— LETTERS TO THE EDITOR —

Response to “Mistakes”

Elizabeth C. Halloran, PhD

Fam Med. 2022;54(4):317-317.

DOI: 10.22454/FamMed.2022.534710

To the Editor:

I applaud Dr Saultz for exemplifying a growth mindset1 in his powerful editorial about health care system mistakes made during the pandemic and the need to discuss them.2 A growth mindset is crucial in constructively moving forward from failures. It is based on the idea that efforts matter and that everyone can grow through experiences. Growth mindsets focus on how to improve skills; they do not believe abilities are fixed or set. They are behind successful outcomes in a variety of fields.1

Dr Saultz delineates multiple areas of inquiry needing deliberation in order to learn from our mistakes in handling this pandemic. He also points out the problems arising from blaming others. Those with a growth mindset face their failures and become curious about them rather than blaming others, shaming themselves, or burying one’s head in the sand. An interest in learning is what sets apart those with a growth mindset even when that learning requires difficult work.

The health care system has benefitted from exploring medical errors, but there is more work to do and cultural change is needed.3 Furthermore, others have argued that adopting a growth mindset would bring positive cultural changes in medical education.4 Family physician educators can facilitate the development of a growth mindset in students and residents. Two strategies go a long way: (1) challenging students and residents at a level that stretches them without breaking them, and (2) supporting learning without judgment or fear of failure.

Family physician educators with a growth mindset have high expectations of trainees while supporting their well-being in order to thrive. While high standards remain important to deliver quality care, it is important to acknowledge human limitations. For example, fatigue mitigation strategies address vulnerabilities associated with sleep deprivation. Furthermore, growth minded educators do not use disapproval as a primary pedagogical strategy. They understand that trainees are prone to error and provide tools, not humiliation, in order to close knowledge and practice gaps in trainees. Errors are expected and seen as opportunities to learn while under supervision.

In addition to improving educational outcomes,1 a growth mindset may also be important in terms of the psychological consequences of medical errors. Family physicians who believe that medical errors mean they are bad doctors will struggle compared to those who see mistakes as inevitable learning experiences not to be repeated as Dr Saultz did early in his career. Without a growth mindset, the association between physician burnout, depression, and medical errors5 may intensify. Family physicians using a growth mindset will learn from mistakes, deliver better care over time, and likely have greater work satisfaction.

Dr Saultz has outlined the collective failures during the pandemic in need of collective corrections. It will take collaboration, patience, and persistence to address them. Above all, it will take an eagerness to improve in multiple areas. Who’s ready to adopt a growth mindset to meet these extraordinary challenges?

References

  1. Dweck CS. Mindset: The New Psychology of Success. New York: Ballantine; 2006.
  2. Saultz J. Mistakes. Fam Med. 2021;53(10):833-834. doi:10.22454/FamMed.2021.623606
  3. Karande S, Marraro GA, Spada C. Minimizing medical errors to improve patient safety: an essential mission ahead. J Postgrad Med. 2021;67(1):1-3. doi:10.4103/jpgm.JPGM_1376_20
  4. Theard MA, Marr MC, Harrison R. The growth mindset for changing medical education culture. EClinicalMedicine. 2021;37:100972. doi:10.1016/j.eclinm.2021.100972
  5. Menon NK, Shanafelt TD, Sinsky CA, et al. Association of physician burnout with suicidal ideation and medical errors. JAMA Netw Open. 2020;3(12):e2028780. doi:10.1001/jamanetworkopen.2020.28780

Lead Author

Elizabeth C. Halloran, PhD

Affiliations: Mercy Health St. Vincent Family Medicine Residency Program, Toledo, OH

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Saultz J. Mistakes. Fam Med. 2021;53(10):833-834. doi:10.22454/FamMed.2021.623606

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