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Indiana University School of Medicine
Indiana University School of Medicine
Internal Medicine

Meaningful Engagement

Appreciation  -  Trust and Respect  -  Reflection  -  Reduced Cynicism 

Appreciation

Appreciation is defined as gratitude and enjoyment of someone or somethings qualities, understanding that unique qualities can positively contribute to function. There are five languages of appreciation that include acts of service, quality time, words of affirmation, tangible gifts, and appropriate contact. Additionally, individuals can pursue appreciative inquiry as a means for leveraging positivity in the workplace and in research to promote social change.

 

Image Source: ResearchGate.net, The 5D-Cycle (Cockell & McArthur Blair, 2012, p. 54)

Graphic illustrates the 5D-Cycle, credited to Cockell & McArthur Blair. It instructs the user to define an affirmative topic, then dream, discover, design and deliver on that topic.

  1. Bogerd, R., Silkens, M. E. W. M., Henriques, J. P. S., and K. M. J. M. H. Lombarts. “Appreciating Appreciation: Residents' Experience Feeling Valued Differently as Learners, Physicians, and Employees.” Academic Medicine, vol. 100, no. 5, 1 May 2025, pp. 578-584. doi:10.1097/ACM.0000000000005959.
  2. “AI Discovery, Dream, Design, and Destiny Model.” Transformative Practices in Management and Applied Psychology (TPMAP), https://www.tpmap.org/wp-content/uploads/2021/03/28.1.4.pdf.
  3. “Introduction to Appreciative Inquiry.” Center for Appreciative Inquiry, https://centerforappreciativeinquiry.net/appreciative-inquiry-offering/introduction-to-appreciative-inquiry/.
  4. Merriel, A., Wilson, A., Decker, E., Hussein, J., Larkin, M., Barnard, K., O’Dair, M., Costello, A., and A. Coomarasamy. “Systematic Review and Narrative Synthesis of the Impact of Appreciative Inquiry in Healthcare.” BMJ Open Quality, vol. 11, no. 2, 2022, e001911.

Trust and Respect

Trust and respect are the belief in someone’s integrity and ability for positive future action while holding esteem for their unique qualities and past achievements. Both trust and respect are vital for healthy and effective relationships and involve general acknowledgement and reliance on the competence of individuals and organizations.

  1. “AAMC Center for Health Justice Trustworthy Toolkit.” AAMC Center for Health Justice, https://www.aamchealthjustice.org/key-topics/trustworthiness/trustworthiness-toolkit?j=1270733&sfmc_sub=211942166&l=248_HTML&u=43231237&mid=7297026&jb=1002&utm_source=sfmc&utm_medium=email&utm_campaign=chj&utm_content=newsletter.
  2. Crits-Christoph, P., Rieger, A., Gaines, A., and M. B. C. Gibbons. “Trust and Respect in the Patient-Clinician Relationship: Preliminary Development of a New Scale.” BMC Psychology, vol. 7, no. 1, 2019, p. 91. https://link.springer.com/content/pdf/10.1186/s40359-019-0347-3.pdf.
  3. Feldman, E. “How to Interrupt Someone’s Workday -- Without Annoying Them.” Harvard Business Review Digital Articles, 17 Feb. 2022, pp. 1–6. https://research.ebsco.com/linkprocessor/plink?id=aec1caaa-b8ae-3edf-8f79-63b53c40004c.
  4. “Guide to Perspective Taking for the Workplace.” AMP Creative, https://ampcreative.com/guide-to-perspective-taking/.
  5. Houldsworth, A. “Trust Me I'm a Doctor; the Importance of Trust in Promoting High Performance Learning in Medical Education.” MedEdPublish, vol. 9, no. 184, 2021. https://doi.org/10.15694/mep.2020.000184.2.

Reflection

Reflection is conscious and informed thought that involves aspects of evaluation, criticality, and problem- solving that leads to increased insight, awareness, and new understanding. The act of reflection can lead to positive self-awareness, reduce stress, and strengthen job satisfaction.

 

Image Source: Gibbs’ Reflective Cycle, SimplyPsychology.org

Graphic depicts the Gibbs’ Reflective Cycle, a framework for reflection that includes the six stages of description, feelings, evaluation, analysis, conclusion, and action plan

  1. Ménard, L., and S. Ratnapalan. “Teaching Moment: Reflection in Medicine: Models and Application.” Canadian Family Physician, vol. 59, no. 1, Jan. 2013, pp. 105-07, e57-59. https://pmc.ncbi.nlm.nih.gov/articles/PMC3555667/.
  2. Ocampo, F. A., McIntyre, B. G., Massey, D., and R. Saunders. “Nursing Student Reflections on a Research Internship: A Reflective Discussion Following the Gibbs' Reflective Cycle.” Nurse Education Today, vol. 145, 2025, 106481. https://www.sciencedirect.com/science/article/pii/S0260691724003915.
  3. “Reflective Practice Toolkit.” University of Cambridge Libraries, https://libguides.cam.ac.uk/reflectivepracticetoolkit.

Reduced Cynicism

Reduced cynicism means to focus on what is within the scope of influence by critically examining evidence for a situation rather than defaulting to negative beliefs. To reduce cynicism means to embrace healthy skepticism by seeking out positive information, embracing agency, practicing empathy, and making trust and respect the default.

  1. “Cultivate an Anti-Cynicism Culture.” Harvard Business Review, 16 May 2023, https://hbr.org/2023/05/has-cynicism-infected-your-organization.
  2. “Fight Cynicism on Your Team.” Harvard Business Review, 18 Sept. 2024, https://hbr.org/tip/2024/09/fight-cynicism-on-your-team.
  3. “Finding Hope in a Cynical World.” Stanford News, 1 Aug. 2024, https://news.stanford.edu/stories/2024/08/finding-hope-in-a-cynical-world.