This question speaks to the concept of motivation, the driving force which individuals achieve their personal and professional goals.1,2
Motivation is a key factor for engaging and maintaining a learning audience. It must be addressed when creating education, and specifically when creating online education, you have to be more innovative when attempting to engage your readers. The learner is, for the most part, in charge of what gets learned. Tuning into what motivates and brings the learner to your course, will aid in maintaining their interest and continued participation.1,2
Three components of motivation1,2:
- Activation - the decision to initiate behaviour
- Persistence - continued effort towards a goal, despite obstacles
- Intensity - level of concentration and vigour that goes into achieving the goal
Flow theory1,2

Flow theory can improve motivation when creating online education, ensure you:
- State clear objectives - clear and focused goals at the beginning allows readers to become focused enough to reach flow state
- Address appropriate skill levels - clearly state upfront the prerequisite knowledge and ensure course matches this skill level and challenges the learner throughout
- Reduce distractions - distractions can interrupt flow, eliminate any unnecessary information, excessive images and clutter to keep the focus on the content
Path-Goal Theory1,2
Robert House created this theory and stated that the learner's performance and motivation is directly influenced by the behaviour of the instructor or leader. It is characterized by 4 types of leadership styles that help to motivate learners. This theory can be applied to the creation of online education by incorporating these leadership concepts into its design.
- Achievement-oriented - create goals and questions that challenge the learner to encourage excellence and confidence
- Directive - create clear, specific expectations for the course
- Supportive - create a course that is user-friendly and approachable, and supports learners
- Participative - encourage participation through course evaluations, polling questions and interaction with other learners, where possible

Self-determination Theory1,2
This theory created by Edward Deci and Richard Ryan speaks about intrinsic motivation. The drive within the learner that is connected to the idea that learning is beneficial and meaningful. In terms of e-learning and continuing education, it can be difficult for learners to develop intrinsic motivation because it can sometimes feel like a job requirement or chore. To help mitigate this, developers need to tap into the learner's internal motivation by maximizing their autonomy, competence and relatedness; the core features of self-determination theory:
- Autonomy - providing the learner with a sense of control over the content. For example, allowing them to choose the order of the content flow or choose the patient case
- Competence - give learners opportunities to develop their competence throughout the course, such as quiz questions, encouraging decision-making with consequences and creating opportunities to complete challenging tasks
- Relatedness - creating a realm for learner interaction with other learners or with the content through discussion forums, quiz questions, etc.
"There are three things to remember about education. The first is motivation. The second one is motivation. The third one is motivation." Terrel Bell
The core principles in each of these theories relate to one another closely. By incorporating these ideas into the development of your online education, participant motivation and engagement will increase. As I begin to move away from the student mentality and into a blossoming pharmacist, I think these motivation principles will help to improve my patient counselling outcomes and encourage lasting behaviour change (e.g. smoking cessation).
As I approach my final days at mdBriefCase and as pharmacy student, I'd like to thank the team for welcoming me and allowing me to be a part of this organization. It has been exciting, eye-opening and fun! This is the beginning of a long-lasting relationship between rxBriefCase and me.
References
1. Gutierrez K. Designing for Motivation: Three Theories eLearning designers can use. Shift: Disruptive eLearning [Internet]. Accessed March 26, 2015. Available from: http://info.shiftelearning.com/blog/bid/340354/Designing-for-Motivation-Three-Theories-eLearning-Designers-Can-Use
2. Summaries of Learning Theories and Models. [Internet]. Accessed March 26, 2015. Available from: http://www.learning-theories.com/