Influencing Mindsets and Motivation in Procedural Skills Learning: Two Randomized Studies

Document Type

Journal Article

Publication Date



Journal of Surgical Education








achievement goals; Motivation; Patient Care; personal differences; Simulation Training


© 2018 Association of Program Directors in Surgery Objectives: An incremental (growth) theory of intelligence (mindset), compared with an entity (fixed) mindset, has been associated with improved motivation and performance. Interventions to induce incremental beliefs have improved performance on non-surgical motor tasks. We sought to evaluate the impact of 2 brief interventions to induce incremental beliefs in the context of learning a surgical task. Design: Two randomized experiments. Participants and setting: Secondary school students participating in medical simulation-based training activities at an academic medical center. Interventions: We created 4 instructional messages intended to influence mindsets (two 60-second videos in Study 1, 2 fabricated “journal articles” in Study 2). In each study, one message emphasized that ability improves with practice (incremental); the other emphasized that ability is fixed (entity). After reviewing their randomly-assigned message, participants completed a laparoscopic cutting task as many times as they desired. Measurements included performance (product quality, self-reported task, and completion time), task persistence (repetitions), and entity beliefs. Results: Two hundred and three students completed Study 1. Postevent entity beliefs (1 = lowest, 6 = highest) were similar between groups (incremental, 2.0vs entity, 2.0; p = 0.78). Contrary to hypothesis, the incremental video group demonstrated slower time (276vs 191 seconds; p < 0.0001), lower product quality (7.2vs 3.8mm deviation; p < 0.0001), and fewer task repetitions (1.4vs 1.8; p = 0.02). In Study 2, 113 participants provided outcomes related to mindset beliefs, but only 14 provided usable performance outcomes. Postevent entity beliefs were lower in the incremental article group (1.7vs 2.4; p < 0.0001). Task time (507vs 585 seconds; p = 0.40) and quality (7.1vs 7.5mm deviation; p = 0.85) were similar between groups. Conclusions: Brief motivational interventions can influence procedural performance and motivation. We need to better understand motivation and other affective influences on procedural skills learning. Mindset theory shows promise in this regard.

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