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A growth mindset approach to preparing trainees for medical error
  1. Jill Klein1,2,
  2. Clare Delany1,3,
  3. Michael D Fischer4,5,
  4. David Smallwood1,6,
  5. Stephen Trumble1
  1. 1Department of Medical Education, Melbourne Medical School, University of Melbourne, Parkville, Australia
  2. 2Melbourne Business School, University of Melbourne, Carlton, Victoria, Australia
  3. 3Royal Children's Hospital, Children's Bioethics Centre, North Melbourne, Australia
  4. 4Peter Faber Business School, Australian Catholic University, East Melbourne, Australia
  5. 5University of Oxford Said Business School, Oxford, UK
  6. 6Respiratory Medicine, Royal Melbourne Hospital, Parkville, Australia
  1. Correspondence to Professor Jill Klein, University of Melbourne, Department of Medical Education, Melbourne Medical School, Parkville, 3010 Australia; jillkleinmbs{at}gmail.com

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Introduction

As medical students transition to become trainee doctors, they must confront the potential for making medical errors. In the high stakes environment of medicine, errors can be catastrophic for the patients and for doctors themselves. Doctors have been found to experience guilt, shame, fear, humiliation, loss of confidence, deep concerns about their professional skills and social isolation, effectively becoming the second victim of an error.1 ,2

A number of programmes and practices have been suggested to provide psychological first aid to second victims after an error has occurred.3 Little attention, however, has focused on how medical training can prepare doctors for the inevitability of error, and thus help protect them from potentially severe emotional consequences in the future. The WHO has developed the Patient Safety Curriculum Guide for Medical Schools, which includes training on understanding and learning from mistakes.4 In addition, the case has been made for error management training in which students are encouraged to experience error in safe settings, such as simulation exercises.5 ,6 While these approaches are promising, a more broad-spectrum psychological intervention aimed at changing how students perceive mistakes and cope with setbacks could be advantageous. Research from social psychology suggests a promising intervention that could help assist students in being resilient when encountering difficulties and setbacks.

The growth versus fixed mindset

Mindset theory holds that our implicit assumptions about the origins of abilities such as intelligence and talent have a profound impact on how we view mistakes or failure.7 Those with a fixed mindset believe that ability is endowed and static, and thus a failure indicates a lack of ability. Those with a growth mindset view ability as acquired through effort, practice and learning from setbacks, and thus a failure represents an opportunity for development and improvement.

A great deal of research …

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