Exhibiting failure toward building a growth mindset: a qualitative study of psychiatric trainees’ experiences of a monthly reflective session

Abstract

Background

Medical trainees frequently encounter academic, clinical, and personal setbacks, yet these experiences are often concealed due to fear of judgment and stigma. Providing a structured, psychologically safe space to share failures may help normalize setbacks, reduce shame, and foster a growth mindset. This study explored psychiatric trainees’ experiences of the “Exhibition of Failure,” a monthly reflective session designed to support open discussion of failure and promote personal and professional development.

Methods

The Exhibition of Failure was held monthly over one academic year at the Department of Psychiatry, Prince of Songkla University, for psychiatry residents in training years 1–3. Using a classroom action research framework, we conducted two iterative focus groups with participating trainees as part of the reflection and improvement cycle. Verbatim transcripts were analyzed using team-based thematic analysis, with the research team iteratively coding the data and jointly refining overarching themes about trainees’ experiences and perceived impact on their learning and mindset.

Results

Nine trainees participated in the first focus group round and ten in the second. Four main themes were identified: (1) establishing a safe environment for disclosing failure, (2) receiving support and building connections, (3) cultivating self-acceptance and acceptance by peers, and (4) generating solutions and preparing for future failures. Trainees described the sessions as liberating and safe, enabling honest discussion of vulnerabilities that they would usually hide. Encouragement from peers and facilitators helped normalize failure and created a sense of mutual support. Facilitators’ willingness to share their own failures reduced trainees’ feelings of isolation and inadequacy, and strengthened their confidence. Over time, repeated participation helped residents feel more equipped to confront challenges and to develop concrete strategies for dealing with future setbacks.

Conclusions

The Exhibition of Failure appeared to provide a reflective forum where psychiatric trainees could speak more openly about failures and begin to reframe them as learning opportunities. These qualitative, interpretive findings suggest that similar structured, failure‑focused sessions may help foster self‑compassion, peer connection, and a growth‑oriented approach, although longitudinal and mixed‑method studies are needed to determine whether such effects are sustained.

Trial registration

NA.

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1186/s12909-026-09880-7.

Introduction

Throughout their medical training, medical trainees may encounter various challenges such as medical errors, disappointing examination results, and interpersonal conflicts with peers or supervisors [1–3]. These challenges often elevate stress levels and can adversely affect their performance during training. Research indicates that medical trainees who experience setbacks or make mistakes are more prone to developing performance anxiety [4, 5]. Furthermore, depression among residency trainees is a prevalent concern, influenced by both training-related factors such as long duty hours, limited time off, and negative learning environments, and personal factors including prior mental health history, sleep problems, and social circumstances [6, 7]. Negative experiences during medical training have been shown to correlate with decreased self-esteem among medical students, subsequently impacting their perceptions of their suitability for the medical profession [8].

In Thailand, psychiatric training occurs within a resource‑constrained mental health system marked by high service demands and a shortage of psychiatrists, leading to substantial workload and emotional strain for trainees [9–11]. National data show considerable rates of depression and burnout among Thai psychiatrists and psychiatry trainees, driven by work overload, limited control over schedules, and the emotional burden of clinical work [11–13]. In this context, training programs must support not only clinical competence but also trainees’ psychological wellbeing and ability to learn from difficult experiences.

In fact, individual medical trainees use different approaches to tackle the challenges over the course of their training. A growth mindset, as articulated by Carol Dweck, is the belief that one’s abilities and intelligence can be developed through dedication and hard work, rather than being fixed traits. Individuals with a growth mindset perceive challenges as opportunities for growth and embrace setbacks as essential steps in the learning process [14]. This mindset fosters resilience in the face of adversity, as individuals are more likely to persist in the face of obstacles and view failures as temporary setbacks rather than permanent limitations [15]. Moreover, cultivating a growth mindset has been linked to increased academic achievement, motivation, and overall well-being [16, 17]. By embracing a growth mindset, individuals are better equipped to navigate the complexities of life with optimism and determination, unlocking their full potential in the process.

For Thai psychiatry trainees, who manage complex clinical care amid systemic pressures and mental health stigma [11, 12], structured opportunities to discuss “failure” may be particularly valuable. Interventions that normalize mistakes as part of learning, promote reflective dialogue about challenging experiences, and explicitly frame setbacks as opportunities for growth may help trainees adopt a more adaptive stance towards failure and support their ongoing development.

Since 2021, inspired by the growth mindset theory, the Department of Psychiatry at Prince of Songkla University has implemented the ‘Exhibition of Failure’, a monthly session aimed at fostering a growth mindset [18]. This initiative involves activities such as openly sharing failures from the past month and discussing views and possible solutions for setbacks. After a year of implementation, we conducted this study with the goal of exploring: (1) psychiatric trainees’ experiences and expectations of participating in the Exhibition of Failure; and (2) their perspectives regarding failure and growth mindset.

Materials and methods

Design

Over the course of a year, we implemented the monthly sessions and subsequently conducted classroom action research (CAR), employing two rounds of focus groups with participating psychiatric residents (Year 1–3), to develop and refine the intervention. CAR is a systematic, cyclical, and reflective approach in which educators plan, implement, observe, and refine teaching and learning practices to generate practical improvements in educational settings. It involves active inquiry into classroom experiences, allowing educators to identify areas for improvement, implement changes, and assess their impact on learning outcomes. Through this iterative process, educators can make evidence-informed decisions that support continuous enhancement of teaching practices and student learning [19, 20]. In this article, we reported qualitative research data of the participants’ experiences, but the process of intervention development was reported in a separate publication [18].

The Exhibition of Failure

In our department, the Exhibition of Failure is scheduled for once a month, with flexibility based on the workload of all participants. The venue is the residency room, chosen to foster a safe, informal, and private atmosphere. Each session is led by one facilitator (WA) and supported by 2–3 co-facilitators (KA, AJ, KS), with a trainee attendance of 8–12 individuals, and typically lasts approximately 1.5–2 h. The session commences with an informal introduction and the establishment of agreements among participants to ensure privacy and confidentiality. Each participant, including the facilitators, is encouraged to openly share setbacks encountered over the past month. We invited participants to share a wide range of clinical and non-clinical mistakes during the sessions (see Table 1 for common topics discussed).The sharing proceeds sequentially, with one participant volunteering to share their failure, followed by an exchange of views and potential solutions among all participants before the next individual is selected to share their experience. This process continues until every participant has had the opportunity to share. At the conclusion of the session, participants engage in reflection, considering their learning experiences from the entire session. The development of these sessions has been described in detail in a separate publication [18].

Table 1.

Common topics discussed in the Exhibition of Failure sessions

Common topics discussed in the Exhibition of Failure sessions
• Medical errors and perceived clinical misjudgments
• Difficulties with time management and meeting responsibilities
• Receiving harsh or critical feedback from supervisors or colleagues
• Conflicts with colleagues and challenges in team dynamics
• Feelings of incompetence or not meeting expectations
• Family expectations and family conflicts
• Financial mismanagement and worries about money
• Difficulties maintaining a healthy lifestyle, including exercise and weight loss
• Feeling distressed or guilty about repeating the same mistakes
• Learning from reflection and feedback, and attempts to change subsequent behavior

Participants and recruitment

All psychiatric trainees who had attended the Exhibition of Failure sessions were invited to participate in the study. They were approached by our research assistants and provided with an information sheet detailing the study’s purpose, procedures, and potential risks and benefits. Participants were afforded ample time to review this information and make decisions regarding their involvement, ensuring their voluntariness. Written informed consent was obtained from every participant before the commencement of the study.

Data collection

As part of the CAR, we conducted two rounds of focus groups with psychiatric residents who regularly attended the Exhibition of Failure. This approach differs from conventional focus group methodology, which is primarily used as a qualitative data-collection technique to elicit participants’ views on a topic. In our study, group discussions were integrated into the action-reflection process rather than used as standalone focus groups, allowing participants’ shared experiences to inform iterative understanding and improvement of the learning activity [19–21].

Employing a team-based approach, we utilized data from the first round of focus groups to refine the existing procedures of the Exhibition of Failure. Subsequently, we conducted the following session with some amendments based on the insights gained from the initial focus groups and then proceeded to conduct the second round of focus groups.

We used a semi-structured focus group discussion guide comprising open-ended questions and prompts to stimulate group discussion among resident participants, with each focus group moderated by AJ, KS, or KA. The guide was developed specifically for this study, informed by a review of the relevant literature and iterative discussions within the research team. It explored residents’ expectations and experiences of joining the sessions, perceived facilitators and barriers to learning, perspectives on failure and related opportunities for personal growth, and suggestions for improving the Exhibition of Failure (see Supplementary file 1 for the focus group discussion guide).

Each focus group session lasted approximately 1–1.5 h. With participants’ consent, the focus groups were audio-recorded and subsequently transcribed verbatim, with anonymization measures implemented to ensure confidentiality.

Data analysis

We employed reflexive thematic analysis with a team-based approach, following the guidelines outlined by Braun and Clarke [22] and Braun and Clarke [23]. KA and WA first familiarized themselves with the transcripts and collaboratively developed an initial coding framework based on participants’ accounts. KA then applied this framework to the full dataset and iteratively refined codes, keeping an analytic diary to document coding decisions and emergent ideas. Draft codes and preliminary themes were regularly discussed with the wider research team, who reviewed selected transcripts and coded segments to check coherence and suggest revisions. Discrepancies in coding or interpretation were resolved through team discussion until consensus was reached, and the coding framework and themes were subsequently updated.

KA gradually refined the initial themes into a more coherent thematic structure, which was presented to the team for further discussion and refinement. To enhance credibility, we conducted member checking by inviting participating residents to review and comment on the preliminary themes and their interpretations; their feedback was incorporated into the final analysis. Data collection and analysis proceeded iteratively, and no substantially new themes emerged in the second round of focus groups, which we interpreted as an indication that thematic saturation had been reached for our study aims. The interviews were conducted in Thai, and transcripts were retained in Thai during analysis to preserve participants’ original language and meaning [24]; only selected excerpts were translated into English for publication.

Reflexivity

All researchers were psychiatrists with 5–10 years of experience as psychiatric instructors. KA and WA had a particular interest in growth mindset theory, while AJ and KS worked closely with the faculty’s medical education team. KA also had substantial experience in qualitative research. As educators aiming to improve psychiatric training and who strongly believed that trainees could learn from failure with appropriate feedback and guidance, we recognized that our backgrounds and commitments might have shaped how we framed questions, facilitated discussions, and interpreted the data. We therefore used ongoing reflexive discussions, documentation of analytic decisions, and member checking to consider and make transparent the influence of our perspectives on the analysis [25, 26].

Ethical considerations

This study was granted ethical approval from the Human Research Ethics Committee (HREC), Faculty of Medicine, Prince of Songkla University (REC: 66-220-3-1). Informed written consent to take part in the research was obtained prior to the commencement of the study.

Results

Participant characteristics

Across both rounds, 19 psychiatry residents took part in at least one focus group. In the first round, 9 residents participated; in the second, 10 participated, with some attending both rounds. The sample was predominantly female (16 women, 3 men) and included residents from all training years (7 first‑year, 6 s‑year, 6 third‑year). Resident participation varied between rounds due to routine clinical rotations, which meant some were off‑service while others had returned to the department.

Key themes

From the thematic analysis, four key themes were derived, aligning with the study objectives: 1) Establishing a Safe Environment for Failure Disclosure; 2) Receiving Support and Building Connections; 3) Cultivating Self-Acceptance and Acceptance by Peers; and 4) Generating Solutions and Readying for Future Failures. Each theme is elaborated through illustrative quotes presented in the main text and is further specified by a set of subthemes. These subthemes, along with concise definitions and additional illustrative details, are summarized in Table 2 to provide an overview of how trainees experienced and made sense of the Exhibition of Failure sessions.

Table 2.

Themes, subthemes, and key processes in the Exhibition of Failure sessions

Theme	Subtheme	Definition and additional illustrative details
1) Establishing a Safe Environment for Failure Disclosure	Private and informal physical environment	Sessions take place in a relaxed but private space (e.g., a residents’ room) that supports comfort and confidentiality.
	Flexible yet agreed-upon schedule	Session dates and times are negotiated to fit residents’ schedules and avoid periods of maximal fatigue.
	Empathic and active listening	Participants listen attentively, respond without judgment, and take care not to hurt others’ feelings.
	Openness in selecting topics	Residents freely choose clinical or non-clinical issues to share, including seemingly minor events, and can wait for the right moment to disclose.
	Increasing comfort over time	Repeated sessions and hearing peers’ stories gradually reduce anxiety about disclosure and increase familiarity with the process.
2) Receiving Support and Building Connections	Verbal and non-verbal expressions of understanding and concern	Supportive words, nods, and appropriate eye or physical contact signal empathy and help create a safe, reciprocal atmosphere.
	Sharing encourages deeper disclosure	Listening to others’ failures encourages residents to share their own experiences in more depth.
	Strengthening relationships and mutual support	Learning about colleagues’ struggles strengthens camaraderie and clarifies how to support one another.
	Guided discussions toward constructive directions	Facilitators intentionally steer conversations toward positive, constructive reflection rather than unstructured venting or gossip.
3) Cultivating Self-Acceptance and Acceptance by Peers	Normalizing failure	Recognizing that many problems are shared reduces guilt and embarrassment and reframes failure as a normal human experience.
	Reframing failure through shared experiences with senior clinicians	Hearing that senior staff also struggle, and that problems can improve over time, lessens the perceived seriousness of failures.
	Accepting repeated mistakes	Reassurance from peers that even repeated mistakes remain opportunities for learning helps residents accept themselves more kindly.
	Self-acceptance enabling further disclosure	Growing self-acceptance makes it easier for residents to acknowledge, disclose, and work through failures in subsequent sessions.
4) Generating Solutions and Readying for Future Failures	Reframing problems and self-perceptions	Exposure to others’ stories and strategies helps residents view problems—and themselves—in a more balanced, growth-oriented way.
	Seeking help after trying to cope alone	Residents first try to manage difficulties independently, then come to see the group as an alternative source of support that helps them practice and develop help‑seeking skills.
	Collaborative problem-solving fostering optimism	Jointly brainstorming responses to failure enhances residents’ sense of agency and optimism about managing similar situations.
	Feeling more prepared for future failures	Reflecting on past experiences and strategies helps residents feel better equipped for future mistakes.

Establishing a safe environment for failure disclosure

Participants conveyed a sense of liberation and security during the Exhibition of Failure, which facilitated the sharing of narratives involving personal vulnerabilities. The physical setting emerged as a primary consideration in facilitating the disclosure of failure. By conducting sessions in the residents’ room and allowing participants to freely utilize their physical space or have snacks with them, a secured, private, and informal environment was established for discussing sensitive topics.

“If it was in a conference room, I wouldn’t have the courage to speak out a lot, but when it was a friendly atmosphere and everyone cheered me up when I spoke, I felt like I could speak whatever is stuck in my mind” (Focus Group (FG) 1 Participant (P) 4)

“It is a stage that allows us to vent something we really don’t talk about it with other people. When there is a stage specifically for this matter like this. So we had to bring this up and tell it, so it was like saying it might make us feel better.” FG1P3

The flexible yet agreed-upon schedule for the sessions was also identified as a key factor in stimulating discussions. Some participants mentioned that if they were too physically and emotionally exhausted from their duties, they doubted the effectiveness of the sessions.

“When [the academic activities] finished quite late. And then it was tiring, exhausted, then if we do this [Exhibition of Failure] and then it felt like we used a lot of mental energy and were not able to concentrate. That is, at that time it should be moved back and forth to do in a relatively free day.” FG2P7

Empathetic listening and expression from other participants, coupled with actively listening to each other’s stories, played a crucial role in fostering open sharing among participants. This environment helped individuals feel comfortable discussing failure, recognizing it as an inherent aspect of life.

“It’s been my experience that I’ve had more courage to talk about my mistakes because, well, when I did tell them, there was a [positive] reaction from other people. It didn’t feel like it was that severe… It feels like it’s actually acceptable, so I feel like mistakes aren’t scary, but we can talk about them for others to listen.” FG2P4

“When I did not prepare a lot of stories, but there are people who seem interested in knowing what this is like… Then they asked for more and then I wanted to reveal more information. At first, I didn’t think that deeply about what it was. But then I delved into my feeling or the real thoughts about it” FG2P6

Many participants mentioned the difficulty of selecting topics to share during the sessions, particularly among those who had just joined the training and were new to the sessions. They thought that “it’s just a small story and [they] won’t dare tell it, but there [was] a process for everyone to share their failures (FG2P8),” so they picked it up even for the small story. Reflecting on privacy concerns, some participants expressed reservations, especially due to the involvement of multiple individuals. Participants also grappled with personal matters that could potentially affect others, leading them to refrain from sharing certain experiences. Additionally, some individuals opted to tackle problems independently or waited until they could manage their emotional intensity towards the failure, aiming to avoid emotional outbursts during the sessions.

“If that subject was still heavy at that time, it would stir up a lot of emotion. I would choose a story that has been around for a while, but it still hasn’t been thought out, and it doesn’t stir up that much emotion for us to be able to tell.” FG1P9

“Self-image popped up in my head. That is, if I have had an emotional outburst… With the juniors and facilitators, even if we know that they are not going to justify us, we feel that our image has already stuck in their memory.” FG2P2

However, over time, participants found themselves becoming more comfortable with the process as they listened to others’ stories and became more familiar with the sessions. They began to realize that even their seemingly insignificant issues were worth sharing. One participant reflected, “[their story was] just the little things that bother [them], … but [they thought] like even though it’s not very important, [they] wanted to share it (FG2P5).” Another participant noted that witnessing others talk about seemingly more serious topics encouraged them to share their own experiences.

This progression aligns with our aim of promoting a safe environment for participants to discuss anything that causes discomfort or a sense of failure. As one participant expressed, it’s about sharing “anything that feels like that makes us feel discomfort… [and have] a feeling of failure, or a feeling that oneself and others were not in the way we want [them] to be (FG2P3).” In fact, the topics shared by participants covered a diverse range of problems, including training or medical errors, financial strains, poor time management, inadequate health-related behaviors, and interpersonal conflicts (see Table 1 above for common topics discussed in the Exhibition of Failure sessions).

Receiving support and building connections

When disclosing their failures, participants noted that peer and facilitator encouragement played a vital role in creating a supportive atmosphere, fostering camaraderie among participants. The empathetic gestures of peer trainees and facilitators, such as encouraging words, nodding, and appropriate eye or physical contact, were employed to convey their understanding and concern for the person sharing.

“Talking like I want to send a message to let [them] know that [they’re] not the only one, we’re the same… I feel like it’s not much like unlucky or something like that.” FG2P1

“I want to encourage people to see that it’s not that serious… I don’t think it’s bad, but if you look at it you might feel that it’s a big deal. Give [them] encouragement… like if I have information that the person doesn’t know yet, I want to tell [them] about it to mainly support and give information from other perspective.” FG2P2

Due to the empathetic support of others, participants who received encouragement felt empowered to elaborate on their experiences, ideas, emotions, and needs regarding their failures. This led to a deeper understanding among the group about the failures and the individuals sharing them. Furthermore, this support helped alleviate burdens and lifted the spirits of the participants.

“[They worried if people might ask them] why you think that way. [But] I feel like it gives me the courage to share because when I see a friend tell a story easily, no one is judging anything and there’s a lot of support, so I dared to speak more.” FG1P8

Most participants reported that during the sessions, they gained insight into their colleagues. Sharing failures allowed them to learn about aspects of their colleagues’ lives that would not typically come up in daily interactions. This deeper understanding helped strengthen relationships among the trainees and provided insights into how they could support and interact with each other more effectively.

“It’s a place where I get to know other people better as well… We think that it might seem like they don’t have any problems at all… This makes me feel like these mistakes are a part of being human. Makes us feel like we understand [them] more. We got to see them from another perspective that we might not normally see from that side… Accepting each other’s various points of view.” FG1P5

Participants emphasized the importance of having a facilitator to establish and sustain a supportive environment, which guided discussions and problem-solving in positive directions. They contrasted this with informal chats among trainees, where discussions might devolve into blame and gossip, potentially exacerbating negative perceptions about failures, others, or themselves.

“Sometimes the facilitator asks for more details and then I get to say more at first, I prepared a short story… We get it without thinking too much, [but then] we dig out more things. Unlike in [the group that we do the gossips], we will interrupt each other to share our thoughts… (laughter)… It’s never finished, which means we didn’t get through the process… to look back and see yourself.” FG2P6

“As said, if there is no teacher to intervene or to ask further questions. Then we talk among ourselves. It will be more like a gossip. It won’t work because there is no positive direction.” FG2P4

Some participants expressed a desire to see the intervention implemented in different departments, acknowledging its potential benefits. However, others highlighted that “facilitator is an important factor, [and they thought] there might need some training or something for the empathic listening and supportive responses (FG2P8).” Without such preparation, there is a risk that the intervention could inadvertently lead to misunderstandings and personal conflicts among participants.

“But I think that if we have the objective that to be keep things positive. It [the mistake] is normal. Even though we don’t like each other [but we] can listen to others and realize that we actually are the same. That’s empathy, [and] we might be able to support each other.” FG2P2

Cultivating self-acceptance and acceptance by peers

Sharing not only evoked reciprocal support but also normalized failures, providing solace as participants assisted each other. This mutual exchange of support alleviated feelings of guilt and disappointment associated with failures, fostering acceptance by others even in situations participants deemed unfavorable or embarrassing.

“When I’m alone with myself, well, I feel really bad. But when I share it, other people will have other points of view, like this problem is a common problem… that other people have actually had this happen in the past as well, so I thought it would be a good idea to minimize it so that it really wasn’t that much of a failure and there would be other perspectives. I feel better, [and] that problem might have a solution.” FG1P8

“It’s an experience that friends have similar problems, but hey, why don’t I think like this?” FG1P9

Facilitators also played a significant role by sharing their own experiences of failure, which helped mitigate the gravity of setbacks and bolster participants’ self-esteem. Some trainees expressed the sentiment that “even if they’re a teacher, they would also have problems… we can have problems and mistakes, and some of our mistakes were just like theirs (FG2P5).” Hearing about facilitators’ setbacks made participants feel more at ease sharing their own experiences, perceptions, and emotions regarding their failures.

“That is, [facilitators] shared stories. I feel like when [facilitator] talked about family. Sometimes there is something similar to my family. The first thing is that I feel impressed that [facilitators] dare to share family stories too. Sometimes there are some things we don’t talk about, or we don’t feel that they are matter.” FG1P5

Many participants mentioned repeatedly making the same mistakes, yet they felt comfortable sharing their failures again because they knew others would be supportive and accepting. Self-reflection allowed individuals to see themselves through their own perspective, fostering a sense of acceptance.

“What I felt special was when I shared the same story over and over. I felt like, “Oh, it’s okay, people can make mistakes over and over again.” Like when I talked about the same topic, other people still reacted with the same attitude. There were no negative responses like why you make the mistake again and again.” FG2P6

Participants reported that the support and acceptance they received from peers and facilitators helped them accept themselves despite making mistakes or failing to meet expectations and requirements. They recognized that experiencing failure was a normal part of being human.

“I feel that there are still people who truly understands us, and our bad feelings. I feel like it [their failure] might not be that much, and you’ll get cheered up from the responses of friends and facilitators.” FG1P1

Self-acceptance further facilitated the process of sharing their failures, embodying the essence of the intervention, the ‘Exhibition of Failure.’ With each successive session, discussing failure became less distressing for most participants, as one participant expressed, “participating in the sessions was less prepared and stressful (FG1P6).”

“At first, I don’t think it started like we knew it was a normal thing. It was like a process that we repeated over and over. Then it was like when we started to dare to share more, we ended up not feeling it that much. With failure, I dare to speak up more and feel like it has become normal. It is a process that is repeated and like listening to other people and trying to tell the story over and over.” FG1P9

Generating solutions and readying for future failures

As residents attended repeated sessions, they reported a growing confidence in articulating their challenges and formulating practical solutions for future failures. Many participants noted that receiving feedback and hearing about others’ similar experiences helped shift their perceptions of their own failures. They learned to view setbacks in a different light, often minimizing their impact and alleviating negative perceptions about themselves.

“I thought that the problem we encountered was a big problem. Other people have also encountered the same problem, and I received a lot of advice [about such problem] from other people as well.” FG1P4

“I think it’s also an atmosphere thing. And then, because of the activity, it feels like there’s someone listening to the failures that we are talking about… The [negative] feeling will decrease, and then I will gradually relax.” FG1P2

Many participants reported attempting to address their failures independently, sometimes succeeding in overcoming them. However, others expressed feelings of uncertainty or helplessness towards their setbacks, prompting them to bring these challenges into the sessions in search of solutions.

“Because in the past, I might have kept everything to myself for months until the problem is insurmountable. But when we talked about it [in the sessions], it felt relieved.” FG1P3

“That is, even though I called to tell my parents, I wanted to do it myself first as well. I didn’t want to call and tell them right away when I was still very emotional. I didn’t think that the atmosphere [of the Exhibition of Failure] was not comfortable enough, [but I just] wanted to try to manage it myself. If I can’t manage it, I’ll start to feel like it might fail. But if we can manage it, we feel like it probably won’t fail anyway. Then it might be better to bring up other topics to talk about because there might be more issues.” FG2P6

However, peers and facilitators offered alternative interpretations of the failures and shared their own solutions to similar challenges, as mentioned earlier. Additionally, participants received suggestions for tactics and strategies from their peers. Through collaborative efforts, trainees and facilitators co-created solutions for each failure, fostering a sense of empowerment and optimism regarding their ability to address or improve their current situations. This process mirrors the development of a growth mindset.

“I really looked at it from a different angle [of the failure] in terms of how really bad it was. It has other good angles. At first, we had just focused on the feeling, and we didn’t see it [a good angle], but when other people pointed it out and it was true. Then I got it.” FG2P5

“It’s probably time to see things that we’ve failed at, and that we’ve done that have been successful in the past. We want to share what it was like when we failed. But when we succeed or get past that failure, we also want to share what method we used to get past it.” FG2P7

Some participants also mentioned applying the process of the ‘Exhibition of Failure’ beyond the sessions. They utilized the approach to reflect on their failures independently and in informal discussions with peers, aiming to cultivate self-acceptance regarding past failures and to prepare themselves for future challenges.

“It makes us see management, how to deal with problems or different perspectives, which makes us feel like we are prepared. That if something similar to this happened to us, it had happened before and it was similar. We might then try using a different perspective to look at the problem.” FG1P6

“Then it made us review what had failed in the past. That is, it feels like actually failure is not just [talking about] a failure in the group because actually we have to prepare [for future failure].” FG1P8

Discussion

From this study, the “Exhibition of Failures” emerged as a platform that enabled psychiatric residents to openly discuss and learn from failures. It appeared to nurture a growth mindset, with individuals approaching problems and setbacks more confidently and viewing them as challenges and opportunities for development. This is consistent with recent work describing growth mindset as a psychological resource that supports resilience, motivation, and engagement in demanding learning environments [16, 27–29].

In our study, a safe environment for sharing disappointing experiences was central to the Exhibition of Failure. Medical trainees often hesitate to acknowledge mistakes, fearing that doing so may signal incompetence and jeopardize their careers [30]. This pressure to excel may stem from the ethical imperative to minimize harm, as errors can have serious consequences, including patient mortality [31]. Our findings suggest that, beyond formal settings, failures may be better explored in private yet supportive spaces that foster open dialogue. Past research has described verbal and emotional abuse by senior staff toward students who struggle or make errors, which can create distress and discourage open discussion and learning about failure [32]. Thus, establishing a physically safe environment and cultivating supportive attitudes are crucial, and recent studies highlight that psychologically safe, growth‑mindset–supportive learning environments help maintain motivation, reduce burnout, and enable trainees to persist when facing setbacks [29, 33–35].

Our findings suggest that psychiatric trainees experienced a perceptual shift toward failure primarily through normalization. Over time, they came to view failures as a natural part of human experience. Listening to others’ stories of failure, especially those of educators, and hearing about recurrent setbacks supported this shift. Consistent with previous research, empathic responses and supportive encouragement appeared to help individuals accept disappointing events [36, 37], and regular debriefings with trained supervisors have been associated with improved mental health and academic performance [8, 38]. Normalizing setbacks fosters self‑acceptance and instils hope for overcoming adversity, and it may also help sustain motivation by reducing shame and performance anxiety and by framing effort and persistence as meaningful pathways to growth—processes associated with greater grit and task engagement in other educational settings [35, 39].

In line with growth mindset theory, our participants seemed to move beyond simply accepting their failures, actively seeking solutions and ways to address vulnerable situations. According to attribution theory, individuals who attribute mistakes solely to external factors often feel little control [40], whereas those who acknowledge their own role and capacity to improve are more likely to adopt a growth mindset [14, 15]. In our study, trainees reported a willingness to discuss failures openly and to welcome feedback, echoing prior work showing that people with a growth mindset are more inclined to seek feedback and view setbacks as learning opportunities [41, 42]. Recent conceptual work in medical education has described “growth attributes” that bring together mindset, motivation, and perseverance, suggesting that learners in supportive environments are more likely to persist toward long‑term goals and sustain motivation [39]. Our participants’ willingness to re‑engage with difficult tasks after failure may represent an early qualitative indication of these attributes, although we did not directly measure motivation or grit.

Recent scholarship in medical education also cautions that growth‑mindset language can be misapplied, for example by promoting “try harder” messages that ignore structural barriers or by fostering a “false growth mindset” that praises effort without changing assessment, workload, or learning climate [28]. Our single‑site, qualitative findings should therefore be interpreted as illustrating how a mindset‑informed activity may function within a particular context, rather than as evidence that such interventions, on their own, will produce durable changes in motivation, performance, or educational culture [27].

Lastly, our study highlights how a safe environment and the normalization of failure can support a growth mindset, with implications beyond our specific setting. In medical education, it is important for educators to recognize and address unhelpful attitudes and communication around errors and to foster a positive learning climate, which has been shown to enhance students’ learning experiences [43]. Building on emerging literature, faculty development that explicitly addresses growth mindset, motivation, and perseverance may help educators design learning experiences that encourage trainees to take on challenges and persist when progress is slow [34, 44]. Providing regular informal spaces for trainees to discuss failures, alongside opportunities for peer support and mentorship, can further cultivate self‑acceptance and foster a growth mindset [14, 45]. Our findings align with calls to embed mindset‑informed approaches within broader systems‑level efforts to promote learner well‑being and sustained motivation, rather than relying on isolated, one‑off workshops [27, 28, 34, 46].

Strengths and limitations

This study used focus groups within a CAR framework to stimulate rich discussion among trainees and to explore experiences of failure at both individual and group levels. The approach generated nuanced, practice‑oriented insights into how psychiatric residents engage with “failure” in a structured educational setting, and these insights were fed back into the ongoing cycles of planning, action, observation, and reflection. In doing so, the findings directly informed iterative adjustments to the sessions and classroom environment, strengthening both the relevance of the intervention and its alignment with trainees’ needs.

However, several limitations warrant consideration. First, the researchers also served as facilitators in the Exhibition of Failure sessions, which may have influenced what participants chose to disclose and how they framed their experiences, as well as our interpretations. Although we encouraged open dialogue and explicitly invited critical or negative views, socially desirable responding and power dynamics cannot be excluded.

Second, the study involved a relatively small, context‑specific sample from a single institution, which limits the transferability of both the intervention procedures and the findings to other training programs and settings. While core elements such as psychological safety, normalization of failure, and supportive facilitation may be relevant across postgraduate training, cultural norms around hierarchy, saving face, and discussing errors—as well as institutional policies, resources, and commitments to reflective practice—are likely to shape how similar initiatives are received and enacted in other environments [47, 48]. In this sense, the specific format, feasibility and impact of the Exhibition of Failure may differ across specialties, institutions, and cultural contexts.

Third, our conclusions about shifts toward a more growth‑oriented view of failure are based on self‑reported accounts from a single academic year and should be treated as preliminary, interpretive insights rather than evidence of transformative or sustained mindset change. Finally, successful implementation of similar sessions likely depends on facilitators and participants being oriented to the concepts of failure and growth mindset and trained in empathic, non‑judgmental communication, as emphasized by our participants.

Research and practical implications

Our findings suggest that structured opportunities to share and reflect on failures in a psychologically safe environment may help psychiatric trainees reframe mistakes and setbacks in more growth‑oriented ways, strengthen peer support, and enhance perceived readiness to face future challenges. Practically, residency programs may consider incorporating regular, facilitated forums for discussing failures that emphasize psychological safety, shared vulnerability, and constructive feedback, alongside explicit orientation to growth mindset principles.

At the same time, several practical implementation challenges warrant attention, including preparing facilitators for empathic, non‑judgmental guidance, securing institutional support, and ensuring the sustainability of such initiatives over time. Implementation literature suggests that sustained organizational backing and ongoing facilitator development are critical for maintaining reflective practices and psychologically safe learning environments [49]. Future studies using longitudinal and mixed‑method designs, including validated measures of mindset and well‑being and follow‑up beyond a single training year, would help clarify whether and how these activities contribute to enduring changes in growth mindset and related educational and mental health outcomes.

Conclusions

In summary, creating a secure and open environment for medical trainees to regularly share negative experiences, guided by supportive medical teachers, may help foster a more growth‑oriented way of understanding failure. This approach appears to support trainees in navigating setbacks during their educational journey and may contribute to resilience and professional development. Initiatives like the Exhibition of Failure may help trainees begin to view setbacks as potential opportunities for learning and growth, rather than solely as insurmountable obstacles. The guidance and support provided by medical teachers seem to play an important role in this process, offering mentorship and encouragement as trainees navigate their development. Overall, championing a culture of openness, support, and growth mindset in medical education has the potential to contribute to the formation of more competent, empathetic, and resilient practitioners.

Authors’ contributions

Conceptualization, W.A. and K.A.; Methodology, W.A. and K.A.; Formal Analysis, W.A. and K.A.; Data Curation, A.J., K.S., K.A., and W.A.; Writing – Original Draft Preparation, K.A.; Writing – Review & Editing, W.A., A.J., and K.S.; Project Administration, W.A. and K.A.; Funding Acquisition, W.A.

Funding

This work was supported by the Faculty of Medicine, Prince of Songkla University. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to their containing information that could compromise the privacy of research participants.

Declarations

Ethics approval and consent to participate

The study adhered to the principles of the Declaration of Helsinki and received ethical approval from the Human Research Ethics Committee (HREC), Faculty of Medicine, Prince of Songkla University (REC: 66-220-3-1). Written informed consent was obtained from all participants prior to study commencement.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.