Title: Growing a Growth Mindset: Tabletop Simulation Game-Based Learning

Author: Samantha Hopkins

Theme: Innovation & Creativity in Teaching

The mindset a doctor in training (trainee) adopts and maintains during their training can contribute significantly to how well they cope in the face of adversity, which is an inevitable part of the training experience. The implicit theory about mindset proposes two different and opposing types: a fixed versus a growth mindset. With a fixed mindset, an individual believes they are born with a certain amount of an attribute and so their potential is both pre-determined and static. With a growth mindset, an individual believes their attributes are malleable and can strengthen over time with intentional and repeated effort, adaptable learning strategies and challenge seeking. The potential benefits to adopting a growth mindset include improved academic success, increased resilience, and better mental health outcomes. All these benefits are essential to the continued wellbeing and success of trainees.

Although the benefits of a growth mindset are clear, few trainees know what a growth mindset is, the advantages of a growth mindset, and how to identify factors that enhance or hinder their ability to adopt one. It is essential for medical educators to highlight to trainees all the potential tools available to them to excel in their training. A growth mindset is not only one of those tools, but perhaps one of the sharpest ones.

Gamification (using game attributes in a non-gaming context) of a simulation can be utilized to optimize students’ learning outcomes. Mindset TSBG is a run-through of the Oncology Specialty Trainee’s on-call shift, in which she encounters various challenging scenarios throughout her day. She can adopt a fixed or a growth mindset in response to these challenges. In two teams (Fixed versus Growth Mindset Teams), the participants compete using playing cards with different numerical values to pull the Oncology Specialty Trainee’s mindset to their end of the game track, like a tug of war on her mindset. Each playing card represents an intrinsic or extrinsic factor that makes it more likely that the Oncology Specialty Trainee will adopt their team’s mindset, such as structured and continuous feedback from supervisors (extrinsic factor for growth mindset) or burnout (intrinsic factor for fixed mindset).

Prior to the game, the facilitator provides a ten-minute presentation explaining the mindset theory. The game is followed by a facilitated debrief, where the participants reflect on the simulation experience, relate mindset to their training and discuss how to overcome barriers and harness enabling factors to adopt a growth mindset.

A total of 11 participants (10 Oncology Specialty Trainees and 1 newly qualified Oncology Consultant) attended one of three sessions and completed an evaluation form. All responded strongly agree or agree to “I learnt something new that will positively contribute to my personal and professional development.”

The next step is to provide Mindset TSBG to other groups of trainees. It can be easily adapted for this purpose as only the scenario cards need to be changed to reflect different clinical settings. We are also undertaking a thematic analysis on the transcripts of the recorded debriefs for a future publication exploring factors that doctors in training perceive to enhance or hinder their ability to adopt a growth mindset.

The TSBG model lends itself to most clinical settings interested in harnessing the combined power of both game-based and simulation-based learning for a low-price tag. It is easily portable, can be set up within minutes, and can be delivered by only one faculty member. The blend of these design features provides endless opportunities for other simulation educators to adapt the model to their clinical setting.