Optimizing Self-Actualization
O'Neal Malcolm, Pharmacist, University of Maryland Medical Center
Over the years I’ve had the opportunity to precept pharmacy students
with various backgrounds, interests and motivation. I have encountered students who appeared to
excel academically, but seemed severely preoccupied with life events that
affected their learning. In fact, some
students shared with me some social, academic and home issues that left them feeling
dull and unexcited about finishing the final few months of their last Advanced
Pharmacy Practice Experience (APPE) rotation.
Those students were more inclined to focus on solving their “life” problems
rather than engaging in active learning, and some expressed extremely low interest
in pharmacy careers after graduation. To
be fair, some of the issues students shared with me would be overwhelming for
anyone who had to deal with them, and while I didn’t get a sense that they were
clinically depressed, they lacked motivation. There is a strong correlation
between motivation and academic performance among pharmacy students (Pate, Payakachat et al.
2017).
My goal as a preceptor is to ensure that students
successfully complete the rotation’s learning requirements, and are inspired to
be highly competent pharmacists in any position. I believe I was successfully able
to achieve those goals based on students’ feedback, and progress reports from
past students. For students in situations
described above, it was different because they didn’t demonstrate any learning
difficulties, but appeared more self-defeated compared to other students who
completed the rotation. Such students
seemed to be thinking of putting learning on the “back burner” a few months
before graduation. It was therefore important for me in those circumstances to
find away to not just merely provide verbal encouragement to those students during
the rotation, but to implement practical strategies within the rotation’s design
and curriculum that would shift their focus back to learning and achieving. This posed a challenge because I would have
to modify the curriculum which would take time and energy, both of which are
fleeting. None-the-less it was worth the
effort, plus the situation gave me an opportunity to re-review previous Continuing
Education (CE) information and notes on strategies for improving motivation in
students. The review of CE notes led me to the concept of Maslow's Hierarchy of
Needs.
Maslow's Hierarchy of Needs posit a five-stage model of
human needs, often portrayed as ranked levels within a pyramid. In ascending order these include: (1) physiological
(e.g. food, home, clothing and rest), (2) safety (e.g. absent parents and unsafe
neighborhood), (3) love/belonging (e.g. friendships, family relations, and extracurricular
activities), (4) esteem (e.g. confidence, achievement, and recognition), and (5)
self-actualization (desire for self-fulfillment). Lower needs should ideally be gratified
before higher-tiered needs can be attained.
The first four tiered needs are considered deprivation needs; which
means that an individual who did not achieve one or more of those needs will be
motivated towards achieving the deficient need(s) ( Burleson & Andrew, 2018).
Aside from directing students to resources and possible
programs, It is near impossible to address all deficient needs for students such
as clothing, shelter, and adequate sleep (physiological needs). It was possible, however, to address safety
needs such as providing clearly defined rotation expectations and learning
behaviors/outcomes, providing daily schedules of assignments/activities, and allowing
students to feel comfortable expressing their thoughts whether through answering
questions, asking questions, or providing feedback, without fear of ridicule. I developed opportunities to address ‘belonging’
needs such as informing students regularly that they were a valued member of
the department’s team, and that all of their efforts are appreciated (Burleson
& Andrew, 2018).
I’ve utilized a modified Maslow type
questionnaire to elicit and address students’ current basic and learning needs. Implementation of the Maslow type questionnaire
would be conducted after obtaining consent from students. Results of the
questionnaire often demonstrate that low motivated students have little to no
deficiency of stages 1-4, but seemed to be lacking self-actualization (stage 5).
While it was a relief that I wouldn’t
have to contend with any deficiency needs for stages 1-4, and focus more on their
growth needs (self-actualization), I wondered how I would practically optimize
self-actualization over 5 weeks.
Self-actualization according to Maslow is a desire for
growth and fulfillment of ones potential
or meaning in life. Maslow suggested that
few individuals would fully attain self-actualization since it is impacted by
deficiency needs (stage 1-4) (Selva, 2018). Finding practical examples of
self-actualization was challenging since most studies reviewed discussed
self-actualization as a theoretical concept versus stages 1-4 where practical examples
could be found. A few studies and online
resources highlighted techniques that were integrated into the curriculum (Janowiak and Hackman 1994,
Jackson, Santoro et al. 2014). These include: (1) using "real"
life scenarios to make learning meaningful, (2) utilizing metacognitive
activities in lesson plan, (3) assigning students to self-expressive projects,
and (4) allowing students to be involved in creative activities and projects (SUNY Cortland,1994). Specifically, students discussed and reviewed
with me weekly cases of patient and provider encounters; and for the
metacognitive activity students engaged in weekly self-reflection of rotation
activities focused on goals achieved, skills learned/acquired, strategies used
to solve problem(s), and self-assessment/evaluation of progress towards
completing requirements for the rotation. Creative activities involved students
creating color coded medication reminders to improve medication adherence; and
others collaborated on a “high-risk re-admitted patients” project with an
interdisciplinary team consisting of a physician, nurse, social worker,
community health worker, and pharmacist.
Weekly self-reflection sessions with students demonstrated improvement
in motivation and desire to learn and achieve.
Students involved in performance improvement exercises expressed favorable
satisfaction, and those involved in collaborative project felt a sense of
satisfaction by being a member of a valued team. All students believed that the learning
activities focused on self-actualization kept them busy and productive, and
less focused on their problems.
Preceptors can contribute to identifying students’ need(s)
to improve ability to learn and achieve.
This does, however, require time and effort to get to know the students’
need(s) by (if applicable) using motivational and theoretical constructs such
as Maslow’s Hierarchy. Maslow's Hierarchy
of Needs allowed me to use a systematic approach and framework for addressing
barriers to learning. The more a preceptor
understands the learning needs of his/her students, the higher the probability of
minimizing learning obstacles and optimizing learning.
Application of Maslow’s Hierarchy of Needs has resulted in
struggling students successfully completing the rotation. Previous students
have shared updates such as pursuing PGY1 and/or PGY2 pharmacy residency
programs; or working in leadership positions.
References
Burleson, S., & Andrew, C. (2018). Maslow’s
Hierarchy of Needs and Its Relation to Learning and Achievement. Retrieved from
https://edis.ifas.ufl.edu/pdffiles/WC/WC15900.pdf
Jackson, J. et al. (2014). Improving
Patient Care Through the Prism of Psychology: application of Maslow’s Hierarchy
to Sedation, Delirium and Early Mobility in the ICU. Journal of critical care, 29(3), 438-444.
Janowiak, J. J., & Hackman, R.
(1994). Meditation and college students' self-actualization and rated stress. Psychol Rep, 75(2), 1007-1010.
Pate, A. et al. (2017). Measurement of
Grit and Correlation to Student Pharmacist Academic Performance. American
Journal of Pharmaceutical Education 81(6): 105.
Selva,
J. (2018). What is Self-Actualization: A definition
plus examples. Retrieved, from https://positivepsychologyprogram.com/self-actualization/
SUNY
Cortland. (1994). Suggestions for application of Maslow's
theory to education, Retrieved from http://web.cortland.edu/andersmd/MASLOW/SUGGEST.HTML
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