Overcoming and adapting

Developing a growth mindset: Are you asking the right questions?

Miko Rose, DO, describes how a minor fall at work helped her adopt a growth mindset.

I was two years into clinical practice and that day already running late with clinic patients. I spent so much time restarting my laptop with system updates and failing wireless connections, I thought for sure I could make up the time by just moving faster—so I did.

Running to my desk between patients, I took a large swig of my iced latte, grabbed my laptop and rushed into the next exam room, cheerfully exclaiming, “Good morning!” to my patient. As I ran into the room, I placed my laptop on the exam table, lost my footing, slipped, bounced face first onto a large trash bin with a dramatic “boom,” then landed face up on the clinic floor.

As I looked up at the popcorn ceiling tiles peppered with fluorescent lights, I wondered, on so many levels, how had I gotten there.

I had spent years learning everything there was to know about psychiatric care for underserved patients but had learned nothing about managing my time or how to stay upright on rushed days.

I’ll be honest, I wasn’t feeling great about my worth as a clinician that morning. However, my fall became a clarifying moment that led me to shift my attitude about time management, self-care and boundaries in medicine. I also recommitted to developing a growth mindset.

If you are a new resident physician, developing a growth mindset can help you enormously during this part of your training to become a fully licensed physician.

Fixed versus growth mindset

Psychologist Carol Dweck, PhD, describes two different types of mindsets. Let’s look at how these two mindsets can be applied to pick a different outcome from staying metaphorically (or literally) face down on the floor after a fall.

Fixed mindset: Dr. Dweck describes a “fixed” mindset as a framework of thinking that one either fails or succeeds, with little room for improvement if one is failing. The quintessential fixed mindset medical trainee is a first-year student who fails their first exam in biochemistry after not having the study skills or knowledge to study with the level of detail required for medical school. These students with a fixed mindset will consider dropping out of school, thinking there is no hope for success after their initial failure, and will often look at “failure” as a measure of their own self-worth and value as humans.

The underlying fundamental belief of a fixed mindset is that there is little to no room for improvement after a failure. Are you asking, “Why am I such a failure?” with every setback? With a fixed mindset, you may fail your first exam and walk directly to the registrar to withdraw from school.

Growth mindset: A growth mindset, in contrast, stems from a foundational understanding of the brain’s plasticity. Plasticity is defined as the adaptability of an organism to change in its environment and to change when responding to various habitats. Much of cognitive behavioral therapy is founded on these tenets.

Changing the framework of one’s thinking can improve one’s mindset and outcomes. Medical students with a growth mindset may fail their first exam, but then will ask, “What can I do? What am I missing that I can learn to crush this the next time?”

These students will find their colleagues who scored the highest and ask them for tips. They will seek student services and tutoring to gain additional assistance, and they will discuss material they did not understand with faculty to ensure they can improve. They will seek additional training on both the materials covered and evidence-based tutorials to master taking multiple-choice exams. A student with a growth mindset will look at the initial failure as a roadmap of areas they can work on to improve.

Research has shown students holding a growth mindset were far more likely to score in the top 20% on a nationwide achievement test. Here is a self-test to see where you fall in the fixed-versus-growth mindset.

If you can foster a curiosity of what each challenge presents to you, the world can shift from pulling at your sides to bring you down to being full of opportunities for expansion, learning and growth. Every great leader in science has faced incredible challenges. Albert Einstein failed the entrance exam to his desired school, Marie Curie was rejected from her university in Poland due to her gender, Spencer Silver “failed” at creating an adhesive that later became the sticky part of Post-It notes, and the list goes on.

When you adopt a growth mindset, you have an inherent sense of self-worth as foundational, and believe you will gain the knowledge and experience needed to succeed. You are just starting out. The beauty of medicine is that no matter where we are in our levels of training or practice, there is always more to learn, and the great news is, the more you are willing to adopt a growth mindset, the more likely you are to succeed.

Looking up at the clinic ceiling from my unexpected fall, I learned that day about paying attention to all the subtle and not-so-subtle signs I had missed: about burnout, over-commitments and time management in clinic care. I took my surprising moment of falling on the floor to start to think deeply about ways I could improve and work on time management, self-care and boundaries within clinic practice.

Eventually, this body of knowledge became a for-credit class that I created. I have been teaching DOs and MDs at Michigan State University about how to pursue happiness and well-being as a health care provider.

If you are a new resident physician, you are just beginning the training needed to become a fully licensed physician. Adopting a growth mindset can be a powerful tool to help you excel and inspire you to keep going on tough days. You can do it, especially when you are equipped with inspiration and hope.

Related reading:

Therapy: A returning back to home

Vulnerability: The path least taken

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