Praise: What actually works

Issue: BCMJ, vol. 65, No. 7, September 2023, Page 237 Editorials

It’s September—back-to-school time. For me, the annual “fall feeling” has never really abated, even though I have not attended school for, ahem, quite a few years now. When days get shorter and leaves start to turn, a familiar anxiety returns. It’s more than just mourning another summer gone by, more than missing the carefree days by the lake and late-night s’mores. For me, the fall feeling is chest-tightening anticipation, which is undoubtedly conditioned from many years of academic pressure, long hours, and innumerable high-stakes exams. Perhaps you can relate?

These days I try to channel my anxiety into something positive, using it as a way to empathize and connect with medical students and my children. To motivate learners without adding undue pressure, I have become mindful about the power and pitfalls of praise.

My interest in praise and human motivation was sparked in a McGill University psychology class. The professor, Richard Koestner, pointed out that we tend to feel bad about giving out rewards, but we readily dole out praise. Praise, referring to the verbal-support kind, not the religious kind, is more complex than one might think, however, as it depends heavily on context. The effect of praise can be motivating, but it can also be detrimental, depending on the relationship, public nature, and specific type of praise one is given.

According to Koestner,[1] of the nine types of praise, only one works for motivation. Therefore, knowing how not to praise may be just as important as learning the best way. The forms of praise that are not motivating are: (1) praise as positive guidance, (2) praise as a transition ritual, (3) praise as balance for criticism, (4) praise as a peacemaker, (5) praise as a consolation prize, (6) praise after student-elicited stroking, (7) praise as attempted vicarious reinforcement, and (8) praise as a vindication of predictions.

Praise is motivational only when it comes as a spontaneous expression of admiration. To act as reinforcement, praise should be contingent, specific, and credible.[1,2] It is also important to note that praise is not the same as feedback.

When referring to praise as encouragement, Professor Koestner often cited a well-known psychologist, Carol Dweck, who has written about the importance of cultivating a growth mindset. In a growth mindset, children and learners are praised for the process, rather than the person. For example, we can recognize a child for their efforts and approach to school, which is entirely within their control, rather than for being good at school, which builds unrealistic expectations to always perform well.

When we foster a child’s intrinsic motivation, we also help them build resilience. By acknowledging their setbacks and failures, we can also strengthen their ability to persevere and develop new tools. Here are some phrases I find help illustrate this approach:[3] “You are good at trying different ways to solve a hard puzzle.” “You solved the problem with great focus.” “You make a difference in this.” “The reason for going to school is to learn, not just to do well on tests.”

Whether in medical school or grade school, feeling pressure to achieve is inevitable. But as physicians, parents, and educators, we can keep in mind that the best motivators are the goals students set for themselves. Although we can’t write their tests or do surgeries on their behalf, we can empower our students to believe in their potential.
—Caitlin Dunne, MD


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1.    McGill Department of Psychology. Richard Koestner. Accessed 29 June 2023.

2.    Brophy J. Teacher praise: A functional analysis. Rev Educ Res 1981;51:5-32.

3.    Li P. How to praise a child with words (50 examples). Parenting for Brain. Accessed 29 June 2023.

Caitlin Dunne, MD, FRCSC. Praise: What actually works. BCMJ, Vol. 65, No. 7, September, 2023, Page(s) 237 - Editorials.

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