A friend who works as a teacher was recently enthusing about encouraging students to have a ‘growth mindset’. It sounded intriguing and so I looked into it and found some really interesting information which opened my eyes to traits which I am sure you will recognise from clinical practice.
You probably want to see growth as a practitioner but the question is what are the labels on the x and y axes of our graph?
What is a growth mindset?
Professor Carol Dweck of Stanford University has spent the last 20 years researching what makes the difference between high achievers and those that don’t fulfil their potential. She has made some fascinating discoveries and has differentiated two mindsets – a fixed mindset and a growth mindset.
In a fixed mindset people believe that their basic qualities, like their intelligence or talent are simply fixed traits. They believe you are born with certain abilities and talents and that is a fixed trait. These people have a goal to look smart all the time and never fail or look dumb. They are always proving themselves over and over, every situation is assessed – Success or failure? Smart or dumb? Accepted or rejected? Winner or loser?
In a growth mindset, people believe that intelligence and abilities can be developed through dedication and hard work. These people believe everyone can improve and get smarter if they work at it. Whilst not everyone is the same and not everyone can be Einstein everyone has potential to improve and no-one knows the limits of what they can achieve. These people thrive on challenges and see failure as a springboard for growth and stretching abilities. These people strive for a different success – overcoming failure, stretching yourself, learning new things, developing yourself.
You may be hearing echos of the nature-nurture debate and essentially Carol Dweck has identified that intelligence and ability can be developed by nurture.
You will probably recognise elements of these categories. People can be very strongly dominant in one mindset or can display different mindsets in different areas of their life such as business and career, relationships, parenting, sporting or creative ability and so on. These mindsets can form very early in life, often from the form of praise and measure of success in a child’s environment. When Dweck offered 4 year olds a chance to redo an easy jigsaw puzzle or try a harder puzzle those with a fixed mindset chose to redo the easy puzzle for affirming their ability and avoiding fear of failure, those with a growth mindset thought it an odd choice and relished the challenge of something new. A fixed mindset sees success as completing the puzzle correctly, the growth mindset sees success as becoming smarter.
Praising children in different ways also produced interesting results – telling children they got ‘X right, you must be really clever at this’ or they got ‘X right, you must have worked really hard’ led to surprising results. Praising ability (cleverness) pushed students into a fixed mindset so they wouldn’t take on a more challenging task because it might show weaknesses and they might not achieve as well. On the other hand most of the students praised for effort were very keen to take on a new challenge. Those that were praised for effort had greater enjoyment and made significant improvements, the other group actually got worse and worse.
This is all very interesting but how does it apply to you and your practice and your patients?
First of all we need to recognise what kind of mindset we have in our professional life. Perhaps if you have been qualified for many years you are at risk of a fixed mindset – you have seen many conditions, got a series of techniques that work and if something new or challenging comes into the clinic you would rather refer the patient elsewhere. Do you believe you can reach the peak of your clinical talents, your brain hasn’t got the capacity for learning any more anatomy, taking on research evidence or developing new techniques. Have you got to the stage where you think you are happy where you are and you don’t want to change anything. If you have more of a growth mindset you will enjoy keeping up with developments in understanding of anatomy, pain science, techniques and so on. You will enjoy the challenge of a different presentation in clinic and be stimulated to read and research the best way to help that patient.
Your mindset will affect the way you approach running your clinic – are you looking to grow, develop and improve or are you happy with how things are and don’t see the need to make changes. With a growth mindset you will strive to improve how your clinic runs, to make sure you are compliant, to make your practice environment safe, to provide an effective and outstanding patient experience. You will make changes, you will read the magazines, you will be receiving feedback from patients and colleagues and acting on it as an ongoing process.
You will also recognise that your patients will have fixed or growth mindsets about the conditions they present with. There are those satisfying patients who are keen to prevent reoccurrence of problems, they do their exercises, they make lifestyle changes and they want to return to even better health. On the other hand there are those patients who don’t believe they will get better, don’t follow your advice, have their pain because someone else in their family has the same pain.
What are your goals?
A big giveaway of your mindset is the goals you have. In clinic your goal may be to see as many patients as possible or to have a full list all the time. Whilst this may not necessarily be a wrong motive if that is your only motive it can be a symptom of a fixed mindset – once your list is full you are satisfied and you become fearful of making changes which may cause a reduction in your patient numbers. Even having the goal of getting everyone better can become a fixed mindset leading to fear avoidance, perhaps by keeping patients on as maintenance patients so you will not have failed as you will keep on helping them a little or maybe making excuses to put blame elsewhere if patients don’t improve instead of using it as a learning experience. On the other hand having a different mindset of putting a high amount of effort into treating your patients to the best of your ability, embracing challenges as an opportunity for development and using negative experiences as a stimulus to learning and being willing to make changes you will often see that practice growth is a natural side-effect. You will also have more enjoyment from your work as you see yourself and your practice developing.
Is it possible to change your mindset?
Yes – there are echoes of cognitive behavioural therapy in the methods used. One important aspect is to recognise your ‘fixed mindset’ traits – the thoughts that you have that are barriers to growth and address them. If you are afraid of making changes, ask yourself why. If you have become complacent ‘I’m a good practitioner, I’ll stick with what I’m good at’, challenge yourself and identify your thought processes. If you would rather bury your head in the sand than face addressing your clinical compliance and improving your practice, face up to it. Fixed mindset thoughts often start with ‘I am not..’ ‘I can’t….’ ‘I don’t…..’ ‘I haven’t….’ Growth mindsets take on responsibility, learn from setbacks, use criticism positively, take on challenges wholeheartedly. The words that we use are extremely important in the growth mindset, you engender a growth mindset in colleagues and patients through praising effort and strategy in taking on challenges and regognising failures as part of the learning process.
Consider your practice, your patients, and yourself. Start to make changes, enjoying challenges, learning new things, developing and growing – you haven’t explored how much more potential you have yet….
Join in the discussion below, let us know your thoughts on mindset and how it affects your professional life.
Dweck has written a book: Mindset: The New Psychology of Success. There are also many other resources on the internet that will inform you about mindset and how it applies in different aspects of life.