Learning and Teaching in Action: Open Issue

Group of students at a computer


Autonomy, Motivation and IT skills:

Impacts on the engagement of Physiotherapy students with eLearning

Claire Hamshire and Rod Cullen


The concept of the independent autonomous learner is at the heart of institutional changes in the learning, teaching and assessment processes and the implementation of an institutional Managed Learning Environment (MLE).

In the Physiotherapy programme team we have conducted a mixed methods evaluation of the provision of online resources that aim to facilitate autonomy and are delivered via the WebCT VISTA component of our MLE.

Primarily, we investigated “facilitators” and “barriers” to uptake and use of these resources by students. Overall, students reported a very positive experience of online activities, with a broad range of factors influencing uptake and engagement. Extrinsic factors related mainly to technical (e.g. home PC setup) and administrative (student enrolment, network access and support) difficulties. These had less impact on our study’s metrics than intrinsic factors such as autonomy, motivation and IT skills.

Our evaluations have also highlighted a mismatch between the programmes aspirations and student perspectives of autonomy. We have made links between the levels of autonomy, motivation and IT skills of our students and considered ways of addressing these issues within the Physiotherapy curriculum. As a result we are in the process of devising a new induction programme which aims to provide “scaffolding” that will motivate our students and assist their development as independent autonomous learners.


Manchester Metropolitan University is currently engaged in fundamental institution wide changes to learning and teaching provision. Strategies are being devised around: the principles of student centred learning; the opportunities offered by an institutional Managed Learning Environment (MLE); and the need to make efficiencies in learning, teaching and assessment processes (Brookes 2005a, 2005b). At the heart of this rethink is the concept of the independent autonomous learner.
The National Health Service (NHS) provides a further driver for change in health professional education. Since 1996, when the ‘Information for Health’ strategy was launched there has been a move to make better use of information technology in all aspects of patient care and staff development (Glen and Cox 2006). The NHS now requires a computer literate workforce able to seek information and communicate through information technology (IT) to enhance clinical practice (Wanless 2002). The ability to use IT effectively is now an important skill for health professional graduates and the pedagogy of health professional education has adapted to include e-learning (Glen and Moule 2006).

Curriculum change and development is linked closely to other institutional issues such as retention and progression and employability as well as a recognition that student needs and expectations are changing. Figure 1 demonstrates the relationship between the curriculum development processes and these issues and emphasises the need to consult with our students about their needs as learners.

Figure 1

Combining traditional face-to-face learning and teaching practice with the use of information and communications technologies such as those supported by most university MLEs is often referred to as “blended learning” (JISC 2004). In the department of Physiotherapy the move to a blended provision was seen as a way of responding to the change agenda outlined at MMU and in September 2006 the use of WebCT (the main component of the MMU MLE) was incorporated into the learning and teaching of all level 1 units on the BSc (Hons) Physiotherapy programme. For each unit (six in total) the WebCT provision included a unit introduction page, discussion boards for asynchronous communication, chat rooms for synchronous communication, quizzes to facilitate formative feedback and interactive learning materials divided into weekly study tasks.

This study aimed to investigate our students’ perceptions of WebCT as a learning environment, the barriers and facilitators to their use of WebCT and any impacts that these had on their learning.


As we recognised that only the students themselves can articulate the learner experience (JISC 2007), listening to the student voice was central to this study. The methodology was designed to explore students’ opinions and beliefs and focus on their experiences, of working with WebCT, described in their own words.

We conducted a sequential exploratory, mixed methods evaluation (Creswell 2003). This involved three basic stages (Figure 2). In stage 1 the emphasis was on initial small scale, detailed, qualitative data collection and analysis targeted at key groups of students. This was used to identify key themes which, in stage 2, informed the development of a larger scale, more quantitative data collection and analysis targeted at the whole cohort of students. Stage 3 required an overall interpretation of the entire analysis.

Figure 2

Data Collection and Analysis

Stage 1: Individuals were selected for one-to-one interview based on WebCT student tracking data from the core unit (Physiotherapy Management 1) between 23 October and 20 November 2006. A purposeful sample of eight students, three high (over ten logins with at least 1 hour active user time), three low (1-3 logins) and two non-users were selected and interviewed. The semi- structured interview schedule began with broad questions, exploring the students’ use of technology and their perceptions of the programme as a whole and then focussed on specific WebCT issues in a “funnel interview” (Tashakkori and Teddlie 1998).

A thematic analysis based on an analytical “framework approach” (Ritchie and Spencer 1994) was carried out to identify key themes in the students’ experience of working with WebCT.

Stage 2: The themes derived from stage 1 were developed into a questionnaire that was sent to the whole cohort (n=120). The questionnaire was designed to substantiate and provide clarification of the data gathered by the interviews. The emphasis was on quantitative data via closed question formats; however, open questions were also included providing a further qualitative component.

Thematic analysis of the open questions and descriptive statistical analysis of the closed questionnaire questions was carried out.

Stage 3: The overall data set comprising of three elements, qualitative interviews, open qualitative questionnaire questions, and closed quantitative questionnaire questions is shown in Figure 3. The central triangle represents the overall interpretation of the entire analysis.

Figure 3:

Results and discussion

Overall perception of WebCT

As with many other studies into the provision of online resources that supplement traditional teaching (e.g. Sharpe et al , 2006) the majority of the students, across all three user groups, perceived WebCT positively and reported a positive user experience during the unit. In general students felt WebCT was necessary for the unit; found learning this way convenient; and liked being able to get lecture notes and access web links online at any time.

The majority of the cohort were first time users of WebCT but they reported that it was easy to access the system, learn how to use it and navigate once inside the course area.

Barriers and Facilitators to engagement with WebCT resources

The key themes that emerged from the combined analysis were:

  • The availability of useful learning resources that are flexibly and easily accessible encourages WebCT usage by a diverse student population.
  • Autonomy and motivation are a key influence on student usage levels.
  • Lack of computer confidence and competence can be a barrier to use.
  • Students value online resources more than the communication tools.
  • Access issues, broken web links, poor navigation and the use of inappropriate software all discourage use.
  • Some students have preferences for different learning media.

We have summarised and categorised these into extrinsic and intrinsic factors in Table 1. The extrinsic factors (external to the student) relate mainly the technology and technical infrastructure that supports it, while the intrinsic factors (internal to the students) are personal attributes of the student.

Table 1: Barriers and facilitators to engagement
Extrinsic Factors Intrinsic Factors
  • Admin issues
    • Access
  • Technical issues
    • Software
    • Broken links
  • Autonomy
  • Motivation
  • IT confidence

In all cases the factors can be both barriers and facilitators depending on the student’s experience. For example, if a student has been enrolled correctly in WebCT and can login consistently without problems this facilitates their engagement with WebCT. If on the other hand the student has had intermittent problems logging into WebCT this can become a significant barrier to ongoing engagement.

Table 2 demonstrates the spectrum of student perspectives from the semi-structured interviews relating to the intrinsic engagement factors. With close analysis of these responses and those of the other interviewees it has become clear that intrinsic factors played a much more significant role in engagement with WebCT than extrinsic factors. Indeed it has become apparent that intrinsic factors can have a direct influence on the impact of extrinsic factors for an individual student. Students with high levels of autonomy and motivation and good IT skills were able to easily overcome extrinsic barriers to engagement. However, students who were less autonomous and motivated and/or were less confident IT users often found the extrinsic barriers they encountered insurmountable.

Table 2: Spectrum of student perspectives
WebCT User Level Autonomy Motivation IT Skills
High user “I think as a mature student and spending a bit of time working and doing other things my organisation is certainly better now than it would have been when I left school. It doesn’t daunt me the fact that a lot of it is self-directed. In fact I quite like that.” “I spend my Tuesdays and Thursdays, full day from nine to about half three then take a break and then from four until six just working through the study tasks that I’ve got to do or looking what I need to be doing longer term with my assignments and things like that.” “I’d say I’m very confident. I used to use the computer a lot with my work as well before I started here so yeah I know my way around a computer pretty well. I use it obviously for Uni, for research and for WebCT and obviously to keep up with emails, Internet shopping, general poking around like that.”
Low user

“At the beginning it was quite a shock to like do work and not necessarily be going over it and sometimes if you get a bit behind or something it’s hard to catch up because you’ve always got things for the next time.”

“We were panicking like mad saying we want just one set textbook you know.”

“Sometimes it’s hard when the studies are looking up things, you get home and you look in your study pack and you’re like look in book such and such and you’re like at home and you don’t have the book and you think, that’s it I’m going to have to go back to it because, I mean, I can’t do it and I’ll have to catch up later. It’s my fault I should look earlier to see what I have to do.”

“We never had to use the computer before really.”

“So I always much preferred doing assignments and that kind of thing handwritten. I much preferred it, it flowed better and here it’s like you must do it by computer and like in the beginning I was all panicky about it.”

“I did everything by hand and then typed it up at the end.”

Non user

“I’ve found it quite hard to adapt to the way that everything is geared towards a DIY attitude. I lost it at times.”

“Basically it’s self orientated learning where the student is left to do the work.”

“It has its merits definitely and in one way I’m being forced into this new way of learning, even though I’m kind of being dragged kicking and screaming.”

“Once I’m really into something that I’m interested in I’ll read it all day but just procrastinating, and there’s always something to be done other than study, like tidying your room or tidying the kitchen, or go out to town, which you don’t have to do but I tend to do instead, that tends to get in the way.”

“I don’t know, I need to sort that out.”

“Yeah communication with friends at home as a data base for finding out things and as a way of getting information from sources that would want to get in contact with me, like bank or airline, the email for this interview, stuff like that.”

“Just for dummies like me that wouldn’t be really good with the computer if you could just make it (WebCT) easier to understand how to use.”


Autonomy in the Physiotherapy curriculum

Physiotherapists, as educators, place great value on students developing independent learning skills and Kell and Van Deursen (2003), in a study of physiotherapy students, suggest that there is an obligation to ensure that our graduates have a desire to be educationally self-directed. The Chartered Society of Physiotherapy (CSP) curriculum framework is in accord and states that Physiotherapy programmes should include opportunities that encourage students to learn independently (CSP 2002).
The ethos of the BSc (Hons) Physiotherapy programme reflects this and has high aspirations in terms of autonomy from the start. Table 3 contains excerpts from the level 1 programme handbook emphasising the need for students to take personal and professional responsibility in the context of their learning and to be highly reflective in their practice. High levels of autonomy are implicit within the programme from the start of level 1.

Table 3: Autonomy in the Physiotherapy curriculum
Source Articulation
Programme Design “The students’ learning is set within a professional context and the curriculum is designed to enable students to increasingly take responsibility for their own professional development.”
Programme Delivery “Throughout the programme there will a strong emphasis on learning through reflection. Students will be encouraged to reflect on their experiences through the use of reflective logs/diaries and reflective writing assignments.”
Level 1 Descriptor “They will be able to communicate accurately and have the qualities needed for a position that requires them to exercise personal responsibility.”


Autonomy is however a complex issue. Ecclestone (2000) considers autonomy as having three different levels (Procedural, Personal and Critical) which reflect increasing student independence from the tutor. (Figure 4).

Figure 4: Levels of autonomy (McAtominey and Cullen (2002), Ecclestone (2000))

It is clear from Table 3 that the programme documentation is aimed at levels of autonomy at the higher critical level of the autonomy spectrum. However, if we look at Table 2 it is clear that some of our students express their autonomy at the lower procedural level i.e. “I’ve found it quite hard to adapt to the way that everything is geared towards a DIY attitude. I lost it at times”. This mismatch presents us with a challenge in terms of curriculum and programme design.
One of the rationales for the use of e-learning resources is that it can encourage active, self-directed learning (Glen 2005 and Santy and Smith 2007). Peacock & Hooper (2007) have linked the use of online resources to the promotion of independent, active learning within a number of studies and McKimm et al (2003) concur.

Our experience indicates that the solution is not as simple as providing e-learning resources as part of blended learning provision. The stage 1 interviews suggest that there may be differences in the way that students experience and interact with online learning. One of the factors identified as influencing this was the apparent degree of readiness that individual students showed for self-directed learning. Although the use of online resources within a programme may encourage self-direction in some students, assumptions cannot be made that this is the case for everyone. The degree of control that students want to take over their learning process depends upon their individual personality, ability and attitude (Fisher et al 2001) and also the stage that they are at within their degree programme.

Our challenge in terms of autonomy is to help our students develop skills that move them through procedural levels of autonomy up to critical levels of autonomy.

Linking autonomy, motivation and skills in curriculum development

Our research leads us to believe that the development of autonomous, independent, self-directed learners, although highly complex, is something which can be enhanced by targeting key areas of the curriculum.

We have summarised our thoughts in Figure 5. It has become apparent to us that the extent to which a student is an autonomous, independent, self-directed learner is a function both of their level of autonomy and their level of intrinsic motivation (want or need to learn).
Although closely linked, autonomy and motivation are not synonymous. For example a student who possesses a critical level autonomy may not be motivated by tasks that are seen as not relevant directly to their studies. At the same time a highly motivated student may simply not have the experience or required skill set to enable autonomous learning. In either case the curriculum needs to be designed to provide appropriate “scaffolding” to enable students to develop higher levels of autonomy and provide the necessary motivational stimuli.

Figure 5: Linking autonomy, motivation and skills in the curriculum

In terms of autonomy the curriculum can target the students’ learning, academic and IT skills, providing them with an understanding of their own learning needs and a skill set that empowers them as individual learners and within a community of practice in Physiotherapy. By developing a curriculum that is relevant to physiotherapy students in the work place, sets out and communicates a clear purpose for the constituent parts of the programme and involves students broadly in all aspects of their learning, including assessment, we can provide motivation for all of our students.

We also see a clear role for the institution’s MLE (including WebCT VISTA) in our future curriculum developments. As reported by others (e.g. McKimm et al , 2003) we feel that independent and active learning can be encouraged through web based programmes where this is embedded thoroughly in the curriculum design and that by utilising integrated, interactive course materials, educators can improve learning and make that learning more enjoyable and meaningful for learners.

Application in the development of level 1 induction programme

In January of 2007, we received funding from the HEA Subject Centre for Health Sciences and Practice for a mini-project titled “Integrated Induction Materials for Physiotherapy (easy start)”. The project will develop and deliver a blended learning induction programme at level 1 that targets key learning skills in Physiotherapy. An overview of the design is provided in Table 4. We do not intend to describe the induction programme fully here, rather we seek to emphasise how the design of the induction programme has taken on board lessons we have learned from the work described above.

Table 4: Level 1 induction design
Timing Pre-entry 1st Week Throughout 1st Year
  • Foster relationships
  • Reduce anxiety
  • Familiarise
  • Motivate/inspire
  • Cement relationships
  • Settle in
  • Promote core skills
  • Set the scene
  • Maintain relationships
  • Reinforce core skills
  • Provide timely relevant support
Strategies/ methods
  • Facilitated online
  • Key contact
  • Online forum
  • FAQ
  • Virtual Tour
  • Coffee morning social
  • Meet personal tutor
  • Core skills small group work
  • Meet student reps
  • Start formal teaching
  • High profile key contact
  • Online core skills area
  • Timely support for assessment
  • Links to personal tutor system


A key element of the design is to embed the materials and resources provided via WebCT into the students’ working practice before they arrive, during their critical first week at university and in ongoing support throughout level 1. This phased induction will be based around small group activities, linked and integrated with the programme and level one unit learning outcomes. We will provide students with flexible access (via WebCT VISTA) to a broad range of resources relating to programme administration, campus orientation, social aspects as well as academic skills learning materials. This induction will help students manage their transition to Higher Education, reduce anxiety, provide a focus for skills development and enable them to communicate easily with their tutors and support staff.
Such a framework, we believe, will build a foundation for the development of student autonomy. The core skills element will be tied closely to in-class activities, particularly those related to assessment. The purpose is to increase the relevance of the core skills resources to specific learning activities and provide “just enough information in just enough time” (JEIJET) to support the students in their work. As students become more familiar with these resources, in appropriate contexts, we anticipate that we will foster ongoing independent use of the resources.

One of the most important roles will be that of the designated “key contact” from the teaching team. They will be responsible for bridging the gap between what takes place in the class rooms and lecture theatres and the resources available to support those activities in WebCT. In simple terms this will mean the “key contact” facilitating the JEIJET principles of easy start by dropping into teaching sessions and directing students to supporting resources at the times when they are most useful. The role of the key contact is to some extent to emphasise the relevance of key resources to inexperienced learners and provide the motivational stimuli for their use. We anticipate that linking assessment activities to the core skills resources available within WebCT will be a major benefit in this respect.


Our work has highlighted to us the importance of detailed consultation with students in the planning and design of blended learning resources. We also recognise that there is to some extent a mismatch in the programme aspirations and some of students’ self perceptions in terms of autonomy. As our programme recruits a diverse student body, their readiness and levels of motivation for learning in HE vary greatly depending on their prior learning experience. This has an impact on their levels of autonomy. The challenge is to embed scaffolding within curriculum design to enable all students to develop appropriate independent learning skills as they progress through the whole programme.


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about the author

photo of Claire Hamshire

Claire Hamshire
Senior Learning and Teaching Fellow, Faculty of Health, Psychology and Social Care

e-mail: c.hamshire@mmu.ac.uk
telephone: 0161 247 2940

photo of Rod Cullen

Dr Rod Cullen
Senior Lecture in Learning & Teaching, CeLT

e-mail: r.cullen@mmu.ac.uk
telephone: 0161 247 3356

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Summer 2008
ISSN 1477-1241