Positive Reinforcement
By Allison Schroeder, MD
Many residents have had the experience of trudging through a busy day: working hard, hoping that you are providing good patient care, and hoping to live up to the standards of your attending physician. We have all probably experienced (or at least dreamed of) an ideal situation where these busy days of rounds, notes, staffing, admissions, notes, discharges, and, did I mention, notes(?) seemed to fly by, and possibly even be enjoyable.
What is the difference between these two situations? I would argue that the work environment plays a role: When you are surrounded by others who have a positive attitude in an environment that encourages collaboration and open communication, these busy days are much more manageable and rewarding.
As a resident, one is frequently thrust into different work environments, where this contrast can be very apparent and often seemingly out of our control. This can sometimes lead to feeling like we are “just spinning our wheels” or to (the dreaded term) “burnout.”
How many times are we working hard day in and day out, just wishing that someone would acknowledge our efforts or at least validate our daily challenges? In an effort to continue to boost resident morale and offer positive reinforcement, our residency program started a monthly “Props for Docs” program, where residents can anonymously submit an acknowledgement of something that they noticed one of their co-residents did well. This initiative has allowed us to praise our colleagues for simple things that might otherwise have gone unnoticed. Overall, we feel the program has boosted resident morale and comradery.
It might seem obvious that making a habit of building up resident colleagues increases successful collaboration and teamwork. Additionally, this environment can be contagious. Positive reinforcement of nurses, therapists, and other staff can have similar benefits, making our day-to-day lives more enjoyable. Positive reinforcement, in the form of praising and acknowledging things done well, has been clearly shown to be effective in strengthening and improving desirable behaviors (1).
Incorporating positive reinforcement into our daily, weekly, and monthly lives can help to create a work environment that encourages open communication. A simple “thank you for ___; I really appreciate that because ____” to a nurse might make it more likely that he or she performs the same behavior next time. Additionally, acknowledging that your attending physician explained a difficult topic concisely while rounding, and thanking them for taking the time to do so, might lead to more teaching on rounds in the future.
Although what is discussed above may seem like a simple exercise in common sense, I challenge you to think about how often you are offering positive reinforcement on a daily basis. When you appreciate the work of others, do you think to yourself, “well, that was very nice of them,” or do you outwardly acknowledge their gesture? It doesn’t even need to be about something they do that is “above and beyond” what is expected. We’ve all had those days where we just need a pick-me-up — for example, someone to validate that we’re doing a great job going through the 1000 page stack of records from an outside hospital transfer…
We feel that the “Props for Docs” program has substantially boosted morale in our residency program. If you have any questions about the program, feel free to contact me at aschroe1@alumni.nd.edu.
1. P. Gohari, A. Ahmadloo, M. B. Boroujeni and S. J. Hosseinipour, “The Relationship between Rewards and Employee Performance,” Interdisciplinary Journal of Contemporary Research in Business, Vol. 5, №3, 2013, pp. 543–570.
