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Comment & Response
May 24/31, 2016

Pimping as a Practice in Medical Education

Author Affiliations
  • 1Division of Hospital Medicine, University of Miami Miller School of Medicine, Miami, Florida
JAMA. 2016;315(20):2235-2236. doi:10.1001/jama.2016.1568

To the Editor Drs McCarthy and McEvoy1 discussed a great divide among medical students regarding whether pimping is viewed as an important educational activity or a means to humiliate and demean. The authors correlated the manner in which pimping is conducted to the student response, but the student’s mindset may also explain the anxiety that many students experience. Mindset theory, as described by Dweck and Leggett,2 involves 2 dichotomous views with which learners view their intelligence. Learners with a “growth mindset” see their intelligence as malleable and are more likely to face challenging questions with anticipation and value the struggle to answer even if they are ultimately wrong. Learners with a “fixed mindset” see their intelligence as predetermined and their failures as proof of their limitations. Paradoxically, individuals with tremendous talent may develop a fixed mindset by virtue of having their identity consistently tied to their intelligence as opposed to their effort in learning. Learners with a fixed mindset may have exaggerated emotional responses to potentially formative situations that challenge them because of the risk of damage to their self-concept. For the gifted learner with a fixed mindset, appearing smart becomes a performance with its maintenance taking precedence to actual learning.3 Importantly, mindset is malleable and a growth mindset can be fostered by tying affirmation to intellectual effort as opposed to ability.4 The implication for pimping should be a modification toward lines of questions that emphasize thinking strategies as opposed to knowledge content, and tailoring feedback to reflect effort as opposed to simply accuracy. Viewed through the lens of mindset theory, pimping may continue to be an important tool for medical education as well as an opportunity to free some learners from unnecessary anxiety regarding their intellectual ability.

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