Exploring Workplace Learning in Surgical Practice: How Mindset and Motivation Are Associated With Self-Regulated Learning Behaviors.

Background: Workplace learning of health care professionals benefits from a cyclical process of self-regulated learning (SRL), in the phases of forethought, performance, and reflection. This SRL process can reduce safety incidents, a particular concern in high-risk situations of surgical practice. Surgeons who endorse a growth mindset and are motivated professionals may engage more actively in SRL. However, the interrelations between mindset, motivation, and SRL remain unclear. Therefore, we investigated how surgeons' mindset is associated with SRL, and whether this association is mediated by motivation. Methods: We invited surgeons of Dutch surgical associations to complete a web-based survey containing validated instruments on growth and fixed mindset, autonomous and controlled motivation, and the three phases of SRL. Data were analyzed using path analysis in a sample of 170 surgeons. Results: Growth mindset was positively associated with all three phases of SRL: forethought (β = 0.30, 95% CI [0.164, 0.441]), performance (β = 0.22, 95% CI [0.076, 0.373]), and reflection (β = 0.18, 95% CI [0.040, 0.323]). Additionally, fixed mindset was indirectly negatively associated with the forethought phase of SRL through lower autonomous motivation (β = -0.03, BC 95% CI [-0.082, -0.002]). Discussion: Surgeons holding a stronger fixed mindset reported lower levels of autonomous motivation, which were subsequently associated with less frequent use of SRL in the forethought phase. Conversely, more frequent use of SRL across its three phases was reported by surgeons holding a stronger growth mindset. These findings call for support of surgeons' growth mindset, to facilitate surgeons' roles as motivated and self-regulating learners striving for continuous performance improvement.