In Part I of this blog series, I described the idea of a
“Growth Mindset” as postulated from the work of Carol Dweck with hundreds of hardworking school aged children. Her research
now supports the idea held by thousands of lifestyle coaches, gurus, and
self-help books, all touting the hidden potential of simply questioning when,
not if, one will accomplish a given goal. As I mentioned before, I am a
pragmatic realist to be redundantly redundant, but the truth of the matter is
that nearly everyone will improve with some degree of encouragement, praise and
handholding. Medical research is rife with studies examining the placebo effect
or to some degree, the effect of an intervention due almost entirely to
establishing a positive, engaging relationship between a doctor and a patient,
or a health care team and a study subject. No one will deny this fact, but many
will be quick to disregard this effect as insignificant or rather irrelevant to
the overall efficacy of the treatment being examined- examples include a drug,
surgery or psychological intervention. But rather than question and spend
millions of dollars researching various drugs and interventions to find some
minor improvement in treatment outcomes, why can’t we attack the problem from a
different angle, how can we enhance and augment the placebo effect as well as
what I call “The Human Love and Attention Effect.” Instead of trying to fix the
nearly irreparable health care system, why not just operate within its confines,
but play by different rules. This is precisely what Carol Dweck decided to do
when she entered the classrooms of underperforming children in an American
education system in desperate need of an overhaul. Her solution: don’t try and
change the curriculum, simply empower the kids to think and be challenged, for
success shouldn’t be judged by A’s on the report card, but by the willingness
of a child to pursue knowledge.
Now having
set the stage for what we hope to accomplish through our “Growth
Mindset,” the question now becomes how do we cultivate this environment for
optimal results? This is where work by Ashley Merryman and Po Bronson in
conjunction with Dweck’s research appears to become so valuable. In their landmark NY magazine article “The
Inverse Power of Praise” Merryman and Bronson outlined the prominent findings
of Dweck’s research studies, students who were praised for their “intelligence”
rather than for their “effort” on a given test or task were subsequently less
likely to later chose to engage in a more challenging and rigorous assessment,
while those praised for their “effort” were seemingly very willing to try
something new that they were told would be more challenging than their previous
task. In addition, after giving both sets of students a purposefully
challenging task to induce failure, Dweck found that when the children were
subsequently retested with the initial task, those praised for their effort
showed a marked improvement- near 30% on their scores, while those praised for
their smarts actually performed worse by nearly 20%. This finding was
astonishing considering the students all acted as their own controls from test
to test and were merely responding to researcher feedback. It is hard to argue
that in this study, the children praised for their smarts were significantly
less resilient in the face of a challenge, so much so, that they performed
worse on a previously easy task. So it appears that encouraging a “Growth
Mindset” as well crafting resilient human beings is the key to ultimately
continuing successful academic pursuits. As Merryman and Bronson point out, the
path to success is paved with actionable and sincere praise, if we are simply
told that getting an A or lowering someone’s Hgb A1c to a certain level is
successful, than it is not surprising that kids will cheat and doctors will
overmedicate and treat to get to this goal. By subtly changing the language
that we use to encourage and empower our youth or when it comes to health care,
our patients, we can likely see dramatic improvements even within a broken
system.
While I
could go on about the fascinating findings of Merryman in regards to
test-taking environments, academic competition and crowd mentality, I want to
end this post with an n=1 acknowledgement of what I have described above. I can
personally attest to being a product of tremendous hard work and dedication to
get to my current place as a medical school student. I distinctly remember
being told repeatedly how smart I was or how amazing my grades were, or how
seemingly easy I made some work appear. For me, however, this praise was really
only fuel telling me that all of my hard work and productive effort was
providing the results desired by my teachers and peers. By the sixth grade, my
parents along with my brother and I, decided we didn’t want our grades
publically shown in the class honor roll, as we believed, for one, that this
was personal, and two, that these results were not necessarily indicative of
hard work or creative thinking. Deep down I knew that I was certainly
intelligent and coming from a family full of academics with more PhD’s than I
can count, I probably have some good genes, if there is such a thing for
natural intelligence. In the end, however, I knew that in order to achieve the
goals I had set for myself, I would have to work harder than some and my “more
gifted” peers. While I can whole heartedly say that I became a persistent and
determined student, it wasn’t until my first months of Medical School that I
realized I was missing one real key ingredient: true resilience. While I
certainly showed elements of this throughout my academic pursuits, I had never
ultimately been challenged to the extent that I required dedicated cultivation
of a resilient spirit. Put another way, I didn’t realize what it meant to be
truly resilient, physically, mentally, and most important spiritually. It is
not sufficient to simply have the will-power and work ethic to pursue your
goals, one must actively cultivate resilience in all aspects of one’s life in
order to find true happiness. This is how we must educate our youth, empower
them to think creatively, praise them for their efforts in the academic
process, and build resiliency in the face of mental, physical, social, and
emotional stress. I wish I could have taken Resiliency 101 instead of
Introduction to Microeconomics, but alas this course did not exist. Hopefully,
someday we will construct an education and health care system that will promote
both the “Growth Mindset” as well as the “Resilient and Compassionate Human
Being,” but for now, we can try to operate within “Straight A” and “Stoic”
frameworks of these systems by changing our language for praise, changing our
self awareness and opening up to the idea that we don’t always have the answers.
Part III
Part III
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