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Understanding Mindset Theory in Surgical Residents
Nathan Coppersmith, Andrew C. Esposito, Mark Chung, Peter Yoo
Surgery, Yale School of Medicine, New Haven, Connecticut, United States

Mindset theory offers an approach to understanding how surgical residents learn. Mindset theory holds that people possess growth or fixed mindsets. A growth mindset holds that skills or intellect can be developed while fixed considers them static and predetermined. A person's mindset is associated with how they respond to challenges, obstacles, effort, criticisms, and the success of others. This study sought to characterize the mindsets of surgical residents and to understand if the character traits of surgical residents were consistent with those in proposed classical mindset theory.

Electronic survey

Department of surgery at a single, tertiary university-based medical center

Patients (or other participants)
Surgical residents

Electronic survey

Main Outcome Measure
The main outcome measure was mindset score, and a secondary outcome was the significance of the relationship between mindset score and a score representing an aspect of each character trait.

The survey achieved a response rate of 38% (46/121). 89% of respondents endorsed features of the growth mindset toward the acquisition of surgical skills. The average mindset score (using a modified Implicit Theories of Intelligence Scale) was 4.15 (+ 0.74) where scores >3 are defined as growth mindset. However, when asked to consider how they would respond to various learning circumstances, the majority of participants (43/46, 93%) endorsed behaviors inconsistent with the growth mindset. Features contrary to classical growth mindset behavior were reflected in how participants responded to challenges (93%), learning obstacles (87%), and the success of others (78%).

The great majority of surgical trainees believe they possess a growth mindset. However, when applying these concepts to hypothetical learning challenges, the reported behaviors of surgical residents were inconsistent with the behaviors expected by classical mindset theory. In particular, surgical residents valued demonstrations of competence in situations where they are observed by others, and residents indicated they may shy away from future situations where they have not performed well in the past. At the same time, the residents nearly unanimously endorsed the importance of self-improvement and hard work. As residency programs have increasing demands for feedback and programs are assessed on the quality of feedback provided to trainees, understanding how trainees understand the acquisition of skill may shape educators' approach to future work.

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