SRFP049: From residency to practice: Mindsets of early-career family physicians

Mao Ding, BSc, MA; Oksana Babenko, PhD; Olga Szafran, MPH, MHSA; Lillian Au, MD; Sudha Koppula, MD, MClSc, CCFP, FCFP

Abstract

Context: A mastery mindset is important for physicians’ engagement in lifelong learning. In primary care, early-career physicians face unique challenges in establishing independent clinical practice following residency training. This study aims to shed light on whether family physicians graduating from a competency-based education (CBME) residency program continue to exhibit mastery-oriented mindsets and motivations that could have an impact on lifelong learning and patient care outcomes. Objective: To examine the mindsets of early-career family physicians following graduation from a CBME residency program. Design: Longitudinal, cohort, survey study of family medicine (FM) residents. Setting: One graduating FM resident cohort (2015-2017) at a large Canadian university was surveyed at three time points: 1) end of residency training, 2) one year into clinical practice, and 3) three years into clinical practice. Population Studied: Of 70 eligible FM residents, 52 (74%), 43 (61%), and 29 (41%) completed the questionnaire at each of the three data collection points respectively. Instrument: Baranik et al.’s instrument was used to measure the three types of mindsets (mastery, performance approach, performance avoidance). Each mindset was measured by 4 statements. Participants indicated their level of agreement with each statement (1=not at all agree; 10=completely agree). Main Outcome Measures: Three types of mindsets: Mastery - self-directed, intrinsic motivation towards learning; performance approach - motivation towards impression management; and performance avoidance - motivation towards ego-protection. Descriptive and multivariate analysis of variance were performed. Results: Irrespective of the time in practice, mean scores were the highest on the mastery mindset and the lowest on the performance avoidance mindset measures (P < 0.001). With time, the mastery mindset scores decreased among the cohort (P = 0.04). Conclusions: Family physicians trained in a CBME residency program continued to be mastery-oriented in the first three years of clinical practice despite a downward trend. Residency programs need to ensure graduating physicians are equipped with knowledge and tools to maintain mastery mindset throughout their professional careers.
Leave a Comment
Judy Belle Brown
jbbrown@uwo.ca 11/20/2021

Very important work - thanks!!

Jack Westfall
jwestfall@aafp.org 11/21/2021

Great poster and abstract. Thanks for sharing at NAPCRG

Gillian Bartlett
gillian.bartlett@health.missouri.edu 11/21/2021

This is certainly seems to speak for the need for a CME curriculum for first five years in practice - keep up the good work.

William R. Phillips
wphllps@uw.edu 11/21/2021

Great poster on very important question. I do not know enough about the mastery mindset science to understand the complete context. My first question: What is the evidence that the mastery mindset improves clinical practice or patient health outcomes. Second question is: Does that relationship persist over time into practice? It seems possible that the mindset most effective for learning the knowledge skills and attitudes of medical practice is not the same as the mindset needed to effectively practice and keep up with changes medical science and clinical practice. It appears that the measure of all three mindsets declined overtime, perhaps suggesting that these measures are less relevant in the practice life than the student life. I love that you've taken on the challenging of following this cohort for several years into their practice lives. We don't see nearly enough of that in medical education research. - Bill Phillips

Diane Harper
harperdi@med.umich.edu 11/22/2021

adult learning at its best ! Thank you for sharing your work with NAPCRG!

Andy Pasternak
avpiv711@sbcglobal.net 11/26/2021

I'm a bit confused at what "Mastery" means. I'm a PGY 25 and I still don't know if I've mastered anything.

Louise Acheson
11/30/2021

Interesting to be able to measure this. I don't suppose it was measured at the beginning of med school or beginning of residency, was it? thanks for presenting your work at NAPCRG.

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