The doctor/patient gap in the medical field is a common topic of controversy that has been discussed and debated for the past half-century. With this topic attracting so much attention from the public, another common gap is often left in the shadow of this topic: the gap between hospital employees. Many people who have shadowed a healthcare professional have seen tension and stress between medical field employees, most commonly observed between physicians, but also between physicians and nurses. More recently, this topic has gained some attention which has led to the promotion of a positive practice environment (PPE). The goal of a PPE is to create a better environment for hospitals and other medical centers to run on, which in turn improves many other facets of the medical field, such as the effectiveness and efficiency of patient care. In this activity, you will be looking at how non-healthcare professionals contribute to a positive practice environment.


Observe the interactions between patients' families and hospital employees that do not directly provide health care such as cafeteria workers, people at the information desk, security, secretaries, etc.


-To develop an understanding of the role of non-healthcare professionals in the hospital setting.

-Compare the non-healthcare professional's role in contributing to a positive practice environment to that of healthcare professional's.

-Evaluate the hospital environment based on positive practice environment principals.


Hospital or Shadowing Site. You can try any of the waiting rooms, cafeterias, information desks, chapel, etc where non-healthcare professionals would likely be.

Recommended Preparatory Reading:

Kilanska et al., "Evaluation of Chosen Determinants of the Positive Practice Environments at Polish Nursing Wards." Med Pr. (2016) 67 (1):11-19.

International Council of Nurses et al., "Positive Practice Environments for Health Care Professionals." WHPA (June 2008). Print.


About an hour.

Appropriate for:

-advanced undergraduate students; undergraduate medical students; graduate students in the health professions.

Activity Description:

Go to a healthcare providing facility such as a hospital or your shadowing site and make note of employees who do not directly provide healthcare such as cafeteria workers, people at the information, security, secretaries, etc. Take notes on at least three interactions involving different groups of people. Be sure to record:

-Who is involved in the interaction

-What happened?

-Where did it happen?

Reflect on these observations in the context of the suggested readings. How well did your observation site provide a positive practice environment? What responsibilities should non-healthcare professionals have in contributing to an amenable environment? Do these responsibilities differ from the responsibilities that you think healthcare professionals have?

Author: Brad Erickson & Michael Cunningham