October 11, 2014

You Can Get All A’s and Still Flunk Life

by Christine Puschak, PharmD, PGY2 Cardiology Pharmacy Practice Resident, University of Maryland School of Pharmacy
        
Take a moment to think about what is required to lead a “successful” life. Is it knowledge, luck, hard work? How about self-awareness and relationships?1  Success in life often requires all these.  It is our job, as educators, to help students achieve success: in the classroom, in the program, and in their lives. Many of us focus on teaching content-specific material to increase students’ factual knowledge and problem solving skills. However, have you ever thought about increasing students’ self-awareness and relationship management skills?




Emotional Intelligence1,2

Daniel Goleman describes emotional intelligence (EI) as a flexible, intangible concept.2 EI is comprised of four major cornerstones: self-awareness, self-management, social awareness, and relationship management (see Table 1). The four cornerstones allow us to work through a situation by evaluating ourselves and effectively interacting with those around us. These skills focus on recognition and regulation of emotions. EI helps build stronger relationships and success at work by empowering others and leading change. It is a skill required by health care workers as they need to effectively communicate with patients and create a plan that meets a patient’s goals. Healthcare providers must be attuned to the emotions and motivations of their patients and co-workers as they address complex issues. Empathy helps providers understand their patients in a way that improves decision-making.

TABLE 1 – The Cornerstones of Emotional Intelligence


Self
Social
Recognition
Self-Awareness
·  Emotional self-awareness
·  Accurate self-assessment
·  Self-confidence
Social-Awareness
·  Empathy
·  Organizational awareness
·  Service orientation
Regulation
Self-Management
·  Self-control
·  Transparency
·  Adaptability
·  Achievement drive
·  Initiative
Relationship Management
·  Inspirational leadership
·  Developing others
·  Influence
·  Change catalyst
·  Conflict management
·  Building bonds
·  Teamwork & collaboration

Most of us acquire these skills through experience and practice, but how do we teach learners to be emotionally intelligent?  Can it even be taught?

Measurement1

Before we can teach EI, we have to determine if there is a way to measure these skills. Drs. Bradberry and Greaves developed the EI Appraisal questionnaire  — a survey to quickly and accurately assess one’s emotional intelligence quotient (EQ).1 This assessment tool is based on the four major cornerstones of EI. It has shown strong reliability through validation studies. In addition to this test, there are currently nine other assessment tools to determine a person’s EQ, all varying in complexity and utility. The details of each assessment can be found at http://www.eiconsortium.org.

Can I Improve my EQ?1

While our intelligence quotient (IQ) is considered to be rigid and remains relatively unchanged throughout life, EQ often increases with age and experience. Improving your EQ is something that you work on regularly. A change can often be seen within a few months with a measurable difference in EQ score often occurring in three to six months. The key to successful developing your EQ is to start small and work on it incrementally. A person should choose one of the four cornerstones and work to improve that area before moving to another. It is beneficial to first identify which cornerstone requires the most development. The EI surveys and assessments can help one identifying these areas. To increase EQ, it requires self-management and a specific action plans. Ultimately, the responsibility is the learner’s.  Personal growth requires a conscious effort and constant practice.

How Do I Teach EI?

To help learners improve their EQ, a teacher must be aware and cognizant of the skills required for emotional intelligence. If teachers are not aware of or do not understand EI, they can not effectively nurture the development of EI skills in their learners. EI can be built through self-reflection and relationships with others. Thus, teachers must first build their own EQ! Once mastered, there are numerous ways of incorporating the skills into your instruction. Activities to raise awareness of the cornerstones of EI are available in print and electronic media.4

EI skill development exercises increase EQ scores.  In one study, third year medical students were assigned to a seven month EI training program which included individual reflections and group activities.5  A second group of medical students who participate in the study did NOT participate in the EI training program.  The group assigned to the EI program had a substantial increase in mean EQ over time while the comparator group actually had a slight decrease. Although an increase in EQ was observed, the benefits remain unclear. The study reported only changes in the EQ score, which is merely a surrogate marker, and did not follow-up with participant over time.   It would useful to know if the EI program participants did better during their 4th year practice experiences, more likely to match with the first preference for residency training, and if their patients and co-workers believed their were more competent (when compared to those who did not complete the EI program). Clearly we need more data to document the impact of EI training on outcomes.

Theoretically, all health professions, including pharmacists, would benefit from EI skill development and a higher EQ.  Health professional interact with patients and these interactions require trust and effective communication.  I believe that EI skills are best taught through communication-type labs. By making the students aware of their EQ score prior to lab, learners can improve their EI skills by developing self-awareness and working through various patient case scenarios and healthcare situations. Reflective exercises related to uncomfortable interactions — such as an angry patient or a competitive classmate  — may also help learners develop their EQ.  These exercises are intended to help them to acknowledge their thoughts, control their emotions, and think about others. These exercises may help to decrease school-related stress as they learn to assess and adjust their emotions.  EI exercise can also help learners work more effectively with others in the classroom and beyond.

EI is not a skill that can be developed overnight. With the encouragement of emotionally intelligent teachers, students can hone their skills and improve their own EQ, which may enhance their chances of success, both personally and professionally.

References:
  1. Bradberry T and Greaves J. The emotional intelligencequick book: everything you need to know to put your EQ to work. New York: Fireside; 2005.
  2. Goleman D. Emotional intelligence: why it can matter morethan IQ. New York: Bantam Books; 1997.
  3. Daniel Goleman’s five components of emotional intelligence [Internet]. 2009 Feb 9. [cited 2014 Sept 22].
  4. Lynn AB. The emotional intelligence activity book: 50activities for promoting EQ at work. New York: Amacom; 2002.
  5. Fletcher I, Leadbetter P, Curran, et al. A pilot study assessing emotional intelligence training and communication skills with third year medical students. Patient Education and Counseling. 2009;76:376-9.

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