Tag Archives: Motivation

Measuring for improvement

One of the things I have to do as a leader is to guide my group to reach its goals. This, of course, requires setting measurable goals. Then we have to monitor our progress based on data that somehow describe the goals we set up. If we do not measure our achievements, we will not know if we have succeeded. If the goals we are to reach are not described in ways that are in accordance with actions we can take to reach them, we might as well save ourselves the trouble of setting goals in the first place.

In the swimming hall in Uppsala where I like to go to do my laps, there are three lanes: Extra fast, Fast, and Exercise swimming. In Melbourne, there were also three lanes: Fast, Medium, and Slow. There was also a sign saying that if someone taps your toe while swimming you should move to a slower lane.

If my goal is to be faster at swimming what should I do? “Exercise” will get me there, right? But if no one taps my toe if I am too slow, how will I know I should be moving faster? If my goal is simply to exercise – is the Exercise lane the right one for me? Well, no, because the ones who swim there are extremely SLOW and I do crawling.

ImagePhoto: Fanni Sarkadi, Melbourne, Australia

The issue of measuring is of course not an easy one. In science we use things, such as impact factors and rankings. Such technical measures of success are criticized for creating a business management paradigm in research and are argued to not necessarily enhance quality. However, I guess the fact that there is a journal called Scientometrics (a Hungarian co-publication) shows that bibliometry is here to stay.

It is also hard to measure quality in health care. Physicians are particularly weary of letting the essence of their profession be forced into dry numbers. Nevertheless – if your loved ones had cancer, would you rather have them treated at a centre with 0,5% complications and 85% 5-year survival rates or somewhere with worse or not even measured outcomes?

Schools are a third sector where measurement is a subject of perpetual debate. Should we or should we not give grades, from which age, based on what criteria?

When Johanna saw her grades in year 5 in Australia she said she wanted better ones. At our meeting to develop Johanna’s study plan for this year in Sweden I asked the teacher if she could help Johanna by giving her an indication of what grade her performance on tests would give her. “We don’t do grades in year 5”, she said. I know that, I said indication, you know, make-belief type of thing. Nope. And my daughter, obviously in need of some kind of measure and/or external motivator simply said: “Ok, I will study in sixth grade, not now”. That really made my day.

Don’t misunderstand me: I truly believe that intrinsic motivation (fun animation of Pink’s book in the link) is the best motivator and that as a research group leader my task is to find, not kill people’s drive to do good work. But even people who are truly intrinsically motivated need a certain measure of goal fulfilment. They want to know they are doing their job well. They want to be reaching goals. They want to know they have contributed!

I have heard so many frustrated colleagues who work hard and never know whether or not they are doing a good job. They become bitter and negative and lose their motivation, not because someone is trying to control them, but because nobody cares to value their work!

So I think the discussion every sector and workplace should be having is not whether we should be measuring our goals, but rather how this should be done best to tell us (and our clients and financers) if we are doing a good job.

How I suddenly became motivated to start my e-learning session on workplace bullying

As a researcher I have deadlines for almost everything I do. Deadlines are my worst enemies and best friends: I hate them because they stress me out and I cherish them because they help me prioritize and structure my work. Even if they are a pain at times, the truth is that without deadlines things just wouldn’t get done. So when I looked through my introductory package of e-learning at my host institution MCRI, the special part of my brain that registers deadlines zoomed in on the sessions that were due, which I completed, and stored the fact that there were more things there, among them one on bullying, with a deadline two months ahead. They didn’t look extremely exciting so I simply postponed their completion until the deadline was going to approach.

Now someone at the HR department might ask themselves: Why can’t people just do as they are told and complete the e-learning tasks as soon as they start their employment? When we are asking people to behave in one way or another, whether they are patients, clients, or employees, we are into the territory of motivation and behavioural change. A few things in life are so intrinsically motivating that people will do them anyway. Such things are eating, having sex, and seeking flow through whatever way is accessible to a person. Some people do sports to achieve flow, others play or experiment, some build, some cook, and some find their flow in art or music. All other things in life we need motivation to do.


The health belief model (HBM) and the transtheoretical model are two helpful tools to understand why people choose to behave the way they do. Given they actually have choices, that is. Both models have been developed in the framework of prevention and health promotion. The HBM says that the perceived barriers to action have to be smaller that the perceived benefits of that action. In addition, the person has to feel susceptible to the outcome we are trying to prevent, needs to believe in his or her own capability to make that change (self-efficacy), and needs a signal for action.

The transtheoretical model was developed by Proschaska and describes the steps involved when a person changes their behaviour. In the Precontemplation phase people are unaware of the need to change and need information. Contemplators are aware of the need to change, but typically perceive barriers to change as significant and gains as too little. People in the Preparation phase are ready to start taking action and here self-efficacy and available support becomes paramount. People in the Action phase have changed their behavior recently and need to work hard to keep moving ahead. In this phase, positive reinforcement and rewards are likely to help the person to keep on the right track. 
People in the Maintenance phase have fully adopted a new behaviour, but need to be aware of the risks of ”sliding back” in the face of e.g. stress.

My signal for action was the workshop I attended at the Grand Rounds, held every week at the Royal Children’s Hospital. It was called the “Mock Court” and was a very well prepared improvisation theatre type of performance. It was held by a couple of lawyers who had started a company to educate people about the implications or labour law in the court system. In no time, we in the audience were in a courtroom where hearings had commenced for allegations of workplace bullying. The “witnesses” were actual employees at RCH, making the experience all the more real. When the cross-examination started I felt the chills down my back.

Two more witnesses came in and were equally diced during the cross-examination and I really wasn’t sure who would win the case. All the while, a slide in the background showed the legal definition of bullying. It was easy enough to understand what the employee’s lawyer was doing when he asked the employer’s representative if the consultant’s alleged bullying behaviour was repeated and inadequate. The defence lawyer, in turn, banged her points into our heads: “You had many options open to you, sir, when your manager wasn’t forthcoming with the support you wanted in this situation”. And she spat out the options with despise, again and again. I think everyone got the point.

This signal threw me into the Preparation phase so I logged onto my e-learning hub to have a look. I set a deadline and on Monday it’s time for Action. I believe now it’s important for me to learn about workplace bullying, I feel susceptible to the consequences of being ignorant to the procedures, and I feel I can overcome my resistance to put in the time needed to complete the online training. And a deadline is a deadline!