Got Motivation? Insights into motivational design

After 4 weeks at mdBriefCase I feel I have come full circle, from novice writer to... slightly better than novice writer. So I haven't quite mastered medical writing after 4 short weeks, but I have experienced the whole spectrum of skills necessary for writing a CE piece; from topic selection and research to first drafts, second drafts and more drafts! For me, the biggest challenge was choosing the right topic to write about; I continually asked myself "Will this interest and keep my potential readers engaged?" 

This question speaks to the concept of motivation, the driving force which individuals achieve their personal and professional goals.1,2

Motivation is a key factor for engaging and maintaining a learning audience. It must be addressed when creating education, and specifically when creating online education, you have to be more innovative when attempting to engage your readers. The learner is, for the most part, in charge of what gets learned. Tuning into what motivates and brings the learner to your course, will aid in maintaining their interest and continued participation.1,2 

Three components of motivation1,2:

1. Activation - the decision to initiate behaviour
2. Persistence - continued effort towards a goal, despite obstacles
3. Intensity - level of concentration and vigour that goes into achieving the goal

Flow theory1,2

Theory developed by Mihaly Csikszentmihaly, describes "flow" as a state of complete concentration, where the person is fully immersed in what they are doing; exactly what you want for your learners. To achieve this state of flow, there must be balance between the challenge of the task and the skill of the performer. When the task is too easy or too hard, flow cannot occur. This is a dynamic process, as the learner masters more skills, the challenges need to become more difficult to keep motivation high. 

Flow theory can improve motivation when creating online education, ensure you: 

• State clear objectives - clear and focused goals at the beginning allows readers to become focused enough to reach flow state
• Address appropriate skill levels - clearly state upfront the prerequisite knowledge and ensure course matches this skill level and challenges the learner throughout
• Reduce distractions - distractions can interrupt flow, eliminate any unnecessary information, excessive images and clutter to keep the focus on the content

Path-Goal Theory1,2

Robert House created this theory and stated that the learner's performance and motivation is directly influenced by the behaviour of the instructor or leader. It is characterized by 4 types of leadership styles that help to motivate learners. This theory can be applied to the creation of online education by incorporating these leadership concepts into its design.

• Achievement-oriented - create goals and questions that challenge the learner to encourage excellence and confidence
• Directive - create clear, specific expectations for the course
• Supportive - create a course that is user-friendly and approachable, and supports learners
• Participative - encourage participation through course evaluations, polling questions and interaction with other learners, where possible

Self-determination Theory1,2

This theory created by Edward Deci and Richard Ryan speaks about intrinsic motivation. The drive within the learner that is connected to the idea that learning is beneficial and meaningful. In terms of e-learning and continuing education, it can be difficult for learners to develop intrinsic motivation because it can sometimes feel like a job requirement or chore. To help mitigate this, developers need to tap into the learner's internal motivation by maximizing their autonomy, competence and relatedness; the core features of self-determination theory:

• Autonomy - providing the learner with a sense of control over the content. For example, allowing them to choose the order of the content flow or choose the patient case
• Competence - give learners opportunities to develop their competence throughout the course, such as quiz questions, encouraging decision-making with consequences and creating opportunities to complete challenging tasks
• Relatedness - creating a realm for learner interaction with other learners or with the content through discussion forums, quiz questions, etc.

"There are three things to remember about education. The first is motivation. The second one is motivation. The third one is motivation." Terrel Bell

The core principles in each of these theories relate to one another closely. By incorporating these ideas into the development of your online education, participant motivation and engagement will increase. As I begin to move away from the student mentality and into a blossoming pharmacist, I think these motivation principles will help to improve my patient counselling outcomes and encourage lasting behaviour change (e.g. smoking cessation).

As I approach my final days at mdBriefCase and as pharmacy student, I'd like to thank the team for welcoming me and allowing me to be a part of this organization. It has been exciting, eye-opening and fun! This is the beginning of a long-lasting relationship between rxBriefCase and me.

References

1. Gutierrez K. Designing for Motivation: Three Theories eLearning designers can use. Shift: Disruptive eLearning [Internet]. Accessed March 26, 2015. Available from: http://info.shiftelearning.com/blog/bid/340354/Designing-for-Motivation-Three-Theories-eLearning-Designers-Can-Use 

2. Summaries of Learning Theories and Models. [Internet]. Accessed March 26, 2015. Available from: http://www.learning-theories.com/

Preventing Burnout Among Pharmacists

Pharmacist Awareness Month 2015, also known as PAM, is upon us! Every March brings pharmacists into the public eye with a wonderful campaign celebrating them for what they are: trusted and knowledgeable healthcare professionals. Without campaigns like this, you’d be hard pressed to see the profession move forward the way it has. Expanded scope would remain at a standstill and the “pill pusher” stereotype would remain ever present. It’s vitally important for the public to realize the value pharmacists have and PAM  is a great way to showcase our abilities. 

Pharmacists are known to be ambassadors of health, but this got me thinking; pharmacists do a fantastic job promoting health to their patients and public, but are they “practicing what they preach”? In other words, are pharmacists remembering their own health?

This brings up an issue often forgotten and under-addressed. Although you see it almost all professions, the highest prevalence is in the world of healthcare; burnout. The fact is that the world of pharmacy is fertile ground for burnout, which impacts physical, emotional and psychological health of pharmacists, not to mention professional viability1,3.

What is burnout?

Burnout is a state of exhaustion; it encompasses mental, emotional and physical health often relating to the workplace.  It’s a slow brewing, multidimensional syndrome made up of three core domains. It is commonly caused by excessive and prolonged stress, inability to meet constant demands and disparity between expectations and reality. Multiple individual and environmental factors have an effect on an individual's risk and ability to cope with burnout.

3 domains of burnout1:

• Cynicism - negative job and workplace attitude (can lead to depersonalization)
• A distinguishing characteristic of burnout
• Exhaustion - feeling physically and emotionally depleted 
• Ineffectiveness - devaluing one's own accomplishments

It’s also important to understand that stress and burnout are different. They have common features but ultimately differ in that stress, involves too much whereas burnout is often about not enough2. The following table helps to differentiate these two concepts:

Stress	Burnout
Over-engagement  Emotions are over-reactive  Urgency and hyperactivity  Loss of energy  Anxiety  Primary damage is physical	Disengagement  Emotions are blunted  Helplessness & hopelessness  Loss of motivation  Detachment and depression  Primary damage is emotional

What does burnout look like?

Burnout is an indolent process that happens over an extended period of time. Recognizing the signs early can help prevent complete collapse.

       Signs of burnout include1,2:

• always feeling tired and exhausted
• frequent back pain, headaches, muscle pain
• feeling trapped
• detachment, helplessness, self-doubt
• loss of motivation, extreme boredom
• isolating yourself from others, withdrawal

5 tips for preventing burnout1,2: 

1. Eat healthy, exercise and sleep well

It is well documented that healthy living builds energy and resilience to life’s daily demands. As pharmacists we know this and preach it, though not easy, it’s time to adopt the advice we so readily deliver.

2. Set boundaries

Learn how to say “no”. You can't do it all and overextending yourself will set you up for failure. Saying “no" means you can say “yes” to things you truly want to do, which will keep you engaged and happy in your profession.

3. Take a daily break from technology

Separate yourself from email, voice mail and phone calls to free your mind of stress and worry. Disconnect and take time for yourself.

4. Nourish your creative side

Try something new, start a fun project or hobby. Choose things that you love and have nothing to do with work.

5. Effectively manage stress
Stress is heavily implicated in burnout, thus effectively managing stress will significantly reduce your chances of burnout. Stress management comes in many forms, check out this resource for strategies.

It's been shown that young professionals in their first 5 years of practice are particularly at risk for burnout1. New grads may refrain from discussing issues with managers, confuse feeling overwhelmed with personal inadequacy and attempt to prove themselves by taking on too much, all factors leading to burnout. As new grads, we have to be on the look-out for signs of burnout and use things like PAM, continuing education to remind us of our value and keep us engaged in order to remain healthy and impactful clinicians.

References:
1. Zanni, GR. Roundup: Burnout: When everyday irritations ruin your career. [Accessed March 12, 2015]  http://www.pharmacytimes.com/publications/issue/2008/2008-03/2008-03-8436
2. Smith M, Jaffe-Gill E, Segal R. Burnout: signs, symptoms, and prevention. [Accessed March 12, 2015]  http://www.helpguide.org/articles/stress/preventing-burnout.htm
3. Mott DA, Doucette WR, Gaither CA, Pederson CA, Schommer JC. Pharmacists' attitudes toward worklife: Results from a national survey of pharmacists. J Am Pharm Assoc. 2004;44(3):326-36.

Another link in the pharmacy student chain

Hello!

My name is Claudia and I'm the next 4^th year to continue the chain of pharmacy students here at mdBriefCase Group Inc.

This is my last APPE rotation and the setting is completely new to me. Not really knowing what to expect, I arrived excited with a slight edge of anxious nerves. I'm fresh off 2 intense direct-patient-care hospital rotations, so this is a drastic (and welcome!) change. As pharmacy students, we are very accustomed to direct patient care and may forget that the pharmacy profession incorporates a broad scope of opportunities outside direct contact with patients. I am interested and eager to see how I can impact patient care with contributions to continuing education.

Shortly after arriving, I was introduced to the team, the company and handed a thorough outline of what my next 5 weeks will look like. Very exciting! For my first task, I will participate in one of the online rxBriefCase programs which I will then critically appraise. The team then works on developing ways in which it, and future programs, could be improved.

Other projects involve multiple venues for content development with contributions to rxPassport and medSchool For You, with ongoing support from pharmacy mentor Mike.

Writing has never been a strong suit for me, so I approach these challenges with trepidation. However, new experiences and challenges can only improve my abilities and skill set, so I am excited to take these on. 

Reading previous blog posts by my classmates has been entertaining, educational and fun so I hope to continue this with posts during my time here.

Stay tuned!