Short abstract
Wolcott provides guidance on where we can start the healing process in healthcare by emphasizing an environment in which growth mindsets can flourish.
‘But how are you really doing?’ The question seems to linger in my mind—how is it that an emphatic question can cause a cascade of emotions, feelings and reactions? When I think about my answer to the question, I often defer to a car gasoline gauge that could float above my head. Is it more towards full or empty? Most days I ashamedly lean towards ‘empty’, and I question whether I have the capacity or potential to do anything about it. Gordon and colleagues, however, confirmed that most healthcare providers and educators are also depleted from the trauma of transition triggered by COVID‐19. 1
Most healthcare providers and educators are also depleted from the trauma of transition triggered by COVID‐19.
In their research, the authors illuminate the impact of COVID‐19 on provider well‐being and the broad reach of transitional experiences across our personal and professional lives. In the process, they identified three critical factors that contribute to our social and cultural well‐being—whether we feel heard, valued and supported. 1 They highlighted the weight imposed on our various support channels, the perceived stigma within our communities about asking for help and the temporary relief provided by our organisations. 1 Most importantly, they expose the challenge of how we move forward, especially as the COVID‐19 pandemic continues to fluctuate.
An area of respite may be an emphasis on our mindset. Carol Dweck's initial work on mindset suggests we have a propensity of being more fixed minded (i.e. we believe our knowledge and abilities are unmovable) or more growth minded (i.e. we believe our knowledge and abilities are malleable with effort); however, our mindset is highly domain specific and readily influenced by numerous factors. 2 We have the potential to be very growth oriented about our potential as a clinician and caregiver yet may be somewhat fixed about our creative abilities or capacity to manage our wellbeing and health. Mindset research in health professions education is still in early stages, so there is limited information about how our mindset may be related to mediating transitory experiences and the impact on our well‐being. 3
An area of respite may be an emphasis on our mindset.
Fortunately, research in non‐healthcare contexts suggests that supporting a growth mindset can be deeply impactful on individual optimism, well‐being and resiliency. Studies of children in educational settings has shown those with a growth mindset often have more optimistic thinking and are better able to welcome new challenges, especially after setbacks. 4 , 5 Those who have more of a growth mindset report a greater connection with their purpose and meaning in life with more positive beliefs about their self, greater self‐awareness and self‐efficacy in their potential. 6 And from a learning perspective, growth mindset messaging can help increase help‐seeking behaviours, which may help diminish the stigma experienced in health professions spaces. 7 A growth mindset, therefore, can serve as a protective feature, one that is replenishing and reinvigorating when present. I imagine fostering a growth mindset as a way to fine‐tune our engines and enhance our miles per gallon (or kilometres per litre depending on your location) that prevents us from depleting our tanks.
A growth mindset, therefore, can serve as a protective feature, one that is replenishing and reinvigorating when present.
However, proceed with caution. It is not entirely clear that our mindset is resistant to all adversity—it is possible that our optimism and growth perspective can be eroded and allow learned helplessness to take root, which may overpower the stamina created by our mindset. For example, those who self‐reported feelings of anxiety and/or depression often present with more fixed mindset beliefs. 8 It is unclear which factor takes precedence, and it is likely each person will differ in the protective power of the mindset compared to the level of adversity experienced. 8
So, how do we move forward? A critical point by Gordon and colleagues is the need to disrupt expectations that the responsibility of well‐being rests exclusively with the individual and that one‐size‐fits‐all approaches are effective. 1 To repeat for those in the back—individuals are not exclusively responsible for their own well‐being and resiliency. To believe otherwise treats our lived experience as existing within a vacuum. It is paramount to understand our mindset, well‐being and resilience are largely a product of our contexts and experiences, including those that may be forced upon us.
To repeat for those in the back—individuals are not exclusively responsible for their own wellbeing and resiliency.
The most important point for movement is organisational action and accountability. Yeager and Dweck identified those who can benefit most from mindset interventions are those at the intersection of vulnerability and opportunity—in other words, those who have a fixed mindset while being supported by a growth mindset environment. 2 , 4 , 9 Gordon and colleagues advocated for greater organisational attention in developing longitudinal and consistent support for providers by not assuming that temporary and impersonal solutions will suffice. 1 In addition, an organisation can benefit from adopting a growth mindset culture that values transparency, is willing to respond quickly to challenges and offers genuine apologies to personnel when an error has occurred. Research demonstrates organisational mindset shapes organisational culture, which has consequences for trust and commitment. 10 Employees who believe their organisation endorse a fixed mindset also endorse the organisational culture as less collaborative, innovative and honest. 10 Unfortunately, our review on mindset work in health professions education noted scarce organisational initiatives that promote and sustain a growth mindset environment. 3
If organisations are unable to make an immediate pivot, we can also do our best to support our peers in the process. Research has shown educators and peers can strongly influence the mindset of those around them simply by adopting a growth mindset and creating a growth mindset environment. 9 , 11 Mindset has a (trigger warning) contagion effect, so we can aim to be aware of the environments we create for others. We can support one another by sharing our lived experiences through vulnerability and the narratives of our lives—stories can be a powerful method for connection. We can also assume a lived experience in others as a way to build empathy and express support. These small, incremental shifts can help build a growth‐oriented environment from the ground up in places where the top‐down approach may be delayed; again, it is important to understand that an individual and peer shift is helpful, but it is not always sufficient and we cannot assume all responsibility for our organisational culture.
Educators and peers can strongly influence the mindset of those around them simply by adopting a growth mindset.
In summary, our well‐being can be influenced by multiple interacting factors and the complexity can be beautiful and challenging to manage. 1 The mindset our organisations support is an important factor that must be considered especially if we hope to begin our transition from trauma to healing through the enduring presence of COVID‐19. At the end of the day—we are all damaged, discouraged and defeated. We constantly cycle between feelings of fullness and emptiness in a field that was previously our source of inspiration and fulfilment. Not all contexts and experiences are created equal in their potential to deplete one individual compared to another. The best we can do is create a supportive environment, assume a lived experience and begin with a genuine question, an open mind and perhaps an authentic apology. These can be our first steps towards healing before it is too late.
CONFLICT OF INTEREST
The authors have no financial disclosures or conflicts of interest to report.
AUTHOR CONTRIBUTION
Michael Wolcott was responsible for the manuscript development in its entirety.
ETHICAL APPROVAL
Not applicable.
Wolcott MD. Damaged, discouraged and defeated? How mindset may offer hope for healing. Med Educ. 2022;56(5):477-479. doi: 10.1111/medu.14740
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