiology as well as other courses. Although there is a great deal of research in the clinical or experimental setting that supports the positive impact of attributional retraining (Dresel et al., 2005), there is little research in the naturalistic classroom setting and no attributional retraining research was found in the nurse education literature. Based upon the strong clinical findings, the lack of information available regarding attribution retraining in nursing students (Wood et al., 2009), and the current findings, it is recommended that future research explore attribution retraining in nursing education students. However, a careful balance must be struck. While it is desirable for students to attribute failures to effort and successes to ability (Siegle et al., 2009), the reverse can actually be detrimental to both students' sense of efficacy and academic success (Dweck, 2000). As was seen in this sample, attributing failures to ability and successes to effort can create a negative cycle that leads to less productive academic outcomes in the future (Siegle et al., 2009). Future research should investigate if this trend is common in other samples of nursing students enrolled in Pathophysiology. If such a pattern emerges as typical, it will be critical to carefully design training that moves students away from this negative attributional pattern. In addition to exploring attributional retraining, the results of this study indicate that self-regulatory training may also serve to improve nursing students' performance in Pathophysiology. In this study, effort (n = 30), study habits (n = 26), time demands (n = 26), and test design (n = 23) ranked among the top causal beliefs regarding failures in Pathophysiology. Each of these may be addressed through improved self-regulated learning strategy implementation. For example, evidence supports the use of peer modeling to improve effort regulation and time management (Bandura, 1986; Orange, 1999; Roberts, 2006). One example of training study habits is simply teaching students to minimize distractions, both physical and mental, when studying (Steel, 2007). Many students noted that the demanding nature of the overall curriculum was the cause of their failures in Pathophysiology. While it is unlikely that any nursing program is going to decrease the demands of their curriculum, it is possible to provide nursing students with time management strategies and learning strategies that enable students to better use their available study time and to meet the academic demands of their course loads. Future research should investigate the impact of academic self-regulation training on nursing students' attributions and academic success. Limitations The current findings are not generalizable beyond the current convenience sample of Midwestern, primarily female Caucasian Pathophysiology nursing students. The findings should be confirmed on a variety of samples. Further, the one time nature of this sample's self-reported attributions does not fully explore the deep structural
nature of casual attributions. Future research should employ interview techniques to delve deeper into students' attributional thinking. Moreover, other research efforts should employ quantitative techniques in order to confirm the nature of Pathophysiology students' causal attributions for academic outcomes, the impact of casual attributional thinking on academic outcomes, and the impact of attributional retraining on causal thinking. Conclusion The majority of students in this study manifested a hedonic attribution bias, in which they tended to attribute academic successes to internal causes (84%) and academic failures to external causes (68%). Moreover, the thematic evaluation of responses revealed that most of these students attributed their successes to controllable, unstable causes—primarily effort. Research indicates that attributing success to effort may reflect that students' confidence in their abilities is suffering, and that attributing failures to external causes, such as task difficulty, are also detrimental to performance and learning (Siegle et al., 2009). While these findings provided important insight into nursing students' causal attributions for successes and failures in Pathophysiology, more research is needed to better understand the impact of these causal attributions on student performance in Pathophysiology and other nurse education courses. Pathophysiology is a difficult course, but it is also critical for safe clinical practice (Elberson et al., 2001; Salamonson and Lantz, 2005). Research indicates that students' attributional tendencies powerfully impact their academic performance (Siegle et al., 2009; Struthers et al., 1996; Weiner, 1989, 2000) and that these tendencies may be altered through targeted training (Doctor, 2004; Wilson and Linville, 1982; 1985; Weiner, 2010). Thus, a better understanding of nursing students' causal attributions in Pathophysiology may provide instructors with a viable means of improving student performance in this difficult and important course. References Bandura, A., 1986. Social foundations of thought and action. Prentice Hall, Englewood Cliffs, NJ. Carr, M., Borkowski, J.G., Maxwell, S.E., 1991. Motivational components of underachievement. Developmental Psychology 27 (1), 108–118. Cheong, L., Ellias, H., Mohd, S., Rahil, N., Uli, Jegak, 2005. Increased mastery of learning strategies through strategy instruction and attribution retraining. Journal Teknologi 39(E), 36–37. Cox, C.B., Yang, Y., 2012. Getting off on the wrong foot: Longitudinal effects of Hispanic students' stability attributions following poor initial test performance. Learning and Individual Differences 22, 123–127. Doctor, T. (2004). Does video-based and live attribution training improve college freshman performance on academic-based tasks? (Doctoral Dissertation, West Virginia University 2004). (UMI No. AAT 3152258) Dresel, M., Schober, B., Zielgar, A., 2005. Nothing more than dimension? Evidence for a surplus meaning of specific attributions. The Journal of Educational Research 99 (1), 31–44. Dweck, C.S., 2000. Self theories: their role in motivation, personality, and development. Psychology Press, Philadelphia. Elberson, K.L., Vance, A.R., Stephenson, N.L., Corbett, R.W., 2001. Cooperative learning: a strategy for teaching Pathophysiology to undergraduate nursing students. Nurse Educator 26 (6), 259–261. Graham, S., Williams, C., 2009. An attributional approach to motivation in school. In: Wentzel, K.R., Wigfield, A. (Eds.), Handbook of Motivation at School. Routledge, New York, NY, pp. 11–33. Hall, N., 2004. The role of attributional retraining and elaborative learning in college student's academic development. The Journal of Social Psychology 144 (6), 159–622. Hall, N., Hladkyj, S., Perry, R., Ruthig, J., 2004. The role of attributional retraining and elaborative learning in college students' academic development. The Journal of Social Psychology 144 (6), 591–612. Hamilton, R.J., Akhter, S., 2002. Psychometric properties of the multidimensionalmultiattributional causality scale. Educational and Psychological Measurement 62, 802–817. Hong, Y., Dweck, C.S., Hi-yue Chiu, L., Derrick, M.S., Wan, W., 1999. Implicit theories, attributions, and coping: a meaning system approach. Journal of Personality and Social Psychology 77, 588–599. Kamins, M., Dweck, C.S., 1999. Person vs. process praise and criticism: implications for contingent self worth and coping. Developmental Psychology 35, 835–847.
K.E. Dunn et al. / Nurse Education Today 33 (2013) 828–833 Lebedina-Manzoni, M., 2004. To what students attribute their academic success and unsuccess. Education 124 (4), 699–708 (ERIC Document Reproduction Service No. EJ705777). Lefcourt, H.M., Von Baeyer, C.L., Ware, E.E., Cox, D.J., 1979. The multidimensionalmultiattribuional causality scale: the development of a goal specific locus of control scale. Canadian Journal of Behavioral Science 11 (4), 286–304. McClure, J., Meyer, L.H., Garisch, J., Fischer, R., Wier, K.F., Walkey, F.H., 2011. Students' attributions for their best and worst marks: do they relate to achievement. Contemporary Educational Psychology 36, 71–81. Menec, V.H., Perry, R.P., Struthers, C.W., Schonwetter, D.J., Hechter, F.J., Eicholz, B.L., 1994. Assisting at-risk college students with attributional retraining and effective teaching. Journal of Applied Social Psychology 24 (8), 675–701. Miller, D.T., Ross, M., 1975. Self-serving biases in the attribution of causality: fact or fiction? Psychological Bulletin 82, 213–225. Orange, C., 1999. Using peer modeling to teach self-regulation. The Journal of Experimental Education 68 (1), 21–39. Patton, M.Q., 2002. Qualitative Research and Evaluation Methods. Sage, Thousand Oaks, CA. Perry, R.P., Hechter, F.J., Menec, V.H., Weinberg, L.E., 1993. Enhancing achievement motivation and performance in college students: an attributional retraining perspective. Research in Higher Education 34, 687–723. Phillips, J.M., Gully, S.M., 1997. Role of goal orientation, ability, need for achievement, and locus of control in the self-efficacy and goal-setting process. Journal of Applied Psychology 82 (5), 792–802. Rimm, S., 1991. Why bright kids get poor grades: and what you can do about it. Crown, New York. Roberts, T.S., 2006. Self, peer, and group assessment in e-learning. Idea Group, Inc., Toronto, Canada. Russell, C.M., Phelps, C.L., 2009. The effect of mastery-focused goal setting to internalize locus of control and increase academic achievement (April) Paper presented at the annual meeting of the American Educational Research Association. Denver, CO. Salamonson, Y., Lantz, J., 2005. Factors influencing nursing students' preference for hybrid format delivery in a Pathophysiology course. Nurse Education Today 25, 9–16. Schunk, D.H., 2000. Learning theories: an educational perspective, 3rd ed. Merrill/ Prentice-Hall, Columbus, OH. Shunk, D., 2005. Try harder? Effects of effort motivational feedback. ERIC Counseling and Student Services Clearinghouse. Siegle, D., McCoach, D.B., 2007. Increasing student mathematics self-efficacy through teacher training. Journal of Advanced Academics 18, 278–312. Siegle, D., Rubenstein, L.D.V., Pollard, E., Romey, E., 2009. Exploring the relationship of college freshman honors students' effort and ability attribution, interest, and implicit theory of intelligence with perceived ability. Gifted Child Quarterly 54, 92–101.
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Steel, P., 2007. The nature of procrastination: a meta-analytic and theoretical review of quintessential self-regulatory failure. Psychological Bulletin 133 (1), 65–94. Struthers, C.W., Menec, V.H., Schonwetter, D.J., Perry, R.P., 1996. The effects of perceived attributions, action control, and creativity on college students' motivation and performance: a field study. Learning and Individual Differences 8 (2), 121–139. Toland, J., Boyle, C., 2008. Applying cognitive behavioural methods to retrain children's attributions for success and failure in learning. School Psychology International 29 (3), 286–306. Weiner, B., 1986. An attributional theory of motivation and emotion. Springer-Verlag, New York. Weiner, B., 1989. Understanding the motivational role of affect: lifespan research from an attributional perspective. Cognition and Emotion 4, 401–419. Weiner, B., 1994. Ability versus effort revisited: the moral determinants of achievement evaluation and achievement as a moral system. Educational Psychologist 29, 163–172. Weiner, B., 2000. Interpersonal and intrapersonal theories of motivation from an attributional perspective. Educational Psychology Review 12, 1–14. Weiner, B., 2010. The development of an attribution-based theory of motivation: a history of ideas. Educational Psychologist 45, 28–36. Weiner, B., Graham, S., 1989. Understanding the motivational role of affect: Lifespan research from an attributional perspective. In: Izard, C. (Ed.), Development of Emotion-Cognition Relations. : Cognition and Emotion, 3. Erlbaum, Hillsdale, N. J, pp. 401–418. Wilson, T.D., Linville, P.W., 1982. Improving the academic performance of college freshman: attribution therapy revisited. Journal of Personality and Social Psychology 42 (2), 367–376. Wilson, T.D., Linville, P.W., 1985. Improving the academic performance of college freshman: attribution therapy revisited. Journal of Personality and Social Psychology 49 (1), 287–293. Wilson, T.D., Damiani, M., Shelton, N., 2002. Improving the academic performance of college students with brief attributional interventions. In: Aronson, J. (Ed.), Improving academic achievement: Impact of psychological factors on education. Academic Press, San Diego, CA, pp. 89–108. Wood, A.M., Saylor, C., Cohen, J., 2009. Locus of control and academic success among ethnically diverse baccalaureate nursing students. Nursing Education Research 30 (5), 290–294. Yailagh, M.S., Lloyd, J., Walsh, J., 2009. The causal relationships between attribution, styles, mathematics self-efficacy beliefs, gender differences, goal setting, and math achievement of school children. Journal of Educational Psychology 3, 95–114.
Contents lists available at ScienceDirect
Nurse Education Today journal homepage: www.elsevier.com/nedt
It's not my fault: Understanding nursing students' causal attributions in Pathophysiology Karee E. Dunn a,⁎, Cara Osborne b, Glenda C. Rakes c a b c
248 Graduate Education Bldg., University of Arkansas, Fayetteville, AR 72701, United States 111-A Ozark Hall, University of Arkansas, Fayetteville, AR 72701, United States 205-F Gooch Hall, University of Tennessee, Martin, Martin, TN 38238, United States
a r t i c l e
i n f o
Article history: Accepted 20 February 2012 Keywords: Nurse education Causal attributions
s u m m a r y Pathophysiology is a difficult subject matter for many nursing students. This course is also critical for safe clinical practice. However, little research has explored what variables may influence nursing students' success in this course. This study is the first in a forthcoming series that seeks to better understand how to facilitate student success in Pathophysiology. In this study, students' causal attributions for successes and failures were explored as these attributions greatly influence future academic motivation and behavior. Students were asked to respond to two open-ended questions in order to better understand what causal attributions students were making for their successes and failures in Pathophysiology. Seventy-five Bachelor of Science in Nursing students who were enrolled in Pathophysiology returned their responses (92.6% response rate). Content analysis was utilized to determine whether students were making internal or external causal attributions for their successes and failures. Additionally, responses were evaluated in order to identify common themes shared by respondents. The majority of respondents (84%) attributed their academic successes in Pathophysiology in part to internal causes, and the majority of respondents (68%) attributed their academic failures, in part, to external causes. In this study the majority of students attributed their successes to controllable, unstable causes—primarily effort. Research indicates that attributing success to effort may reflect that students' confidence in their abilities is suffering, and that attributing failures to external causes, such as task difficulty, are also detrimental to performance and learning (Siegle et al., 2009). The results of this study are further presented and discussed. © 2012 Elsevier Ltd. All rights reserved.
Introduction
Attribution Theory
Undoubtedly, one of the challenges nursing faculty face is teaching Pathophysiology. Although not all nursing students agree, the majority of nursing students perceive Pathophysiology as one of the most difficult and least interesting courses in the nursing curriculum (Elberson et al., 2001). While this course may not be students' favorite in nursing school, it is critical for safe practice in the clinical setting (Salamonson and Lantz, 2005). Often times when students consider learning tasks to be difficult, unpleasant, and/or boring, the students attribute their learning outcomes to factors that are outside of their control (Miller and Ross, 1975). This is unfortunate because these types of causal attributions negatively impact motivation and future academic behaviors (Doctor, 2004; Russell and Phelps, 2009; Weiner, 1994, 2010). The purpose of this study was to explore the causal attributions undergraduate nursing students make for both their successes and failures in Pathophysiology.
A central assumption of attribution theory is that students attempt to devise the causal determinants of their behavioral outcomes (Weiner, 1986, 2010). These attributions in turn impact future academic choices and behaviors (Weiner, 1989, 1994, 2000, 2010). In short, student attributions can significantly impact learning and academic success (Siegle et al., 2009; Struthers et al., 1996). Weiner's attribution theory is sequential and begins with an individual designating an outcome to be a success or a failure (Graham and Williams, 2009). Then, the learner experiences happiness or sadness with regard to their interpretation of the outcome. Finally, the individual attempts to understand why the outcome occurred. Individuals may attribute these perceived successes or failures to ability, effort, context, luck, or mood (Hamilton and Akhter, 2002; Lefcourt et al., 1979). These perceived causal determinants of outcomes fall within three dimensions—locus (i.e., internal or external), stability, and control (Weiner, 1994, 2000; Weiner and Graham, 1989). For example, luck is external (locus), unstable (stability), and uncontrollable (controllability). The first dimension is locus, the location of the cause, which may be internal or external to the person. Of the dimensions, locus of
⁎ Corresponding author. E-mail address: [email protected] (K.E. Dunn). 0260-6917/$ – see front matter © 2012 Elsevier Ltd. All rights reserved. doi:10.1016/j.nedt.2012.02.012
K.E. Dunn et al. / Nurse Education Today 33 (2013) 828–833
control is one of the most influential for student success. An internal locus of control is associated with more successful academic outcomes where as an external locus of control is more strongly associated with negative academic outcomes (Carr et al., 1991; LebedinaManzoni, 2004; Phillips and Gully, 1997; Russell and Phelps, 2009). The second dimension is stability, which reflects whether the cause of the outcome is perceived as being the same across time or different depending upon the context. Stability is associated with expectations for the future. If failure is associated with something stable such as the difficulty of material in a particular course, a student may believe they will fail and are less likely to be motivated to try harder. The final dimension, controllability, reflects the degree to which the individual believes they controlled the cause of the outcome. Controllability is related to emotions. If one experiences failure and believes the causes were controllable, he or she may feel angry. These attributions impact how individuals affectively, cognitively, and behaviorally respond in future situations (Weiner, 1994). Thus, understanding students' explanation for both academic successes and academic failures may be important to future academic success (Graham and Williams, 2009). Individuals tend to claim responsibility for their successes, attributing such behavior to internal factors, but blame failures on external reasons (Miller and Ross, 1975). This pattern of explanation allows learners to rationalize failures and to view themselves in a more positive light, regardless of what the outcome of a particular behavior might be. Unless the pattern of attributing failures on external influences is interrupted, the cycle is continued to the detriment of learning. Some research indicates attribution training that focuses on effort and strategies, rather than ability, can motivate students to work harder and perform more successfully on academic tasks in the future. Attributional tendencies have been shown to change after a single training presentation (Menec et al., 1994; Schunk, 2005; Wilson and Linville, 1982; 1985). In light of Pathophysiology's difficult nature (Elberson et al., 2001) and the evidence that suggests the highly malleable nature of student attributions (Doctor, 2004), understanding nursing students' causal attributions in Pathophysiology may provide nursing faculty with a means of improving student performance, and subsequently, teachers experience of teaching Pathophysiology. The greatest impediments to learning caused by attributions arise when students attribute failures to external, stable, and uncontrollable causes (Weiner, 2000). Such attributions are likely to lead to low motivation and a sense of helplessness. Ideally, a nursing instructor would want Pathophysiology students to feel in control of their learning because such attributions lead to increased effort, strategy use, persistence, and selection of more challenging academic tasks (Schunk, 2000; Weiner, 1994). Moreover, nursing faculty would want Pathophysiology students to attribute failures to unstable variables such as effort. Students who attribute failures to internal, controllable, unstable variables have more confidence in their abilities and are more likely to succeed (Weiner, 2000; Graham and Williams, 2009). While psychological literature and educational literature have extensively explored the topic of attribution theory, there is limited research on this topic in nursing (Wood et al., 2009). In the one article found on attributions in nursing students, Wood et al. (2009) found that nursing students in a medical-surgery theory made lower grades if they attributed their academic outcomes to caus.es outside of their control. The existing psychological and educational research indicates that student attributions related to academic outcomes significantly impact their academic achievement (Siegle et al., 2009; Struthers et al., 1996). In light of the limited research on the role causal attributions play in nurse education, it is important to understand what variables influence nursing students' attributions in order to help nursing students develop attributions that support success in the academically rigorous nursing curriculum. Such understanding is of particular import for a course as difficult as Pathophysiology (Elberson et al.,
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2001) that so significantly impacts in-service nurses' clinical practice (Salamonson and Lantz, 2005). Therefore, this study sought to better understand nursing students' causal attributions for both successes and failures in Pathophysiology. Because of the strength of the influence of students' locus of control on academic success, this study primarily focused on respondents' description of causes as internal or external (Carr et al., 1991; Lebedina-Manzoni, 2004; Phillips and Gully, 1997; Russell and Phelps, 2009). A secondary focus was to identify the prevalence of the following causal attribution pattern for academic failures—external, stable, and uncontrollable. Methodology Participants The sample in this study consisted of 81 fully admitted nurse education undergraduate students enrolled in Pathophysiology. The Midwestern university's nursing program from which the sample was taken is fully accredited. Of those surveyed, only 75 returned their responses to the two open-ended questions. Respondents ranged in age from 20 to 47 (M = 26). Eighty-eight percent of the respondents were female (n = 66) and 12% were male (n = 9). Procedures and Research Questions Approval to use human subjects and to conduct this study was granted by the university's Institutional Review Board. The researchers provided participants with a two item open-ended survey and explained that participation was voluntary and anonymous. Prior to participating in this study, students were required to submit a signed informed consent form. The surveys are given as part of course requirements in order to enhance students learning experiences. The researchers asked participants to respond to the following two open-response items: 1. When you do well in this class (quizzes, tests, etc.), to what do you attribute that success? 2. If you do not do as well as you like on assignments in this class (quizzes, tests, etc.), how would you explain the cause of that performance? Two of the researchers examined responses to these open-ended questions in order to explore the following three guiding research questions: 1. How many students attributed successes, at least in part, to internal causes? 2. How many students attributed failures, at least in part, to external causes? 3. What common themes were presented among students' responses to the two open-ended questions? The third researcher, who taught the course, did not review openended responses as students sometimes reported their names along with their responses. Thus, only two of the authors reviewed responses to protect students' anonymity. The teacher–author never saw the students' responses as a non-teacher-author collected the responses from students. Data Analysis Content analysis was used to identify the emergent themes of participants' responses to the two open-ended questions. It is important to note that many students reported more than one causal attribution for each item. Content analysis has been defined as “any qualitative data reduction and sense-making effort that takes a volume of qualitative material and attempts to identify core consistencies and meanings” (Patton, 2002, p.453). Two of the authors separately examined participants' responses.
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Because the identification of causes as internal or external has such a powerful influence on student learning and achievement (Carr et al., 1991; Lebedina-Manzoni, 2004; Phillips and Gully, 1997; Russell and Phelps, 2009), student responses to questions were first evaluated for internal and external attributions. These causal attributions were then evaluated for common themes. Subsequently, responses were analyzed to identify external, stable, and uncontrollable causal attributions as such attributions are detrimental to academic success (Weiner, 2000; Graham and Williams, 2009). The findings of these analyses are presented below. Results The two authors who evaluated the responses to the first question agreed on 96.7% of the categorizations. The authors then discussed the reasons for their different analyses. Upon further discussion, the authors reached an agreement upon the remaining items. With regard to the responses to the second question, the authors agreed on 100% of the categorizations. Attributions for Success Fifty-one respondents (68%) indicated that they attribute their academic successes to internal causes. Twelve respondents (16%) indicated that they attribute their academic successes to external causes. Twelve respondents (16%) indicated that they attribute their academic successes to a mix of internal and external causes. Therefore, 63 of 75 respondents (84%) attribute their academic successes, at least in part, to internal causes (see Fig. 1). The two authors agreed upon 11 themes that manifested in students responses to what causal attributions they make for their academic successes. The internal causal attribution themes that emerged were— effort, study habits, understanding, class attendance, ability, interest, and intelligence. An example of a response coded as effort was: “I worked hard and earned that grade.” An example of a response coded as study habits was: “I broke the material in to small units that made sense to me before I studied.” An example of a response coded as understanding was: “I simply understood the material.” An example of a response coded as class attendance: “I wouldn't have done so well, if I hadn't gone to hear class lectures.” An example of a response coded as ability was: “I've got really good critical thinking abilities.” An example of a response coded as interest was: “I do better when I really enjoy what I study. That interest helps motivate me to study.” An example of a response coded as intelligence was: “Honestly, I do good because I'm smart.” The external causal attribution themes that emerged were—professor, luck, program time demands, and test design. An example of a response coded as professor was: “The [professor] has explained things clearly.” An example of a response coded as luck was: “Being a good guesser.” An example a response coded as program time demands was: “Breaks in
other classes help me get adequate hours of study time.” An example of a response coded as test design was: “The test questions were fair.” The frequency of each type of response was reported in Table 1. Attributions for Failures Twenty-six respondents (32%) indicated that they attribute their academic failures to internal causes. Thirty-one respondents (41%) indicated that they attribute their academic failures to external causes. Eighteen respondents (27%) indicated that they attribute their academic failures to a mix of internal and external causes. Therefore, 49 of 75 respondents (68%) attribute their academic failures, at least in part, to external causes (see Fig. 2). Twenty-six respondents (35%) attributed failures to external, stable, and uncontrollable causes. Of those 26 respondents who attributed failures to external, stable, and uncontrollable causes, 85% reported purely external attributions for failures (not mixed attributions, see Fig. 3). An example of a student attribution comment coded as external, stable, and uncontrollable was: “There are too many classes that have papers, homework, quizzes, and tests on the same days and week. Therefore, it is hard to get all the studying in we need to keep up…It gets to be VERY overwhelming.” The two authors agreed upon nine themes that manifested in students responses to what causal attributions they make for their academic successes. The internal causal attribution themes that emerged were—effort, understanding, study habits, ability, and interest. An example of a response coded as effort was: “Laziness.” An example of a response coded as understanding was: “I didn't understand as well as I should have.” An example of a response coded as study habits was: “I have really bad study habits.” An example of a response coded as ability was: “My general inabilities.” An example of a response coded as interest was: “I am not interested.” The external causal attribution themes that emerged were—professor, program time demands, test design, and outside stress. An example of a response coded as professor was: “The professor goes too fast.” An example of a response coded as program time demands was: “We are expected to do too much in all our nursing courses.” An example of a response coded as test design was: “The test doesn't cover what I expected.” An example of a response coded as outside stress was: “I need to quit my job.” The frequency of each type of response was reported in Table 2. Discussion If entered in the Google search engine, the statement “I earned an A.” returned 54,600 hits. When the statement “I earned an F.” was entered, the search returned only 2,860 hits as compared to “He gave me an F.” that resulted 75,700 hits. Clearly this is merely anecdotal evidence, but this informal search supports and serves to drive home the point that while many students are willing to take full Table 1 Frequency of attributions for success (n = 75).
16%
16% EXTERNAL
68%
INTERNAL MIXED
Fig. 1. Causal attributions for academic successes in Pathophysiology.
Internal attributions
f
%
1. Effort 2. Study habits 3. Understanding 4. Class attendance 5. Ability 6. Interest 7. Intelligence Internal total External attributions 8. Professor 9. Luck 10 Program time demands 11. Test design External total
47 19 9 9 3 3 2 92 f 10 9 9 1 29
38.8 15.7 7.4 7.4 2.5 2.5 1.7 76 % 8.3 7.4 7.4 0.9 24
K.E. Dunn et al. / Nurse Education Today 33 (2013) 828–833
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Table 2 Frequency of attributions for failure (n = 75).
27% 41%
EXTERNAL INTERNAL
32%
MIXED
Fig. 2. Causal attributions for academic failures in Pathophysiology.
responsibility for their academic successes, the majority are not as willing to take responsibility for their academic failures. The results of this study align with this anecdotal evidence. The majority of this study's respondents (68%) indicated that they attributed their academic successes in Pathophysiology to internal causes. This number grows substantially if students who provided at least partial credit to internal causes for their successes (84%) were included. An example of such a mixed response was “I've done pretty well so far because I work really hard. I also have a lot of working knowledge from other courses that help with this one, but I don't think I'd be doing as well if the teacher didn't care if we understand this stuff.” Although a number of students reported internal attributions for academic failures, the majority attributed their academic shortcomings at least in part to external causes (68%). This attributional style was more salient than the positive finding that some students attributed part of their failures to internal causes (39%), as the attributional tendency to associate academic failures with external causes is related to decreased academic achievement (Yailagh et al., 2009). An example of such a mixed response was “My study habits are pretty bad, but I do fine in other classes. I think the biggest issue is that the we are not told what will be on the tests.” In other words, the current findings supported both Miller and Ross' (1975) position and the anecdotal evidence above. Students believed they earned their success, and believed their failures were imposed upon them. When examined more closely, the analysis of these students' causal attributions for their successes and failures in Pathophysiology revealed interesting patterns with powerful implications for Pathophysiology instructors. The determination of a casual attribution for academic success as internal alone is insufficient to determine if a student holds productive or detrimental interpretations of their learning experience. In this study the majority of students attributed their successes to controllable, unstable causes—primarily effort. While on the surface this may seem ideal, research reveals that such attributions may indicate that students' confidence in their abilities are suffering (Dweck, 2000). Essentially, these students may be questioning their ability and competence in this course because they must exert greater
15%
85%
PURELY EXTERNAL MIXED
Fig. 3. External compared to mixed attributions for external, stable, and uncontrollable attributions.
Internal attributions
f
%
1. Effort 2. Understanding 3. Study habits 4. Ability 5. Interest Internal total External Attributions 6. Professor 7. Program time demands 8. Test design 9. Outside stress External total
30 11 7 3 3 54 f 33 26 23 3 85
21.6 5.0 7.8 2.2 2.2 38.8 % 23.6 18.6 16.4 2.2 61.2
amounts of effort (Hong et al., 1999). Only a small number of students attributed successes to causes such as ability (n = 3) or intelligence (n = 2). Attributions to ability or intelligence are actually more beneficial to student self-efficacy (Siegle and McCoach, 2007). These findings are not surprising as the sample is primarily female, and females are more likely to attribute successes to effort than to ability (McClure et al., 2011; Rimm, 1991). However, addressing these attributions presents a challenge as providing students with praise for their ability may actually increase student fear of failure, decrease efficacy, and result in students avoiding challenging tasks because they desire to preserve the belief in their abilities (Kamins and Dweck, 1999). Moreover, these students may become more performance-oriented rather than mastery-oriented (Siegle et al., 2009). Thus, future research should investigate means of increasing Pathophysiology ability-oriented attributions for success. A second theme that emerged and may be of great concern to those teaching Pathophysiology was the attribution of failure to external, stable, and uncontrollable causes. Such attributions may be detrimental to future motivation and result in a sense of learned helplessness (Weiner, 2000). The most common of these attributions related to the impact of the demands of the program on students' time. An example of one of these attributions was “Its impossible to get enough studying in because we have WAY too much to do in ALL our courses to ever dedicate enough time to be really successful in Patho.” If students believe that the demands of the program make it “impossible” for them to succeed, they will be less motivated to do what is needed to succeed. In other words, they may be developing a sense of learned helplessness. It will be important to retrain these attributional tendencies to help students feel in control of their learning because students who feel in control of their learning are more likely to increase effort, strategy use, persistence, and selection of more challenging academic tasks (Schunk, 2000; Weiner, 1994). The goal of attribution retraining is to help students develop attributional patterns in which failures are associated with internal attributions that are controllable and unstable such as effort in order to alter maladaptive behavior (Cheong et al., 2005; Hall et al., 2004; Wilson et al., 2002). Evidence exists to support that single training sessions can powerfully impact student attributions (Wilson and Linville, 1982; 1985). For example, Menec et al. (1994) found that when low achieving college students in an introductory psychology course viewed an eightminute attribution training video, their test scores improved. Furthermore, simply providing feedback that failures are caused by lack-luster effort levels lead to significant increases in performance (Schunk, 2005; Toland and Boyle, 2008). Much of the empirical research regarding the impact of attribution retraining has been garnered from research on low achieving, at-risk, or learning disabled children or college students (e.g., Cox and Yang, 2012; Perry et al., 1993). Hall (2004) applied two types of attribution retraining to groups of college students defined as high achievers and low achievers. One employed cognitive strategies in which students were taught to
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understand their thinking processes (meta-cognitive strategies). The second employed affective strategies in which students were taught to understand their emotional reactions to successes and failures. Both types of attribution retraining strategies benefited both groups of college students. Weiner (2010) notes that while the research regarding the malleable nature of students' attributions and the impact of attribution changes on achievement-related outcomes is encouraging, further research is needed to confirm and elaborate upon this conclusion. Based upon the existing literature, it is recommended that future research explore the impact of brief attribution retraining that focuses on connecting academic difficulties to unstable and controllable causes in lieu of the external and uncontrollable factors to which students in this study attributed academic shortcomings. Moreover, it is recommended that cognitive strategies that focus on metacognitive training in order to help nursing students be more aware of their attributional thinking and errors in Pathophysiology as well as other courses. Although there is a great deal of research in the clinical or experimental setting that supports the positive impact of attributional retraining (Dresel et al., 2005), there is little research in the naturalistic classroom setting and no attributional retraining research was found in the nurse education literature. Based upon the strong clinical findings, the lack of information available regarding attribution retraining in nursing students (Wood et al., 2009), and the current findings, it is recommended that future research explore attribution retraining in nursing education students. However, a careful balance must be struck. While it is desirable for students to attribute failures to effort and successes to ability (Siegle et al., 2009), the reverse can actually be detrimental to both students' sense of efficacy and academic success (Dweck, 2000). As was seen in this sample, attributing failures to ability and successes to effort can create a negative cycle that leads to less productive academic outcomes in the future (Siegle et al., 2009). Future research should investigate if this trend is common in other samples of nursing students enrolled in Pathophysiology. If such a pattern emerges as typical, it will be critical to carefully design training that moves students away from this negative attributional pattern. In addition to exploring attributional retraining, the results of this study indicate that self-regulatory training may also serve to improve nursing students' performance in Pathophysiology. In this study, effort (n = 30), study habits (n = 26), time demands (n = 26), and test design (n = 23) ranked among the top causal beliefs regarding failures in Pathophysiology. Each of these may be addressed through improved self-regulated learning strategy implementation. For example, evidence supports the use of peer modeling to improve effort regulation and time management (Bandura, 1986; Orange, 1999; Roberts, 2006). One example of training study habits is simply teaching students to minimize distractions, both physical and mental, when studying (Steel, 2007). Many students noted that the demanding nature of the overall curriculum was the cause of their failures in Pathophysiology. While it is unlikely that any nursing program is going to decrease the demands of their curriculum, it is possible to provide nursing students with time management strategies and learning strategies that enable students to better use their available study time and to meet the academic demands of their course loads. Future research should investigate the impact of academic self-regulation training on nursing students' attributions and academic success. Limitations The current findings are not generalizable beyond the current convenience sample of Midwestern, primarily female Caucasian Pathophysiology nursing students. The findings should be confirmed on a variety of samples. Further, the one time nature of this sample's self-reported attributions does not fully explore the deep structural
nature of casual attributions. Future research should employ interview techniques to delve deeper into students' attributional thinking. Moreover, other research efforts should employ quantitative techniques in order to confirm the nature of Pathophysiology students' causal attributions for academic outcomes, the impact of casual attributional thinking on academic outcomes, and the impact of attributional retraining on causal thinking. Conclusion The majority of students in this study manifested a hedonic attribution bias, in which they tended to attribute academic successes to internal causes (84%) and academic failures to external causes (68%). Moreover, the thematic evaluation of responses revealed that most of these students attributed their successes to controllable, unstable causes—primarily effort. Research indicates that attributing success to effort may reflect that students' confidence in their abilities is suffering, and that attributing failures to external causes, such as task difficulty, are also detrimental to performance and learning (Siegle et al., 2009). While these findings provided important insight into nursing students' causal attributions for successes and failures in Pathophysiology, more research is needed to better understand the impact of these causal attributions on student performance in Pathophysiology and other nurse education courses. Pathophysiology is a difficult course, but it is also critical for safe clinical practice (Elberson et al., 2001; Salamonson and Lantz, 2005). Research indicates that students' attributional tendencies powerfully impact their academic performance (Siegle et al., 2009; Struthers et al., 1996; Weiner, 1989, 2000) and that these tendencies may be altered through targeted training (Doctor, 2004; Wilson and Linville, 1982; 1985; Weiner, 2010). Thus, a better understanding of nursing students' causal attributions in Pathophysiology may provide instructors with a viable means of improving student performance in this difficult and important course. References Bandura, A., 1986. Social foundations of thought and action. Prentice Hall, Englewood Cliffs, NJ. Carr, M., Borkowski, J.G., Maxwell, S.E., 1991. Motivational components of underachievement. Developmental Psychology 27 (1), 108–118. Cheong, L., Ellias, H., Mohd, S., Rahil, N., Uli, Jegak, 2005. Increased mastery of learning strategies through strategy instruction and attribution retraining. Journal Teknologi 39(E), 36–37. Cox, C.B., Yang, Y., 2012. Getting off on the wrong foot: Longitudinal effects of Hispanic students' stability attributions following poor initial test performance. Learning and Individual Differences 22, 123–127. Doctor, T. (2004). Does video-based and live attribution training improve college freshman performance on academic-based tasks? (Doctoral Dissertation, West Virginia University 2004). (UMI No. AAT 3152258) Dresel, M., Schober, B., Zielgar, A., 2005. Nothing more than dimension? Evidence for a surplus meaning of specific attributions. The Journal of Educational Research 99 (1), 31–44. Dweck, C.S., 2000. Self theories: their role in motivation, personality, and development. Psychology Press, Philadelphia. Elberson, K.L., Vance, A.R., Stephenson, N.L., Corbett, R.W., 2001. Cooperative learning: a strategy for teaching Pathophysiology to undergraduate nursing students. Nurse Educator 26 (6), 259–261. Graham, S., Williams, C., 2009. An attributional approach to motivation in school. In: Wentzel, K.R., Wigfield, A. (Eds.), Handbook of Motivation at School. Routledge, New York, NY, pp. 11–33. Hall, N., 2004. The role of attributional retraining and elaborative learning in college student's academic development. The Journal of Social Psychology 144 (6), 159–622. Hall, N., Hladkyj, S., Perry, R., Ruthig, J., 2004. The role of attributional retraining and elaborative learning in college students' academic development. The Journal of Social Psychology 144 (6), 591–612. Hamilton, R.J., Akhter, S., 2002. Psychometric properties of the multidimensionalmultiattributional causality scale. Educational and Psychological Measurement 62, 802–817. Hong, Y., Dweck, C.S., Hi-yue Chiu, L., Derrick, M.S., Wan, W., 1999. Implicit theories, attributions, and coping: a meaning system approach. Journal of Personality and Social Psychology 77, 588–599. Kamins, M., Dweck, C.S., 1999. Person vs. process praise and criticism: implications for contingent self worth and coping. Developmental Psychology 35, 835–847.
K.E. Dunn et al. / Nurse Education Today 33 (2013) 828–833 Lebedina-Manzoni, M., 2004. To what students attribute their academic success and unsuccess. Education 124 (4), 699–708 (ERIC Document Reproduction Service No. EJ705777). Lefcourt, H.M., Von Baeyer, C.L., Ware, E.E., Cox, D.J., 1979. The multidimensionalmultiattribuional causality scale: the development of a goal specific locus of control scale. Canadian Journal of Behavioral Science 11 (4), 286–304. McClure, J., Meyer, L.H., Garisch, J., Fischer, R., Wier, K.F., Walkey, F.H., 2011. Students' attributions for their best and worst marks: do they relate to achievement. Contemporary Educational Psychology 36, 71–81. Menec, V.H., Perry, R.P., Struthers, C.W., Schonwetter, D.J., Hechter, F.J., Eicholz, B.L., 1994. Assisting at-risk college students with attributional retraining and effective teaching. Journal of Applied Social Psychology 24 (8), 675–701. Miller, D.T., Ross, M., 1975. Self-serving biases in the attribution of causality: fact or fiction? Psychological Bulletin 82, 213–225. Orange, C., 1999. Using peer modeling to teach self-regulation. The Journal of Experimental Education 68 (1), 21–39. Patton, M.Q., 2002. Qualitative Research and Evaluation Methods. Sage, Thousand Oaks, CA. Perry, R.P., Hechter, F.J., Menec, V.H., Weinberg, L.E., 1993. Enhancing achievement motivation and performance in college students: an attributional retraining perspective. Research in Higher Education 34, 687–723. Phillips, J.M., Gully, S.M., 1997. Role of goal orientation, ability, need for achievement, and locus of control in the self-efficacy and goal-setting process. Journal of Applied Psychology 82 (5), 792–802. Rimm, S., 1991. Why bright kids get poor grades: and what you can do about it. Crown, New York. Roberts, T.S., 2006. Self, peer, and group assessment in e-learning. Idea Group, Inc., Toronto, Canada. Russell, C.M., Phelps, C.L., 2009. The effect of mastery-focused goal setting to internalize locus of control and increase academic achievement (April) Paper presented at the annual meeting of the American Educational Research Association. Denver, CO. Salamonson, Y., Lantz, J., 2005. Factors influencing nursing students' preference for hybrid format delivery in a Pathophysiology course. Nurse Education Today 25, 9–16. Schunk, D.H., 2000. Learning theories: an educational perspective, 3rd ed. Merrill/ Prentice-Hall, Columbus, OH. Shunk, D., 2005. Try harder? Effects of effort motivational feedback. ERIC Counseling and Student Services Clearinghouse. Siegle, D., McCoach, D.B., 2007. Increasing student mathematics self-efficacy through teacher training. Journal of Advanced Academics 18, 278–312. Siegle, D., Rubenstein, L.D.V., Pollard, E., Romey, E., 2009. Exploring the relationship of college freshman honors students' effort and ability attribution, interest, and implicit theory of intelligence with perceived ability. Gifted Child Quarterly 54, 92–101.
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Steel, P., 2007. The nature of procrastination: a meta-analytic and theoretical review of quintessential self-regulatory failure. Psychological Bulletin 133 (1), 65–94. Struthers, C.W., Menec, V.H., Schonwetter, D.J., Perry, R.P., 1996. The effects of perceived attributions, action control, and creativity on college students' motivation and performance: a field study. Learning and Individual Differences 8 (2), 121–139. Toland, J., Boyle, C., 2008. Applying cognitive behavioural methods to retrain children's attributions for success and failure in learning. School Psychology International 29 (3), 286–306. Weiner, B., 1986. An attributional theory of motivation and emotion. Springer-Verlag, New York. Weiner, B., 1989. Understanding the motivational role of affect: lifespan research from an attributional perspective. Cognition and Emotion 4, 401–419. Weiner, B., 1994. Ability versus effort revisited: the moral determinants of achievement evaluation and achievement as a moral system. Educational Psychologist 29, 163–172. Weiner, B., 2000. Interpersonal and intrapersonal theories of motivation from an attributional perspective. Educational Psychology Review 12, 1–14. Weiner, B., 2010. The development of an attribution-based theory of motivation: a history of ideas. Educational Psychologist 45, 28–36. Weiner, B., Graham, S., 1989. Understanding the motivational role of affect: Lifespan research from an attributional perspective. In: Izard, C. (Ed.), Development of Emotion-Cognition Relations. : Cognition and Emotion, 3. Erlbaum, Hillsdale, N. J, pp. 401–418. Wilson, T.D., Linville, P.W., 1982. Improving the academic performance of college freshman: attribution therapy revisited. Journal of Personality and Social Psychology 42 (2), 367–376. Wilson, T.D., Linville, P.W., 1985. Improving the academic performance of college freshman: attribution therapy revisited. Journal of Personality and Social Psychology 49 (1), 287–293. Wilson, T.D., Damiani, M., Shelton, N., 2002. Improving the academic performance of college students with brief attributional interventions. In: Aronson, J. (Ed.), Improving academic achievement: Impact of psychological factors on education. Academic Press, San Diego, CA, pp. 89–108. Wood, A.M., Saylor, C., Cohen, J., 2009. Locus of control and academic success among ethnically diverse baccalaureate nursing students. Nursing Education Research 30 (5), 290–294. Yailagh, M.S., Lloyd, J., Walsh, J., 2009. The causal relationships between attribution, styles, mathematics self-efficacy beliefs, gender differences, goal setting, and math achievement of school children. Journal of Educational Psychology 3, 95–114.