Evaluating the main components of motivation for learning histology in medical, dentistry and pharmacy students is important because it can help instructors to help their students, aid in monitoring their motivation to learn science, and support efforts to better organize collaborative learning activities based on an appropriate selection of highly motivated students . In this connection it is worth noting that the elements essential for stimulating motivation in health science students appear to be absent as a primary aim in many curricular plans . In the present work, we have used the SMQII questionnaire developed by Glynn and cols., which has been previously validated by these authors as one of the most accurate instruments for assessing motivation and its components, and showed high reliability as determined by the alpha coefficient of Cronbach obtained in our study.
One of the most innovative aspects of the SMQII is the transformation of the classical scale termed extrinsic motivation (or “learning science as a means to a tangible end”) into two scales, i.e. grade motivation and career motivation, which more clearly target the objectives that students perceive to be important in this stage of their education. This is especially important in health science education because the motivation to learn health science disciplines is influenced differently by short-term goals such as obtaining a high course grade and long-term goals such as success in their professional career practice, which in health science professions is explicitly regulated by professional and government bodies.
The results of the present study show that in relation specifically to learning histology, the profiles for components of motivation defined as career motivation and self-efficacy were similar in all three degree programs. The scores for both components were highest in the group of medical students, followed in decreasing order by dentistry and pharmacy. In the career motivation component there were significant differences when the overall mean scores for the three groups were compared (medicine vs. dentistry, medicine vs. pharmacy and dentistry vs. pharmacy students) whereas differences were not significant in self-efficacy. Interestingly, both profiles were positively correlated with the students’ final performance in histology, pointing out that the extent of career motivation and self-efficacy are clearly influencing the final outcome of the students in histology. Our study confirms some previous reports using different methods suggesting that self-efficacy is associated with effort, persistence, and performance [49, 50]. The relationship between these two components of motivation and their correlations with each of the three groups of students reflects the relationship between the primary long-term goals that students focus on, which is what characterizes career motivation, and students’ beliefs about their capabilities in a specific area (e.g. histology), which is what characterizes self-efficacy and influences the choice of activities that allow individuals to decide which tasks to focus on [25, 51–54].
In the health professions the long-term goal of professional career practice is an important component of motivation, which is related more closely with future competencies to be used in regulated professional practice than with knowledge and skills to be acquired in the learning process during university study. In this regard our results are consistent with several studies which found that compared to dentistry students, medical students had a more professional attitude, whereas dentistry students showed a greater commitment to personal and financial gain [29, 55, 56]. Regardless of these observations, the higher scores in our group of medical students are most likely related with a more highly developed system of regulations for professional practice. The lower scores among pharmacy students are most likely related with the fact that this area, according to Figgs and Cox  is a profession that lends itself to many career avenues. The intermediate scores in our group of dentistry students are most likely related with the lack of a sense of public service among these students –a perception that results in attitudes detrimental to the public perception of the dental profession as a whole . The results we obtained with the SMQII for histology learning are consistent with our earlier finding of a high level of motivation for professional practice among medical students who were offered a choice of different learning methods .
In the present study the self-determination and grade motivation components yielded a similar motivational profile in all three groups of students. Mean scores for these components were highest in dentistry, followed in decreasing order by medicine and pharmacy. The differences between degree programs were statistically significant for the grade motivation, and between pharmacy and medicine students and between pharmacy and dentistry students for self-determination. The similarities in the response profiles for these components among the groups shows that a relationship exists between self-determination, and hence the control that students believe they have over their learning process, and the grade motivation, that is, the short-term primary goals of students enrolled in different degree programs. It is therefore unsurprising that dentistry students scored highest in both of these components of motivation, especially in grade motivation. Our results suggest, as Boiche and cols.  showed for physical education, an adaptive role for the self-determination component of motivation towards histology among dentistry and medicine students, with high levels of self-regulation thanks to which individuals do not act without feelings of control or competence to achieve success during their undergraduate degree program. Self-determination, i.e. the option to control the learning process for histology and therefore to self-regulate this activity during undergraduate education, is seen by dentistry and medicine students as a more attainable goal under these circumstances. When the overall mean scores for these two components were correlated with the final performance in histology of the students corresponding to the three curricula, we did not found a significant correlation. This could mean that self-determination and grade motivation will not determine the final score of the students enrolled in the histology matters.
The use of this questionnaire allowed us to analyze independently the two major components of the extrinsic motivation -career motivation and grade motivation-. Our data illustrates clear differences in the results obtained for these components among groups of students, and suggests that it may be possible to identify relationships between components that might otherwise be overlooked. In addition, our results show that both components have different influence on motivation for learning histology in health sciences curricula. Whereas the career motivation, which showed the same profile that self-efficacy, was correlated with the final outcome of the students, grade motivation, whose profile was similar to that of self-determination, was not correlated with the final performance.
Finally, intrinsic motivation showed the highest mean scores in medicine, followed in decreasing order by pharmacy and dentistry. The differences between medical and pharmacy students vs. dentistry students were statistically significant. The lower mean scores for this component in dentistry students vs. medicine and pharmacy students is likely related with the general perception, supported by several studies, that there is no statistical correlation between the amount of undergraduate basic science education and performance in dentistry school or on board exams, although dentistry graduates and practitioners do perceive the importance of these science a posteriori, including histology [34, 58]. No correlation with the final histological performance was found for this component, thus confirming that this important component of motivation is not as relevant as career motivation and self-efficacy for the academic achievement.
Regarding the differences between genders, our results suggest that only one of the components of motivation was different in the case of medicine and dentistry students, although three components were statistically different in pharmacy students. Although Hulsman and cols.  reported no differences between males and females in the strength of motivation, more recent work by Kusurkar and cols. , showed that strength of motivation appears to be a dynamic entity, changing primarily with age and maturity and to a lesser extent with gender and experience. In the present study we found no differences between male and female medical students for any of the components except career motivation, which was higher in male than in female students, although none of the specific items in this component was significantly different between males and females. Among dentistry students there were no gender differences for intrinsic motivation, career motivation, self-determination and grade motivation, whereas men and women differed with regard to self-efficacy. Among pharmacy students we found gender differences for intrinsic motivation, self-determination and grade motivation but not for self-efficacy or career motivation. Although the differences between genders in the motivation to learn sciences remain poorly understood, they may result from factors such as role modeling and socialization by parents, teachers, peers and the media, and not from “innate or natural differences” between women and men [15, 16, 45].
Our findings with regard to the relative influence of different components of motivation in different groups of health science undergraduates are potentially useful in future efforts to answer some interesting questions. For example, are there gender differences in how students self-regulate in order to control their motivation and behavior? What role do the different components of motivation play in the overall motivation of males and females to perform well in these degree programs?
The motivational process is a substantially undervalued factor in curriculum development . Because the motivation to learn, as conceptualized in social cognitive theory, is a multicomponent construct, determining the role of each component of motivation is useful not only to help individual students succeed in the learning process according to their motivational background, but also to help instructors develop appropriate teaching strategies based on their knowledge of specific motivational profiles among students enrolled in different programs.
Limitations of the present study are related to the lack of knowledge on the previous motivation of the students before being incorporated to the study, on their previous knowledge on histology and other related sciences that could influence their perceptions. In addition, we do not know to what extent we can generalize our findings to other students and other disciplines.
A strength of our study is that the histology course of interest was taught with the same methods by instructors from the same department to all participants, who were enrolled in different undergraduate programs at the same university. We feel our results contribute to our knowledge about the close relationships among different components of motivation in specific disciplines within different health sciences curricula. Ultimately, these findings can support improved efforts to develop more effective medical education curricula.