(2015 marks the introduction of a new book review editor at the ICE blog. Please welcome Rob Cooney who is an influential medical educator on the ‘internets.’ Check out his blog FlippedEM.com for more details about some of his projects. Many thanks to Felix Ankel (@felixankel) for starting the book review series. Felix will be starting a new series on educational leadership this year. –Jonathan (@sherbino))

———————————————————————————————————————————–By Rob Cooney (@EMEducation)

Getting off of the elevator for the first time at the Institute for Healthcare Improvement , I was struck by their mission statement, posted on the wall for all to see:



What I found the most interesting was the third goal, the “joy of the healthcare workforce.” I found this to be a noble, but almost overwhelmingly difficult, goal to even understand, let alone change. At times, it seems that many factors are conspiring to make our work as physicians less joyful.

It wasn’t until a week and a half later that I was able to meet Ken Tebbetts, the Vice President of Human Resources at the IHI. Ken is a man with his finger on the pulse of what influences joy at work. He’s even trying to measure it objectively at the IHI (see photo below). In discussing their mission to improve joy in healthcare workers, he recommended the book The Progress Principle: Using Small Wins to Ignite Joy, Engagement, and Creativity at Work by Teresa Amabile and Steven Kramer as an introduction to factors that influence joy at work. The book covers several in-depth studies performed by the authors, including a massive qualitative analysis of “inner work life” that included 238 people in seven companies, spanning three industries.

The authors found that inner work life has a profound effect on a worker’s performance, especially on creativity, productivity, commitment, and collegiality. The progress principle posits that joy is the outcome when people are able to experience events in their jobs that demonstrate “progress,” including small wins, breakthroughs, forward movement, and goal completions. This principle was the most power influencer of a healthy inner work life.

The authors unpack the progress principle, providing quotes from their research and factors that support and detract from making progress on meaningful work.

Positive Factors:

Catalysts include events that support the work:

-Setting clear goals

-Allowing autonomy

-Providing resources

-Providing sufficient time

-Helping with the work

-Learning from problems and successes

-Allowing ideas to flow

Nourishers include events that support the individual:

-Respect

-Encouragement

-Emotional Support

-Affiliation

Negative Factors:

-Having one’s work or ideas dismissed

-Losing a sense of ownership

-Doubting that the work being done will see the light of day

-Changing priorities or expectations

-Feeling overqualified for many of the specific tasks that they are being asked to do

Inhibitors include events that negate the work, such as:

-Lack of clear goals

-Not making resources available

-Lack of help

-Constrained autonomy

-Blocking flow of ideas

-Significant time pressure

-Active hindrance

-Failure to learn from problems

Toxins include events that negate the individual, such as:

-Disrespect

-Apathy

-Absence of real affiliation

-Antagonism

-Discouragement

-Distrust

-Conflict

-Unclear roles

-Dismissive, discourteous, patronizing

The book is well written and I found myself reflecting on my own experiences as I read through it. The book concludes with a chapter about “Tending Your Own Inner Work Life.” For 3 months I’ve kept a journal based on their questions and can easily attribute the principles examined in the book to both good and bad days at work. I highly recommend this book to educators with leadership responsibilities as well as educators who have an interest in the psychology of motivation.

Featured image via Pexels