College Connection Fall 2016 - Page 2

college connection PROFESSIONALISM FIVE FUNDAMENTALS OF CIVILITY: BE AWARE The Spring issue of College Connection provided an introduction to “The Five Fundamentals of Civility for Physicians,” a series of articles that examines the impact of incivility to a profession and strategies to foster civil behaviour. This article, written by Dr. Michael Kaufmann, focuses on the importance of demonstrating respect for others and oneself. And it didn’t help that you and your spouse don’t agree on how that problem should be managed. Further, sleeping in, you left home in a hurry, skipping breakfast. Under all of these stresses, even you weren’t aware of how these things were affecting you. Neither were you aware of the impact of your behaviour upon the technician. You immediately regret the manner and tone you used. But it was too late — primed and challenged, you “shot the first thing that moved,” an act of incivility that might have been avoided. Mindlessness Imagine you just arrived at the clinic to conduct rounds. It’s a busy morning and you’re reviewing the status of several patients when a technician approaches saying: “Good morning. Mr. Smith’s dog has had a bad night and Mr. Smith has some questions for you. You should call him right away.” Irritated and frustrated, you turn to the technician and snap: “How do you expect me to talk to Mr. Smith when I don’t even know the case?” The technician leaves in a huff of indignation. The technician probably doesn’t know this behaviour is uncharacteristic of you. She has no way of knowing that you had trouble sleeping due to a recurrence of back pain, along with your ongoing concerns about how your teenage son is struggling in school. 2 / College Connection Reflection and self-awareness practices help veterinarians examine many aspects of themselves that contribute to their thoughts, moods and actions. Without this awareness, we can be said to be functioning “mindlessly”. That’s fine when considering mechanical skills, such as driving a car, considering how often this action has been successfully performed in the past, resulting in the desired level of unconscious competence. But mindless interactions with colleagues and co-workers can sometimes lead to uncivil behaviour, chosen indiscriminately. In fact, mindlessness accounts for many deviations from professionalism, which seem to occur more often when veterinarians find themselves in pressured, emotionally charged situations There is plenty that requires attention in order to be truly self-aware: your physical state, emotional state, temperament and personality style, communication style, attitudes and cognitive distortions, assumptions, biases, knowledge gaps, personal values, and so much more. Everything we experience is perceived through these filters shaping our thoughts, reactions and deeds. Mindlessness can catch us up into negative emotional, cognitive and behavioural patterns without our being able to intervene. Mindlessness also prompts shifting of blame and avoidance of personal responsibility. In short, if we are not mindful, or sufficiently selfaware, and just allow our attention and actions to be engaged in these negative loops, choosing civil behaviour would be difficult; we might even do harm to ourselves and others. Mindful Self-Awareness Hence we see the connection of mindful self-awareness to civility. Gilbert describes this form of awareness as accepting, nonstriving, contented well-being. He says that mindfulness practice puts people into the “being mode” rather than the “doing mode.” Self-awareness is the moment-tomoment, non-judgmental recognition of what’s happening within us. The goals of mindful self-awareness include enhanced expression of core values, such as empathy and compassion, the courage and ability to see the world more as it is rather than as one would have it be, and the humility to recognize, tolerate and embrace one’s “blind spots” — areas of weakness — while leveraging our strengths. Cultural Awareness If the simple definition of culture is “the way things are done around here,” then we need to pay attention to that as well. Our behavioural choices are influenced broadly by external norms and expectations just as they are by our internal status and the behaviours of others. Civility is easier to choose if one is aware of the cultural influences, positive and negative, all around us. Kindness is good, meanness is not. Teaching by asking tough questions is fine, shaming is not. Humour is fun, sexist jokes are not. Ultimately, one by one, we are able to make civil choices. Barriers to Awareness Barriers to self-awareness are numerous in veterinary training and practice. Fatigue, dogmatism, emphasis upon an overly continued on page 3