The Power of Positive Engagement to Motivate the Poor Performer. Disclosure. Opening Skit Questions

Transcription

1 The Power of Positive Engagement to Motivate the Poor Performer Anita Cleven, PharmD, RPh Huy Hoang, PharmD, RPh Disclosure In accordance with the ACPE s and ACCME s Standards for Commercial Support, anyone in a position to control the content of an educational activity is required to disclose their relevant financial relationships. In accordance with these Standards, ASHP is required to resolve potential conflicts of interest and disclose relevant financial relationships of presenters. In this session: All planners, presenters, reviewers, and ASHP staff report no financial relationships relevant to this activity. Opening Skit Questions 1. Is Huy motivated to be at this experience, why or why not? 2. Is Dr. Cleven supportive of Huy s dreams?? Page 1 of 17

2 Objectives Identify the pillars of motivation according to Self Determination Theory. Explain self efficacy/regulation and its impact on motivation. Evaluate and determine the cause for a poor performing unmotivated learner. Design and tailor a dialogue to motivate the poor performer using positive engaging techniques. Pre Test Questions 1. According to Self Determination Theory individuals must seek to satisfy what psychological needs? Satisfaction, Competence, Relatedness Competence, Autonomy, Belonging Competence, Autonomy, Relatedness Satisfaction, Belonging, Competence Pre Test Questions 2. What type of motivation is the most desirable level of motivation? Extrinsic Intrinsic Integrated regulation External regulation Page 2 of 17

3 Pre Test Questions 3. Why is positive engagement important to a learner s motivation? Creates an environment of safety and facilitates connection with the learner Helps support competence Helps support autonomy All the above Pre Test Questions 4. What is a positive engaging technique that you can utilize to enhance intrinsic motivation in the unmotivated poor performer? Give rewards Provide feedback Give emotional support Provide directives Human Functioning Reject growth Diminished responsibility Crushed Non optimal Passive Indolent Optimal Human Condition Thriving Inspired Agentic Active Constructive Normative Page 3 of 17

4 Motivation Move to act, it produces Motivation Amotivation Self Determination Theory (SDT) Inherent Growth Tendencies Innate Psychological Needs Self motivation (Intrinsic and Extrinsic), Personality Integration SDT and Innate Psychological Needs Competence Autonomy Relatedness motivation = anything that thwarts CAR motivation = anything that enhances CAR Page 4 of 17

5 SDT Continuum of Motivation Extent to which basic psychological needs, CAR are met Amotivation Extrinsic Motivation External Regulation Introjected Regulation Identified Regulation Integrated Regulation Intrinsic Motivation The Self Determination Continuum of Motivation (Adapted from Ryan & Deci, 2000) Amotivation Unwillingness to perform, lacking intention to act Not feeling competent, expecting no desired outcome Type of regulation Amotivation Locus of causality Reason for behaviors Effects Impersonal Passivity, avoidance, oppositional Insecurity, fear of failure, resistance, apathy SDT Continuum of Motivation Extent to which basic psychological needs, CAR are met Amotivation Extrinsic Motivation External Regulation Introjected Regulation Identified Regulation Integrated Regulation Intrinsic Motivation The Self Determination Continuum of Motivation (Adapted from Ryan & Deci, 2000) Page 5 of 17

6 Extrinsic Performance of an activity in order to attain some separable outcome External Introjected Identified Integrated Locus of causality Reason for behaviors External External rewards and punishments Somewhat external Self control, ego, internal rewards and punishments Somewhat internal Personal importance, conscious valuing Internal Congruence, awareness, synthesis w/ self SDT Continuum of Motivation Extent to which basic psychological needs, CAR are met Amotivation Extrinsic Motivation External Regulation Introjected Regulation Identified Regulation Integrated Regulation Intrinsic Motivation The Self Determination Continuum of Motivation (Adapted from Ryan & Deci, 2000) Intrinsic Motivation Doing an activity for the inherent satisfaction of the activity itself Autonomous motives, integrated, self determination Type of regulation Intrinsic Locus of causality Internal Reason for behaviors Interest and enjoyment Effects Sense of volition, pleasure, energy, persistence Page 6 of 17

7 Think Pair Share Lisa completes all projects assigned to her because she grasps the value and understands its importance in the profession Adam completes projects because he is fearful of what others think and is getting directives from his preceptor Based on this synopsis, who is more likely to remain motivated throughout the experience and why? Case 1: Anxious TJ Self Assessment: Identify the motivation behind the performance... TJ appears to be tense and confides in you that he is highly anxious and is completing this experience because he has to. He is having trouble getting his assignments in on time and is not meeting many competencies of the experience. At midpoint he is not on track to pass. Case 2: Good ole Laura Self Assessment: Identify the motivation behind the performance... Laura comes to your site after having not passed her previous APPE. She is upset and you come to find out that she is indifferent and disinterested in being at your site. She is lagging behind the other learners and has an attitude of who cares? Page 7 of 17

8 Techniques to positively engage the unmotivated poor performer Positive Feedback How to direct properly Communicate value in uninteresting activities Give emotional support Identify and nurture needs and wants Positive Learning Environment Creates a climate of safety, trust and respect Make learning relevant to goals Reinforce positive behaviors Respond with positivity Get to know the learner Get learner involved in the process Stay optimistic and enthusiastic The Power of Positivity Brain performs significantly better when it is positive than when it is negative, neutral or stressed. Shawn Achor Positive Feedback Positive Feedback You can help set the trajectory for learners motivation If used effectively, positive feedback has a positive impact on learners behavior, engagement, competence, self regulation, and can increase intrinsic motivation Influences the relationship you have with learners Important not to overuse (i.e. use too frequently and without a specific purpose) as this can facilitate extrinsic motivation Page 8 of 17

9 How to deliver positive feedback Positive Feedback Timely, constructive and supportive environment Non threatening, directed towards learning issues not learner Ask learner what went well and opportunities for improvement Provide points for improvement through use of suggestions Phrases to assist with positive feedback Positive Feedback Wow, I love how you did that patient write up. It was thorough and included all pertinent information. My suggestion is to utilize xyz to help ensure your findings. Positive words: surely, absolutely, assure, great, fantastic, gladly, certainly, terrific, not yet What does your learner want? Identify and nurture needs and wants Attempt to understand what the learner wants Be realistic Tailor experience Page 9 of 17

10 Create a sense of belonging Give emotional support Sharing Positive Warm Learners feel vulnerable to express feelings, doubts and questions Fosters a positive relationship Direct with can, may, could instead of must, need and should How to direct properly Refrain from obligatory statements You can learn this Maybe you can do it this way It is your choice It would help to include xyz If you study this it will increase your understanding of Uninteresting Activities... Communicate value in uninteresting activities Communicate value of doing these activities Provide rationale Relevance to profession and practice Relate to colleagues, friends and family Page 10 of 17

11 Reflection time 1. Which one of these positive engaging techniques have you tried? 2. Which one would you like to try? Revisit Case 1: Anxious TJ How would you positively tailor your conversation to motivate TJ? TJ appears to be tense and confides in you that he is highly anxious and is completing this experience because he has to. He is having trouble getting his assignments in on time and is not meeting many competencies of the experience. At midpoint he is not on track to pass. Revisit Case 2: Good ole Laura How would you positively tailor your conversation to motivate Laura? Laura comes to your site after having not passed her previous APPE. She is upset and you come to find out that she is indifferent and disinterested in being at your site. She is lagging behind the other learners and has an attitude of who cares? Page 11 of 17

12 Polling Slide: Post Test Questions 1. According to Self Determination Theory individuals must seek to satisfy what psychological needs? Satisfaction, Competence, Relatedness Competence, Autonomy, Belonging Competence, Autonomy, Relatedness Satisfaction, Belonging, Competence Polling Slide: Post Test Questions 2. What type of motivation is the most desirable level of motivation? Extrinsic Intrinsic Integrated regulation External regulation Polling Slide: Post Test Questions 3. Why is positive engagement important to a learner s motivation? Creates an environment of safety and facilitates connection with the learner Helps support competence Helps support autonomy All the above Page 12 of 17

13 Polling Slide: Post Test Questions 4. What is a positive engaging technique that you can utilize to enhance intrinsic motivation in the unmotivated poor performer? Give rewards Provide feedback Give emotional support Provide directives Key Takeaways Key Takeaway #1: The greater the psychological needs of competence, autonomy, and relatedness are met, the greater the learners motivation level Key Takeaway #2: Autonomy supportive teaching enhances intrinsic motivation (e.g. refrain from obligatory statements) Key Takeaway #3: Positive engaging techniques (positive feedback, directing properly, value in uninteresting topics, emotional support, identify needs and wants) help foster motivation References 1. Ryan, R. M., & Deci, E. L. (2000). Self determination theory and the facilitation of intrinsic motivation, social development, and well being. American Psychologist, 55, Kusurkar RA, Croiset G, Ten Cate TJ. Twelve tips to stimulate intrinsic motivation in students through autonomy supportive classroom teaching derived from self determination theory. Med Teach.2011;33(12): Pankonin, Ashlie, and Rebekah Myers. Home. Center for Health Identity Behavior and Prevention Studies CHIBPS, 2018, wp.nyu.edu/steinhardt appsych_opus/teachers use of positiveand negative feedback implications for student behavior/. Page 13 of 17

14 References continued 4. The Power of Praise and Recognition. Training Journal, 13 Nov. 2017, praise andrecognition. 5. Sogunro, O. A. (2015). Motivating factors for adult learners in higher education. International Journal of Higher Education, 4(1), doi: /ijhe.v4n1p22 6. Zimmerman, B. J. (2000). Self efficacy: An essential motive to learn. Contemporary Educational Psychology, 25, Orsini C, Evans P, Jerez O. How to encourage intrinsic motivation in the clinical teaching environment?: a systematic review from the self determination theory. J Educ Eval Health Prof. 2015;12:8. doi: /jeehp Page 14 of 17

15 RESOURCES 12 Tips to Stimulate Intrinsic Motivation 1. Identify and nurture what students need and want 2. Give positive and constructive feedback 3. Have students internal states guide their behavior 4. Give emotional support 5. Encourage active participation 7. Encourage students to accept more responsibility for their learning 9. Provide structured guidance 10. Give choices 11. Provide optimal challenges 6. Acknowledge students expressions of negative effect 8. Communicate value in uninteresting activities 12. Direct with can, may, could instead of must, need, should Adopted from: R. A. Kusurkar, G. Croiset & Olle Th. J. Ten Cate (2011) Twelve tips to stimulate intrinsic motivation in students through autonomysupportive classroom teaching derived from Self-Determination Theory, Medical Teacher, 33:12, , DOI: / X Textbooks 1. Ryan, Richard M., and Edward L. Deci. Self-Determination Theory: Basic Psychological Needs in Motivation, Development, and Wellness. Guilford Press, Deci, Edward L., and Richard Flaste. Why We Do What We Do the Dynamics of Personal Autonomy. G.P. Putnam, Gagné Marylène. The Oxford Handbook of Work Engagement, Motivation, and Self-Determination Theory. Oxford University Press, Articles 1. Pankonin, Ashlie, and Rebekah Myers. Home. Center for Health Identity Behavior and Prevention Studies CHIBPS, 2018, wp.nyu.edu/steinhardt-appsych_opus/teachers-use-of-positive-and-negative-feedback-implications-forstudent-behavior/. 2. Sogunro, O. A. (2015). Motivating factors for adult learners in higher education. International Journal of Higher Education, 4(1), doi: /ijhe.v4n1p22 3. Zimmerman, B. J. (2000). Self-efficacy: An essential motive to learn. Contemporary Educational Psychology, 25, Page 15 of 17

16 Preceptor Motivation Checklist Handout Self-Determination Theory-based criteria to assess motivation Competence I create an environment where learners can feel confident in his/her ability to manage I assign workload that my learner is capable of completing (e.g. assignments, projects, presentations, journal clubs, etc.) My learner is able to do his/her own work-up on a patient and review patient charts independently I set realistic expectations where my learner can meet the challenges of the experience My learner is confident in his/her ability to learn this material My learner is capable of learning new material for this course My learner is able to achieve my goals in this course My learner feels able to meet the challenge of performing well in this course Autonomy I provide my learner with choices and options I am able to be open with my learner at our meetings I convey confidence in my ability to make changes I encourage my learner to ask questions I feel trust in my learner I answer my learner s questions fully and carefully I make an effort to understand how my learner see things before suggesting a new way to do things I create an environment where my learner feels able to share his/her feelings with me Relatedness I care about my learner as a person I make an effort to have the learner feel like he/she is a part of the pharmacy team I serve as a good role model for the learner I respect the learner I value the learner I am warm and inviting I feel connected to my learner I serve as valuable resource that my learner can look up to Adopted from: Questionnaires. An Approach to Human Motivation & Personality, selfdeterminationtheory.org/questionnaires/. The more boxes that are checked, the greater likelihood your learners will feel intrinsically motivated. Do these results match your perception of your learners motivation at your site? If so, how? Page 16 of 17

17 How would you handle the following situations? CASE 1: Sarah is from out of state and tells you she does not have a strong social support system. She is engaged and has a strong desire to learn and grow. She tells you that doing a pediatric residency with you has been her lifelong dream and she is absolutely grateful for this opportunity. As an effective preceptor, how would you support Sarah? Sarah appears to be motivated, however does not have strong social support. Her sense of relatedness may be thwarted. This may ultimately impact her motivation. A suggestion for you to consider: connect her with some other residents, and or other social networks. Show your support by checking-in with her. <Fill in with additional suggestions> CASE 2: Robert is completely disengaged and struggling to meet the demands of the experience. You are frustrated with him because he just doesn t care. What would you do? A suggestion for you to consider: seek to understand what is happening by utilizing positive dialogue (e.g. abstain from accusatory language). Based on his response tailor your approach to help meet his career goals. <Fill in with additional suggestions> Page 17 of 17