By: Allison Kenneally, PharmD
In my first advanced practice pharmacy experience (APPE), I participated in a book club on Mindset: The New Psychology of Success by Carol S. Dweck, PhD. Her book describes why people with fixed mindsets (who believe abilities are fixed) are less likely to flourish in school, work, sports, and the arts than those with a growth mindset (who believe abilities can be developed). What I didn’t know starting this book was that it would change how I view learning and failure, and how it was the key to success in my APPE rotations and life as a pharmacist.
What My Fixed Mindset Looked Like and How I Changed
As a twin, I grew up in competition with my brother. My desire to appear intelligent resulted in me avoiding challenges for fear of failing, ignoring negative feedback, and hiding areas that I didn’t understand. Not only was I in a fixed mindset, but had imposter phenomenon, which is characterized by feeling inadequate despite evident success, so I was terrified to be exposed as a fraud. For example, I hid from my preceptor that I didn’t understand the purpose of certain medications in cirrhotic patients because I wanted to appear competent. I attributed previous failures to a personal deficiency, and feared new experiences that provided a risk for failure again.
If not for my preceptor, Dr. Christie Davis, I may have never transitioned to a growth mindset. During the book club, she continually steered me toward this new mindset. She knew the way feedback is provided is essential, as praising attributes, such as “you are smart” rather than my critical-thinking process could lead to a fixed mindset. When I found an important detail or answered a difficult question, she praised my process of reaching that conclusion, as knowledge and facts will change but the critical-thinking process must persist. When I was wrong, she didn’t address me with judgement or failure, but instead fostered a safe environment where failure was an opportunity to learn something new. This helped chip away my imposter phenomenon because my new growth mindset taught me that my abilities were still developing.
What My New Growth Mindset Looks Like
Now as a PGY1 resident, my growth mindset has benefitted me. For example, while on my Neonatal ICU rotation I cared for an infant with bilateral kidney dysplasia and the nephrologist wanted to start an erythropoietin stimulating agent. After looking at primary literature, I created my recommendation for darbepoetin. My preceptor praised me for taking the first steps but encouraged that I read into the safety and monitoring parameters as darbepoetin was inappropriate based on the hemoglobin and hematocrit. Instead of feeling defeat that I was wrong, I took it as a learning opportunity. By the end of my rotation, one of my strengths was detailed monitoring plans for all medication therapies.
Is There A Link Between Imposter Phenomenon and Your Mindset?
One intriguing question I have: Is there a link between imposter phenomenon and a fixed mindset? Discovering this could be vital for student success, as it could help tailor interventions directed towards reducing imposter phenomenon and fixed mindsets. Imposter phenomenon causes psychological distress, lower well-being, anxiety, and depression.1 Individuals in the fixed mindset care less about learning than performance, are less persistent with problems, and have decreased enjoyment of challenging tasks than those in a growth mindset.2 There have been postulated links1 and a study in Chinese adolescents that didn’t find a correlation,3 but this connection between imposter phenomenon and fixed mindset should be studied further.
How Can We Apply This to Our Students?
In addition to further research, what else needs to be done? The first step is helping students recognize their mindset, followed by education. Literature suggests the following methods:4,5
- Direct, didactic instruction via classroom, topic discussion, or book club with socratic questioning
- Pre- and post-tests to aid in goal-setting
- Guided self-reflection, for example writing a letter to their past or future self about their mindset or how they would “talk back” to their imposter phenomenon
- Most importantly, model the growth mindset, as students may cultivate this mindset by mimicking what they see
In the competitive world of pharmacy school, faculty and preceptors play a vital role in promoting a growth mindset in their students. This serves as a reminder there is more to developing pharmacists than just teaching content. It is about creating an environment where students can thrive and have a “safe” place to learn from their mistakes. A small book club and the right encouragement was all it took for me to start transitioning to a growth mindset and reduce imposter phenomenon. How are you cultivating a growth mindset for your students? A simple dialogue could be all that is needed to help students like me.
Dr. Jeff Cain of the University of Kentucky College of Pharmacy
- Zanchetta M, Junker S, Wolf A, et al. Overcoming the fear that haunts your success – the effectiveness of interventions for reducing the imposter phenomenon. Front Psychol. 2020;11:405.
- Nussbaum AD, Dweck CS. Defensiveness versus remediation: self‐theories and modes of self‐esteem maintenance. Pers Soc Psychol Bull. 2008;34(5):599‐612.
- Xu X. The links between imposter phenomenon and implicit theory of intelligence among Chinese adolescents. Advances in Social Science, Education and Humanities Research. 2020:408;1-10.
- Cooley JH. Larson S. Promoting a growth mindset in pharmacy educators and students. Curr Pharm Teach Learn. 2018;10:675-9.
- Wolcott MD, McLaughlin JE, Hann A, et al. A review to characterize and map the growth mindset theory in health professions education. Med Educ. 2020;00:1-11.
Allison Kenneally is a PGY1 Resident at University of Kentucky HealthCare. Educational scholarship interests include pediatrics and academia. In her free time, Allison enjoys exploring new restaurants around Lexington, hiking and biking, and spending time with her co-residents.
Pulses is a scholarly blog supported by Currents in Pharmacy Teaching and Learning