How to get people to live up to their training commitments
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How to get people to live up to their training commitments

People make a lot of commitments at work and at home, whether it’s a pledge to get expense reports in on time, go to the gym three times a week or bring cupcakes to the next office party.

When it comes to training, some organizations have instituted learning commitments or contracts that learners promise to honor after the training is done.

It’s easy to assume that these promises aren’t worth much, but it turns out they can be – if you make them public.

The research
A study looked at how to change on-the-job behavior – in this case, in the medical field.

Researchers were looking for ways to get doctors to stop prescribing antibiotics unnecessarily. It’s a significant problem, with more than 2.5 million inappropriate prescriptions written annually. But in the past it’s been hard to get doctors to change their behavior.

The researchers decided to try a low cost intervention in five clinics across Los Angeles.

Doctors signed a poster-sized letter that detailed their commitment to eliminate unnecessary antibiotic prescriptions. The letter included a head shot of the doctor and was displayed in the examination room.

The study then looked at data over the following three months to see whether prescriptions went down. They also monitored a control group of doctors at the clinics who didn’t sign the commitment.

Among doctors who signed, inappropriate prescriptions went down approximately 10% from the previous year’s average. Meanwhile, unnecessary prescriptions actually went up 10% among physicians who didn’t commit. Bottom line: At the end of the study, the doctors who signed the commitments were prescribing 20% fewer unnecessary antibiotics than the no-commitment group.

Why did it work?
Researchers found that the key was displaying the letter publicly. With the letter in plain view of patients and coworkers, the doctors felt social and professional pressure to fulfill their commitment. With their photo and signature staring back at them on the wall, they made good on their promise.

The study also found that – unlike previous interventions that involved financial incentives – doctors weren’t falsifying their paperwork to appear to be in compliance. Where financial rewards led to dishonesty, social pressure led to real results.

Here are some suggestions for making your training commitments more likely to stick:

1. Create one big commitment letter and get everyone to sign it (think of the Declaration of Independence). Consider including head shots of the learners as well. A shared document creates a shared commitment.

2. Display the commitments publicly. Take advantage of the social pressure created by putting up the posters in the office. It will boost compliance and keep learners honest.

Meeker, D., et al. (2014). Nudging guideline-concordant antibiotic prescribing: A randomized clinical trial. JAMA Internal Medicine, 174(3), 425-431.

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