Perspective

Abstract

Despite ongoing efforts to improve working conditions, address well-being of faculty and students, and promote professionalism, many still feel the culture of academic medicine is problematic. Depression and burnout persist among physicians and trainees. The authors propose that culture change is so challenging in part because of an evolutionary construct known as the negativity bias that is reinforced serially in medical education. The negativity bias drives people to attend to and be more greatly affected by the negative aspects of experience. Some common teaching methods such as simulations, pimping, and instruction in clinical reasoning inadvertently reinforce the negativity bias and thereby enhance physicians' focus on the negative. Here, the authors examine the concept of negativity bias in the context of academic medicine, arguing that culture is affected by serially emphasizing the inherent bias to recognize and remember the negative. They explore the potential role of practices rooted in positive psychology as powerful tools to counteract the negativity bias and aid in achieving desired culture change.

Common Evaluations of Disease Activity in Rheumatoid Arthritis Reach Discordant Classifications across Different Populations

“…For the CDAI and SDAI, PGA was the most influential measure across all disease activity states, except for high disease activity. This could be due to the subjective nature of the PGA, as patients’ assessments of disease activity may vary depending on their individual characteristics, such as personality, sociodemographic factors, or culture ( 7 , 17 – 20 ). Taken together, our results suggest that, by weighting the individual components of the assessment differently, the DAS28-ESR and the CDAI/SDAI may result in different classifications of RA disease activity.…”

Medical student wellbeing – a consensus statement from Australia and New Zealand

“…Medical schools should have clear processes for how students can report incidents throughout their education and training and how such incidents will be handled, including consequences for inappropriate behaviours in themselves and others. Attention to behaviours that inadvertently reinforce human tendencies to focus on negative aspects, or “negativity bias” [74], and adoption of practices from positive psychology [75] may be helpful.…”

Broadening conceptions of medical student mistreatment during clinical teaching: message from a study of “toxic” phenomenon during bedside teaching

“…Explanations for medical student mistreatment in the clinical settings have included: the supposedly low position of medical students in a large hierarchical culture of medical training and practice 24 , 25 challenges associated with the use of patients’ bedside for workplace learning; 26 the culture of negativity bias in medical education and its influence on feedback mechanism; 27 and clinical teachers’ beliefs about teaching and learning. 28 Other scholars have argued that the lack or limited formal training in teaching skills of a majority of medical educators constitute the most important reason for student mistreatment.…”