This week the KeyLIME team focuses on Growth Mindset, a topic often touched on in their podcasts (most recently, in epsisodes, 247, 257 and 282, in case you missed them!). This week’s article presents a study of articles of growth mindset theory in HPE, aimed at summarizing its aspects, discussing its benefits and outlining strategies to promote a growth mindset.
Listen to the co-hosts discuss here.
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KeyLIME Session 306
Reference
Wolcott et. al., A review to characterise and map the growth mindset theory in health professions education Med Educ. 2020 Sept 21.
Reviewer
Jon Sherbino (@sherbino)
Background
True story. Several years ago I chaired a national committee to develop national training standards in emergency medicine. Over the course of 3 years of multiple retreats and meetings I discovered that the frequent laughter and good cheer of the committee was not a function of my excellent facilitation skills. Rather, the committee of 50 was playing buzz word bingo. An enterprising member had developed cards (and prizes) with each square containing a #meded buzz word. As I would utter the buzz word, the player would score the square. Now I understand why people on occasion would stand up, yell bingo, and be cheered by the rest of the committee.
If I was going to play buzz word bingo today, I would definitely have as my centre square “growth mindset”. It’s a popular (overused?) term that infuses our conversations around competency-based medical education.
Motivation for learning is often divided between performance-orientation (performance-avoidance, minimizing failure compared to a cohort; performance-approach, competition against others) and learning-orientation. Implicit theories of intelligence are informed by personalized belief about controllability of intelligence / ability.
If you’re interested in a deeper articulation of Dweck’s growth mindset theory and it’s relevance to HPE, read on.
Purpose
The authors state:
“This study characterised articles on growth mindset theory in health professions education to: summarise the aspects of growth mindset being researched, describe the discussed benefits of growth mindset theory and outline strategies discussed that may promote a growth mindset.”
Key Points on the Methods
A systematic search of MEDLINE, EMBASE, CINAHL, Scopus, ERIC and PsycInfo was conducted without restriction by publication date. Articles were screen independently by two reviewers with a third reviewer resolving a lack of consensus. Articles were excluded if the context was not HPE. Commentaries and research articles were included in the analysis.
Included articles incorporating growth mindset as a major feature of the study (informing design, analysis) or moderate (referencing for describing growth mindset theory). Studies with a minor incorporation of growth theory were excluded.
There was not quality review of included articles.
A content analysis, using inductive coding, was performed of included articles to systematically quantify, organize and demonstrate connections and gaps between themes.
Key Outcomes
From 2286 identified manuscripts, 59 were relevant to HPE and 27 were included in the analysis (13 commentary, 14 research manuscripts), all published since 2016.
Medicine, veterinary medicine, nursing, physical therapy, and pharmacy were included in research studies from USA, Canada, Sweden and Australia. Students were studied in the vast majority of cases with the remaining in-practice professionals. The majority of research studies used survey methodology. Most research studies compared the growth mindset to other variables such as self-reported medical errors, grit, resilience, anxiety and performance. Correlation was variable and in some cases non-existent. Fixed versus growth mindset ranged in studies from 30 to 90%.
There are 25 benefits for learners, educators and organizations, such as improved teamwork, receptivity to feedback and supportive safe learning environments. However, these were influenced by commentaries.
27 strategies (9 learner, 14 educator, 4 organisational) to promote a growth mindset were described.
Again, these strategies were influenced by commentaries. Strategies for learners included creating learning goals focusing on progress not performance. Strategies for educators included appropriate delivery of praise and feedback. Strategies for organizations included establishing a safe and just learning culture.
Only one small study with nursing students evaluated a growth mindset intervention
Key Conclusions
The authors conclude…
“This review identified an expanding interest in the growth mindset theory for health professions education…. Researchers are encouraged to explore how interventions can be designed to promote growth mindset and encourage more productive responses to educational challenges….”
Spare Keys – Other take home points for Clinician Educators
- Growth mindset should not be viewed (although too often it is studied) as being fized across multiple physician competency domains. Our self-identified spectrum of fixed vs. growth mindset can vary across the CanMEDS Roles.
- Social desirability, as a special type of response bias, is not discussed in a meaningful way at this meta-level of analysis of the research articles.
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