Leadership Advisory Board (LAB) Professional Meaning by Elizabeth A. Duggan, MD Man's main concern is not to gain pleasure or avoid pain, but rather to see a meaning in his life.1 Psychologists, sociologists, and behavioral economists have contemplated the concept of "meaningful work" for more than a half-century. William Osler touched on its nature, reflecting on the work of a physician as "a calling, one in which your heart will be exercised equally as your head."2 Organizational literature argues that meaning is tied to one's sense of purpose, a method of self-expression whereby we derive personal significance by connecting with our values, our potential and our community.3-5 Work meaning continues to draw attention, particularly as medicine explores the consequences of two simultaneous healthcare crises: COVID-19 and physician burnout.6 Today, the Institute for Healthcare Improvement (IHI) outlines meaning and purpose as one of the fundamental strategies required of healthcare leadership.7 The American Medical Society’s Wellness-Centered Leadership Playbook highlights “meaning in medicine.”8 Healthcare is not alone in stressing the importance of occupational meaning; Harvard Business Review and Sloan MIT Management Review feature recent articles asserting “work meaning may be more important to employees than any other aspect of our job.”9, 10 Why does the concept of meaningful work capture the interest of healthcare leaders, wellness authors, and business executives? Relevant social and psychological research demonstrates that meaning positively influences our sense of intrinsic motivation, engagement, personal fulfillment, and empowerment.5,11-14 At the organizational level, workplace meaning is linked to positive employee outcomes including performance, creativity and commitment.5 To which end, we find ourselves asking the same questions asked by workplace scholars: What are the sources of work meaning? And, perhaps more importantly, when does work becomes meaningful? Meaning is construed both individually based on values, perceptions and experiences, and socially, derived from norms and shared belief-systems.15 Meaningful work does not reflect a continuous psychological state but instead an episodic experience.16 Workplace science proposes that certain encounters allow us to integrate our efforts with self-worth; the worker conducts actions that align with their values and fulfill esteem needs, while additionally achieving a positive emotional response linked to one’s sense of significance (inspiration, pride, self-transcendence).17 Meaningful experiences in this way, are individualized based on a complex affective and cognitive evaluation of existential goals. A constituent element of work meaning often extends beyond a focus on oneself, it arises when work contributes to the greater good.12 While a given workplace experience is individually construed to be meaningful (or meaningless), organizational science has long-researched workplace factors that increase the potential to experience meaning at work. When job characteristics and tasks align with one’s individual values and esteem needs, workers are more likely to experience work meaning. There is an overlap between work meaning and life meaning; an association that when strengthened, fosters a sense of personal and professional growth.17 Job conditions demonstrated to increase work meaning are listed in Table 1, including associated workplace climate dynamics and individualized practices. Table 1: Job Conditions that Increase the Potential to Experience Meaningful Work
Recent meta-analyses and empirical reviews examine the outcomes of meaningful work, the results defined below in four categories:5,20 Work-related attitudes: Increasing work meaning is positively associated with engagement, job satisfaction, and intrinsic motivation. Individual outcomes: Those experiencing meaningful work are more likely to report positive life measures including work-life enrichment, feelings of happiness and life meaning. Additionally, they report better psychological adjustment (being more adaptive to both the job and work environment). Performance-related outcomes: Meaningful work is strongly associated with perceived organizational reputation, knowledge-sharing, creativity and performance. Organizational outcomes: Employees express higher levels of organizational commitment and decreased turnover intentions. The best fitting model of work meaning demonstrates that the most proximal outcome, work-related attitudes, subsequently predicts downstream results: individual work-life enrichment, job performance, and organizational results. The concept of self cannot be separated from one’s sense of meaning. How an individual sees themself and the work they perform plays a crucial role in one’s sense of meaningfulness. The key for organizations is thus two-fold: constructing environments rich in experiences that offer potential for work meaning and, to consider the individual as a unique contributor. The power of small work groups- teams, divisions and even departments – can emphasize the importance of individual-level experiences through a method labeled job crafting, a process by which employees proactively change their roles to better align with their personal values, goals, skill set and growth needs.19 Additionally, for individuals who seek enriching work, assessing work meaning beyond a single item (“my work is meaningful to me”) is recommended. The Work as Meaning Inventory (WAMI) evaluates three subscales: positive meaning, meaning making through work, and greater good motivations, allowing job components to be specifically enhanced where most needed.12
Re-investing in the individual anesthesiologist to create work meaning, while also promoting leadership styles, work patterns, social support systems, and workplace cultures is a daunting task. Yet, it offers a much-needed opportunity to combat the pervasive impact of burnout and lack of professional fulfillment currently impacting academic anesthesiology.22,23 Development-minded leaders can deploy work meaning research to influence local environments, and to equally, work with individuals to connect work with their values, align intrinsic appeal with job tasks, form supportive collaborations, and live the positive impact of their work. References:
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