Belief in the value a “growth mindset”—that a person can, through hard work and effort, improve their skills—has been in vogue in primary and secondary education for years. But physician educators at Danville, Pennsylvania-based Geisinger say the theory also perfectly suits medical education.
Growth mindset “is about this idea that everybody is capable of an effort that will move them toward greater success,” said Rebecca L. Hoffman, MD, a colon and rectal surgeon and vice chair of education and research at Geisinger. Dr. Hoffman discussed growth mindset’s benefits in medical education with Michael Furey, DO, a general surgery resident at Geisinger College of Health Sciences, at the AMA ChangeMedEd® 2025 national conference in Chicago.
Geisinger is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Dr. Hoffman added that having a growth mindset “doesn't mean that there isn't something to be said for natural ability, or that there isn't something to be said for being good at one thing over another. But it's about being able to improve and get somewhere and be resistant to this idea of failure, because you know that there's always some way you can improve with the right kind of effort.”
Explore other highlights from AMA ChangeMedEd® 2025, along with session slides, visual notetaking and more.
Two kinds of mindsets
The idea that learners can have one of two mindsets, “fixed” or “growth,” was explored by psychologist Carol Dweck in scholarly publications and her 2006 book, Mindset: The New Psychology of Success. Someone with a fixed mindset believes that achievement is due to unchangeable factors such as intelligence or natural aptitude, whereas someone with a growth mindset believes that effort, training and persistence always lead to improvement.
Dr. Hoffman said many studies have demonstrated growth mindset’s benefits—benefits that include positive effects in academic performance, wellness and resilience, and in motivation for learning.
She began to think about the psychology of learning through the lens of achievement motivation/mastery orientation as the precursor to her work in growth mindset starting in 2014, as a young resident herself. The latest project started about two years ago when Dr. Hoffman worked with research residents to create a code book for the kind of language that works best for encouraging a growth mindset.
Practically, that means Geisinger shows instructors how to give feedback incorporating language that praises progress, acknowledges effort, offers support, highlights opportunities for learning or emphasizes that deficits are only temporary. They are taught to lean heavily on the word “yet,” which reinforces the idea that failure isn’t permanent.
The rollout began with faculty and residents in surgical training, with hopes to expand to medical students of all interests, as well as non-surgical specialties. Research on the language of growth mindset at Geisinger is now moving into pediatrics and internal medicine.
“In our experience, this seems to be very broadly applicable,” she said.
Both faculty and residents—who are in a “unique position” as both a learner and an educator to medical students and younger residents, Dr. Furey said—are educated on the theory.
“At the end of a hard day, having something in your back pocket that you can comment on that still achieves that level of … really good feedback because it uses this kind of language, it can be really great,” Dr. Hoffman said, adding that the cognitive load is lessened on the educator as well. “It sets you up to think about what that next step may be.”
Fake it to make it?
When Geisinger first introduced the project, some jumped right on board, Dr. Furey said. Others weren’t immediate converts, but after trying out the techniques they came around.
“One of my co-residents started using some of the language we had taught, and he came to me and said: ‘You know, I have to tell you, I think I'm giving better feedback. The students are liking it. This stuff really works,’” he said.
Dr. Hoffman said the most common pushback has been when instructors ask her what to do when they truly don’t believe in the sentiment behind the supportive or encouraging language. Then, someone might ask her: “What if I don't feel like this person has it? What if I don't feel like they're going to get it? And how do I tell someone or relay that?”
An interesting phenomenon can take place when a less-than-enthusiastic instructor follows through with growth mindset feedback anyway, she said.
“What happens is that the learner resonates with that. They can find a more successful way to be effortful,” Dr. Hoffman said. “That's part of it: getting the skeptics to fake it till they make it and really understand that it makes a difference in how their learners feel and how they may be motivated to learn or put different effort in.”
Ultimately, though, “not all effort is created equal,” she said. “It's not just ‘everyone can do and be great at everything.’ It's about how you put the effort in—and believing in someone's effort and progress.”
