Abstract: This case study examines the use of an eHealth application for improving preoperative rehabilitation (prehabilitation). We have analysed healthcare professionals' motivators and drivers for adopting eHealth for a surgical procedure at academic medical facilities. The research focused on when and why healthcare professionals are inclined to adopt eHealth applications in their way of working? For this qualitative study, we selected 12 professionals involved in all levels of the organisation and stages of the medical process and conducted semi-structured interviews. Kotter’s transformational change model and the Technology Acceptance Model were used as analytical frameworks for the identification of the motivation of eHealth adoption. The findings suggest that contrary to Kotter’s change model, which argues that adoption of change is based on perceptions and feelings, the healthcare drivers are rational when it comes to deciding whether or not to adopt eHealth apps. This study further elaborates the observation made by the Dutch expertise centre on eHealth, Nictiz, that when the value of an eHealth pplication is clear for a stakeholder, the adoption process accelerates. Analysis of the motivations and drivers of the healthcare professionals show a strong relationship with an evidence-based grounding of usefulness and the responsibility these professionals have towards their patients. We found that healthcare professionals respond to the primary goal of improving healthcare. This is true if the eHealth application will innovate their work, but mainly when the application will improve the patient care they are responsible for. When eHealth applications are implemented, rational facts need to be collected in a study before deployment of eHealth applications on how these applications will improve the patient's health or wellbeing throughout their so-called medical journey for their treatment. Furthermore, the preference to learn about new eHealth applications from someone who speaks from authority through expertise on the subject matter, suggests adoption by healthcare professionals may be accelerated through peers. The result of this study may provide healthcare management with a different approach to their eHealth strategy. Future research is needed to validate the findings in different medical organisational settings such as regional healthcare facilities or for-profit centers which do not necessarily have an innovation focus but are driven by other strategic drivers.
Increasing students’ motivation in higher education by designing a specific curriculum has always been a challenging but very complex process. The Department of Business, Finance and Marketing (BFM) of The Hague University of Applied Sciences (THUAS) initiated a redesign of the curricula with the major goals of increasing flexibility of learning opportunities and offering students a more motivating, inspiring and richer diversity of learning experiences. In the literature of learning in higher education this has often been labeled as ‘offering extracurricular learning opportunities’. The redesign of the curriculum implies that the new one will result in an enhancement of the flexibility of the curriculum, by offering learning opportunities beyond the borders of specific programs like marketing, finance or entrepreneurship and retail management. The richness and diversity should create flexible platforms, offering students the possibility to enrich their career choices to design their own personalised career path, hopefully maximizing the possibilities for their talent development. However, very little is known about the relationship between the students’ satisfaction with extracurricular learning opportunities, aiming at the personalisation of students’ career choices, and their motivation. In this chapter we describe our research into this relationship between student motivation and learning environments. Designing a network curriculum by increasing the possibility of extracurricular learning opportunities in higher education could have a positive impact on students’ motivation when it is combined with activities to increase goal students’ commitment. This depends on teachers’ qualities to communicate the valence and instrumentality of the learning possibilities offered for the prospective work environment. This is a complex issue however. Teachers from different educational programs, even in the same domain, have a different orientation on existing learning opportunities within one specific program. Excellent coaching skills by tutors are important. These coaching skills are necessary to support students in the process of envisioning extracurricular learning opportunities when important career choices have to be made.
Unhealthy eating behaviors and low levels of physical activity are major problems in adolescents and young adults in vocational education. To develop effective intervention programs, more research is needed to understand how different types of motivation contribute to health behaviors. In the present study, Self-Determination Theory is used to examine how motivation contributes to dietary and physical activity behaviors in vocational students. This cross-sectional study included 809 students (mean age 17.8 ± 1.9 years) attending vocational education in the Netherlands. Linear multilevel regression analyses were used to investigate the association between types of motivation and dietary and physical activity behaviors. Amotivation was negatively associated with breakfast frequency and positively associated with diet soda consumption and high-calorie between-meal snacks. A positive association was found between autonomous motivation and water intake, breakfast frequency, fruit intake, and moderate-to-vigorous physical activity. Autonomous motivation was negatively associated with the consumption of unhealthy products. Controlled motivation was not associated with physical activity or dietary behaviors. Different types of motivation seem to explain either healthy or unhealthy dietary behaviors in vocational students. Autonomous motivation, in particular, was shown to be associated with healthy behaviors and could therefore be a valuable intervention target.
