10 February 2022 – KYPtraining

Self-efficacy is central to health behaviour theories due to its robust predictive
capabilities. In this paper, we present and review evidence for a self-efficacy-as motivation argument in which standard self-efficacy questionnaires – i.e., ratings of whether participants ‘can do’ the target behaviour – reflect motivation rather than perceived capability.

The potential implication is that associations between self-efficacy ratings (particularly
those that employ a ‘can do’ operationalisation) and health-related behaviours simply indicate that people are likely to do what they are motivated to do.
There is some empirical evidence for the self-efficacy-as-motivation argument, with three studies demonstrating causal effects of outcome expectancy on subsequent self-efficacy ratings. Three additional studies show that – consistent with the self-efficacy-as-motivation argument – controlling for motivation by adding the phrase ‘if you wanted to’ to the end of self-efficacy items decreases associations between self-efficacy ratings and motivation.
Likewise, a qualitative study using a thought-listing procedure demonstrates that self-efficacy ratings have motivational antecedents.

The available evidence suggests that the self-efficacy-as-motivation argument is viable,
although more research is needed. Meanwhile, we recommend that researchers look
beyond self-efficacy to identify the many and diverse sources of motivation for health-related behaviours.

Self-efficacy – defined as perceived capability to perform a target behaviour (Bandura, 1977, 1986, 1997, 2004) – is a robust predictor of various health behaviours
(Armitage & Conner, 2001; Godin & Kok, 1996), including physical activity
(Bauman et al., 2012), healthy eating (AbuSabha & Achterberg, 1997), smoking cessation (Gwaltney, Metrik, Kahler, & Shiffman, 2009), alcohol abstinence (Adamson, Sellman, & Frampton, 2009), health behaviour change among cancer survivors (Park & Gaffey, 2007) and general health outcomes (Holden, 1991). Self-efficacy is the primary explanatory construct in Bandura’s (1986, 1997) social cognitive theory – one of the most often used health behaviour theories (HBTs) (Glanz & Bishop, 2010) – and is included in several other often-used HBTs, including protection motivation theory (Rogers, 1983), the health belief model (Rosenstock, Strecher, & Becker, 1988) and the transtheoretical model (Prochaska & DiClemente, 1983).

Additionally, perceived behavioural control in the theory of planned behaviour is defined and operationalised in ways that are similar to self-efficacy (Ajzen, 1991, 2002).
Thus, the concept of self-efficacy is pervasive in health behaviour science.
One of the purported strengths of self-efficacy is that it explains why people are (or are not) motivated to perform health-related behaviours, rather than merely predicting who is (or is not) motivated to perform health-related behaviours. Specifically, according to self-efficacy theory (a component of social cognitive theory that emphasises the role of self-efficacy; Bandura, 1997), self-efficacy is positioned early in a causal chain of factors that are posited to determine behaviour. Self-efficacy influences behaviour directly and
through its effects on expected outcomes of the behaviour, the setting of relevant and challenging goals, and perceived barriers to and facilitators of the target behaviour (Bandura, 1997). Self-efficacy, in turn, has four sources: mastery experiences, vicarious learning, verbal persuasion, and physiological and affective states at the time of the behavioural opportunity (Bandura, 1997). Thus, in self-efficacy theory, both the sources of self-efficacy and the mechanisms through which it influences behaviour are specified and can be used to design behavioural interventions.

The concept of work-based learning can be approached from different perspectives (Fenwick, 2008). Nisbet et al. (2013) define work based learning as informal learning that occurs inside the work community in the interaction between employees. Work-based learning requires participation in work processes, collaborating with colleagues, taking challenging tasks and working with customers. Thus, learning occurs as a by-product of working (Eraut, 2007.).

Work-based learning can also include formal learning (Choi and Jacobs, 2011). For example, universities and other educational institutes can offer curriculums to organisations that the employees can carry out alongside their work without qualifications. This kind of learning can also be defined as a form of work-based learning, in which case the employee has responsibility to set the learning objectives, look for learning situations, search knowledge, and evaluate and reflect on their own learning (Stanley and Simmons, 2011.). The aim of this kind of work-based learning curriculum is to encourage employees to study independently and to take responsibility for their own learning and the continuous development of their professional skills and know-how (Chapman, 2006). In this review, work-based learning is defined as informal learning that occurs inside the work community in the interaction between employees by participation.

The traditional understanding of learning is that knowledge is offered to the employees without them actively seeking and processing that knowledge themselves (Jensen, 2007; Williams, 2010). However, knowledge never passes on from one person to another as it is; the new knowledge is always constructed via the thinking processes of the individual. The person’s preconceived assumptions and previous knowledge – as well as the prevailing culture – have an effect on this process of shaping knowledge (Billett, 2008.). People try to understand their experiences and give meanings to them. Because the experiences affect what kind of significance a person gives to their learning and professional development (MacKeracher, 2004), it is important to describe experiences of work-based learning by care worker staff.

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