The Science of Motivation and Behavior Change – Episode #4

In this episode we are digging into The Science of Motivation and Behavior Change, and here are our Big Three Takeaways:

1. Knowledge rarely leads to action
2. Action is a product of motivation to change, ability to change, and critical triggers that spark, facilitate, or signal a behavior
3. BJ Fogg and others have provided us with invaluable tools for understanding these elements and how we must leverage them to engineer change

Our community seems generally aware that to drive behavior change one must be appropriately motivated. This is not a simple task and here is a great overview from Daniel Pink:

We now know far more about what types of motivations work best – and intrinsic motivation is far more powerful than extrinsic motivation

Extrinsic MotivationIntrinsic Motivation


More recently intrinsic motivations have been further explored by Fox and colleagues – we must, as educators understand perceived needs!

Intrinsic Motivation - Actual Vs Perceived Needs

In 2012 while he and I were both speakers at the first Medicine X conference at Stanford, I had the pleasure of first hearing, and then spending some time chatting with BJ Fogg – Dr Fogg is a behavioral scientist at Stanford University. In 2009, Dr Fogg began sharing what he refers to as the Behavior Change model. Here is just a bit of what he describes,

This paper presents a new model for understanding human behavior. In this model (FBM), behavior is a product of three factors: motivation, ability, and triggers, each of which has subcomponents. The Behavior Change model asserts that for a person to perform a target behavior, he or she must (1) be sufficiently motivated, (2) have the ability to perform the behavior, and (3) be triggered to perform the behavior. These three factors must occur at the same moment, else the behavior will not happen. The Behavior Change model is useful in analysis and design of persuasive experiences. The Behavior Change model also helps teams work together efficiently because this model gives people a shared way of thinking about behavior change.


To simplify Fogg’s work think in terms of the relationship between motivation, ability, and triggers!

Fogg's Equation

Fogg and Triggers

Fogg and Ability

Fogg and Simplicity


Finally, before we end – a complementary field of behavioral science study referred to as Nudge science or Theory has emerged over the past decade. And it might help for our community to understand its impact on behavior change too.

In 2008 Rich Fowler and Cass Sunstein introduced Nudge science to the masses with their landmark book called Nudge. In their words,

[a nudge] is any aspect of choice architecture that alters peoples behaviors in a predictable way without forbidding options or significantly and changing their economic incentives.


Nudge Book

Nudge science focuses on creating environments that make it easier for behaviors to change. Implicit in this emerging field is the reality that we, as humans, find it nearly impossible to consistently make rational decision – we struggle to balance short-term and long-term benefits and 9 times out of 10 we will take the easy way out….and we, as designers must account for this with effective nudges! For example,

Nudge Staircase

Nudge Alarm Clock

I have put together a primer for Nudge Science and if you are interested the following may provide some invaluable references:

In brief, the basic idea of Nudge Science is that humans are unrelentingly irrational. As a result, our choices are often neither rational or constructive – worse yet, our everyday choices are usually just the opposite. We struggle to balance long-term and short-term benefits and risks, we are more in tune with negatives than positives when reflecting and more in tune with positives than negatives when forecasting…and this undermines our lives, moods, and careers more so than just about any other element of ‘being human’….The research behind these statements has been masterfully summarized and explored in the following works:

To help construct a practical value proposition – this NY Times article from 2013 is a great place to start: Britain’s Ministry of Nudges 

And, just to end with one, more analytical perspective – check out the work of Stanford professor BJ Fogg. I love Dr. Fogg’s work because of how simple he has connected decades of research into Behavioral economics (Motivation), Adult Learning (Ability), Nudge Theory (Triggers)…B = M x A x T!

Finally, to connect these dots – as educators we must understand that learning alone will rarely lead to the behavior changes that are needed in the provision of the highest quality healthcare. But even more importantly there are critical behaviors OF learning that we must drive to support our learners as they engage in continuing education. From our research over the past 4 or 5 years, triggers and nudges have emerged as a critical piece of the Learning Actions Model and educators must leverage these devices to ensure that learners effectively learn!

New Learning Actions Graphic