Medical Education Directorate, NHS Lothian, Edinburgh, UK.
Scottish Centre for Simulation and Clinical Human Factors, NHS Forth Valley, Larbert, UK.
BMC Med Educ. 2024 Oct 23;24(1):1199. doi: 10.1186/s12909-024-06211-6.
Doctors in training (trainees) have higher rates of burnout, anxiety and depression than other professionals. An important psychological tool to combat this crisis is promotion of a growth mindset, which increases resilience and improves mental health outcomes. How growth mindset might be promoted within the clinical learning environment is underexplored. This study aimed to explore the factors promoting a growth mindset versus fixed mindset in trainees from the perspective of the trainees.
This constructivist study employed a novel method of encouraging trainees' reflections on mindset adoption in the clinical learning environment. Trainees played Mindset, a tabletop simulation board game that included challenges encountered within training. This was followed by a facilitated debriefing, focusing on factors that promoted growth or fixed mindset adoption in the clinical learning environment. Debriefing transcripts were analysed using template analysis.
Three groups of oncology trainees and one group of medical education fellows participated (16 participants in total). Factors promoting growth mindset adoption included passion, collaboration, diverse career and role modelling. Factors promoting fixed mindset adoption included burnout and competition. Some factors, such as grit, previous success experience and singular training location promoted a fixed mindset when too much or too little were present, and promoted a growth mindset when they were in balance (the Goldilocks principle).
The importance of balance versus excess of certain factors, and the ubiquitous competitive culture in medicine promoting a fixed mindset, were compelling reflections. This study may aid invested parties to reflect on what factors they can upregulate and down regulate to optimise trainees' adoption of a growth mindset.
受训医生（受训者）的倦怠、焦虑和抑郁发生率高于其他专业人员。对抗这一危机的一个重要心理工具是促进成长型思维，这可以提高韧性并改善心理健康结果。在临床学习环境中，如何促进成长型思维尚未得到充分探索。本研究旨在从受训者的角度探讨促进成长型思维而非固定型思维的因素。
本建构主义研究采用了一种新方法，鼓励受训者反思在临床学习环境中采用思维模式。受训者玩 Mindset，这是一款桌面模拟棋盘游戏，其中包括培训中遇到的挑战。随后进行了有针对性的讨论，重点是在临床学习环境中促进成长型或固定型思维模式采用的因素。使用模板分析对讨论记录进行了分析。
共有三组肿瘤学受训者和一组医学教育研究员参加（共 16 名参与者）。促进成长型思维模式采用的因素包括激情、协作、多样化的职业和榜样作用。促进固定型思维模式采用的因素包括倦怠和竞争。有些因素，如毅力、以前的成功经验和单一的培训地点，在过多或过少的情况下会促进固定型思维模式，而在平衡时（金氏原则）会促进成长型思维模式。
某些因素的平衡与过度的重要性，以及医学中普遍存在的竞争文化促进了固定型思维模式，这是令人信服的反思。这项研究可以帮助相关方反思他们可以上调和下调哪些因素，以优化受训者采用成长型思维模式。
