Teaching Towards a Culture of Growth-Oriented Learning

Rebecca Lichtin, MD

BWH Internal Medicine Residency – DGM Primary Care 
PGY1

It’s amazing the things we are expected to be instinctively good at as doctors.  As a budding intern, I am now in both the learner and the teacher’s shoes; it is hard not to feel the pressure to magically possess a deep fund of knowledge and to effortlessly be able to pass that knowledge onto the medical students with whom I work.

The Clinical Educator Teaching Course offered a fantastic survey of evidence-based teaching tactics. It certainly made me feel more comfortable in my role as a teacher, and it is a course I would highly recommend to anyone who wants to hone their abilities as a clinical educator.  However, what most impacted me most was the time we spent discussing growth-oriented learning and feedback.

In medicine, we are taught that framing is everything. The way a patient tells their story, the way a resident or attending presents a case – it biases our cognitive processes and can significantly affect outcomes. The same principal holds true for medical education. In a flipped-classroom format, we explored two opposing learning mind sets: growth-oriented and performance-oriented.  Classically, medicine drives us towards a performance-oriented frame.  It is easy to feel the need to know everything about everything, asking questions can feel like a sign of weakness, and any form of feedback leads to either defensiveness or self-doubt.  On the other hand, a growth-oriented mindset appears the ideal framing for medical learning environment – it fosters a mindset of continuous learning, where mistakes are used as an opportunity for growth and targeted feedback offers a direction for further personal growth. 

Giving a micro-teaching talk

In a room full of PGY 1's to PGY 7's from a range of medical and surgical fields, it was fascinating to discuss how different components of a growth or performance-oriented mindset framed each of our experiences with clinical education. It was fulfilling to then practice giving and receiving feedback on micro-teachings in small groups within a goal-oriented frame.

I feel incredibly fortunate to have attended this teaching courses as an intern.  The frame with which I view my personal development as a learner and teacher, and the frame I hope to set for those I work with in the future has been shifted for the better. Through these multi-disciplinary courses, and ideally similar sessions held among house-staff, I hope we can instill a culture of lifelong growth-oriented learning in generations of trainees to come.