Dr. Julie Haizlip’s article “Perspective: The Negativity Bias, Medical Education, and the Culture of Academic Medicine: Why Culture Change is Hard,” published in Academic Medicine, was recently recognized by the ABIM Foundation as one of three top articles in medical professionalism. The prize was established to recognize outstanding articles in medical professionalism, a frequently overlooked category of medical literature but one essential to improving health care.
Dr. Haizlip’s article is about negativity bias – the tendency for people to remember negative experiences more strongly than positive ones – and the ways it is reinforced in the medical community. The committee, which reviewed more than 100 articles, praised Dr. Haizlip’s article as “a rare piece that provides a new framework and a new language for understanding a problem that has long been recognized.”
Dr. Haizlip’s interest in her subject matter originated several years ago when she went on a retreat focused on what faculty members found valuable in medical education. “It was well timed,” says Dr. Haizlip, “because, despite being a relatively young faculty member, I was very disillusioned with medicine.” At the retreat she heard many inspiring stories, and she left feeling re-energized and hopeful.
In the years that followed, Dr. Haizlip began working with a group that ultimately became the UVA Center for Appreciative Practice. She had the opportunity to work with a broad cross-section of health system members. She realized that when people were asked open-ended questions about the work, answers were almost pervasively negative. However, when the questions were specifically composed to generate positive answers, amazing stories of teamwork, passion, and innovation suddenly appeared. This made Dr. Haizlip wonder: Why is our natural tendency to always focus on what’s wrong?
The question took her to psychology literature, where she discovered negativity bias, a functional and protective phenomenon in some cases – after all, being aware of and prepared for threats can help to ensure your safety. To Dr. Haizlip, the negativity bias felt very familiar – she and other doctors had been educated to think this way in medical school. When students are trained in clinical reasoning, they are taught to always consider and rule-out the worstcase scenario first. Dr. Haizlip wondered if one reason health care systems are frequently described in negative terms is because medical professionals are highly trained to focus on what’s wrong.
Culture change is difficult because negativity bias has been inadvertently reinforced by years of medical training. But change is important – doctors and trainees have been known to become depressed and experience burnout. It’s possible that recognizing and confronting the negativity bias can reduce the incidence of such experiences.
“Now,” says Dr. Haizlip, “I’m interested in trying to find ways to bring attention to the many things that go well in our system, to help members of the community notice the dedication, innovation, and compassion that is all around us.”
“Perspective: The Negativity Bias, Medical Education, and the Culture of Academic Medicine: Why Culture Change is Hard,” by Julie Haizlip, MD, Natalie May, PhD, John Schorling, MD, Anne Williams, MA, and Margaret Plews-Ogan, MD, MS. Academic Medicine. http://www.ncbi.nlm.nih.gov/pubmed/22836850
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