Back in medical school, during a first-year retreat, our whole class did the Myers-Briggs Type Indicator (MBTI) psychometric test, supposedly to help us learn what field of medicine might be the best fit for our unique combination of characteristics. It was the first time I’d done a formalized personality assessment, and it felt like something closer to a Cosmo quiz than a valid tool for career guidance. Since then, I’ve gained a greater appreciation for the value of appraisals to help me better understand not just myself but my colleagues, staff, patients and systems. As I’ve gained self-awareness, I’ve seen unexpected benefits in both my personal life and in my career.
It turns out, my medical school was part of a growing movement to use such testing in the health care field. In fact, in the latter 20th century, extensive data showed the utility of personality assessment in an array of settings. But the conceptualization of unique personality traits can be traced back to 460 BC, when Hippocrates theorized that humans had a “persona” linked with four “humours”: choleric (yellow bile), melancholic (black bile), sanguine (red blood) and phlegmatic (white phlegm).
Galen took this concept further to publish a comprehensive typology of temperament. These early attempts paved the way for the formal science of psychology in the late 1800s and the use of formal psychological testing to address individual personality styles. Today, personality tests are being used to predict which health care intervention might be most effective for an individual patient, to organizations assessing fit between a role and candidate to, as in my experience, medical educators aiming to enhance awareness of self and others, assist in specialty selection, predict student performance and decrease evaluative bias.
As a first-year medical student, I didn’t find the MBTI particularly helpful; at that point in my training, I was more eager for medical facts than understanding myself. I recently came across those results when cleaning out a drawer, which made me reflect on the unintentional experiences I’ve had since then, and how the insights have made me a convert to the point where I now actively recommend them to my family, friends, patients and students.
For example, I discovered a way to tailor my approach to patients by using The Four Tendencies quiz, developed by Gretchen Rubin. The quiz explores how we respond to expectations — both expectations of ourselves and expectations of others. From this we are divided into four groups: upholders, obligers, questioners and rebels. The author posits that knowing our “Tendency” helps us personally understand how to achieve our own goals, and as physicians can help us work with our patients more effectively. Is your patient a questioner, who responds well to reams of data, an obliger who will do well with monitoring and accountability, a rebel who resists being told what to do, or the easiest of clients: an upholder who will faithfully follow your suggestions?
I’ve also found tests helpful on a team level. Our clinical team had been going through a rough spot, with staff turnover and poor morale. A team member who is a certified coach suggested that we all take the 16 Personalities assessment.
This construct has five personality aspects (mind, energy, nature, tactics and identity) that, when combined, assign us into one of 16 personality types. After the team did their self-assessments, we put them up on a bulletin board in the lunchroom with brief descriptions of the types and where we all fell.
Portions of team meetings were devoted to discussion of what we found and how to use the information to better understand the people we work with every day. Overall, the process led to more intimate discussions and a better appreciation for how who we are as individuals plays into how we show up for the team.
And, of course, the tests help with your own personal growth and relational understanding. As part of a leadership program, I completed an Enneagram Type Indicator and a formal debrief with a coach, and I found it so interesting I had my spouse complete it, too. What I’d previously dismissed as a glorified form of horoscopes turned out to be a tool that helped my husband and me understand each other better.
For example, as an “Observer,” I need time to process before resolving a conflict, which helped my husband, a “Peacemaker,” understand he needs to give me space. The concept in the enneagram construct that we can be healthy/average/unhealthy versions of our type gives each of us the chance to know when we are in flow (what they term “integration” or “growth”) versus in a state where we’re decompensating (“disintegration” or “stress”), and take steps to reset.
I’ve done other personality assessments over the years, and each time uncover another layer of understanding about myself and human nature in general. As humans, we naturally tend to think others will respond to what works for us. The reminder of the uniqueness of individual make-up can enrich our relationships on the home-front as partners and parents, and in the health care workplace as a colleague, boss, employee and caregiver.
To be sure, these tests are not perfect. They provide a look at a slice of someone’s personality without looking at the full picture, can lack reliability, and can be “gamed” by the user. However, if you use these personality explorations and invest the time to reflect on the findings, you can have a better understanding of yourself, your patients and your colleagues and ultimately enrich your professional career and personal life.
Melinda Ring is an integrative medicine physician.
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