#KeyLIMEPodcast 247: Grit? Growth Mindset? Just give me the answer.

Failure: not generally seen as a positive thing – particularly in the field of medicine, full of bright, successful, high achievers. However, the authors of this week’s article set out to find its positive effects by examining the concept of productive failure. Their RCT compared the effectiveness of productive failure vs. direct instruction: examining  how it affected acquisition and application of a novel concept, as well as future learning.

What do you think they found?

See below or listen here for further details and the results!

KeyLIME Session 247

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Steenhof et. al. 2019. Productive failure as an instructional approach to promote future learning. Advances in Health Sciences Educcation. Theory and Practice. 24(4):739-749.


Jon Sherbino (@sherbino)


I talk a good game. In theory I know that effortful learning is more effective. But in practice I’m lazy. Example A: my recent flash card program – a process that I adopted after lecturing on retrieval practice and realizing I was a hypocrite – is falling apart. At first reviewing flash cards of physiology, toxicology, infectious disease was fun, likely because I was getting more cards right than wrong. Lately I have been mired in endocrinology and epidemiology. I no longer even have the desire to flip the (electronic) card for the answer. Rather, I simply skip. I mean is thyroid disease or receiver operator curves that important??

Ok. Where is the long digression taking us. As frequently as I promote the evidence for retrieval practice, I also believe in effortful learning or the most recent iteration of this concept – the growth mindset: that ability is a result of practice and not an innate ability.

I worry that the selective pressure in the health professions has led to cohorts of learners and faculty who have rarely (if ever failed) experienced challenges or set backs in learning. There are three elements at play: high performing learners, the value of effortful learning, and the ambiguous/complex problems of authentic practice that require novel solutions. Can productive failure – guided instruction in problem solving that teaches general principles, while allowing learners to fail in their initial, specific solutions, help learners acquire the skills for future practice in a psychologically safe manner? Read on.


“…the objectives of the current study were (a) to compare the effectiveness of productive failure relative to direct instruction on acquisition and application of a novel concept, and (b) to compare the effectiveness of productive failure relative to direct instruction on an assessment which tests students’ preparation for future learning.”

Key Points on the Methods

This was a RCT.

All first year doctor of pharmacy students from a single school were invited to participate by email.

The study involved a 2 hour session with a $30 honorarium. (Note the time : $$ ratio #meded researchers)

40 minute learning phase

  • Direct instruction group was provided a standard explanation and a standard solution for a physiology problem
  • Productive failure group was provided a standard explanation and the necessary variables to develop their own solution for a physiology problem

10 minute practice phase

  • Both groups worked through 10 MCQ questions with the productive failure group exposed (for the first time) to the standard solution

40 minute assessment phase

  • Both groups answered 16 MCQ that tested recall of knowledge, application of knowledge to standard cases and application of knowledge to novel cases.

There was no washout between these consecutive phases. The timing between phases was strictly enforced and was not participant dependent.

Key Outcomes

n = 41 (18%)

**During the learning phase none of the participants in the productive failure group were able to generate a correct solution for the physiology problem.

There was no difference in recall of knowledge and application of knowledge to standard cases. The productive failure group performed better (0.75 v 0.67). Using analysis of covariance demonstrated that this difference was significant. The effect size was moderate (Cohen’s d = 0.69).

Key Conclusions

The authors conclude…

“The results of this study emphasize the value of struggle during learning and support the theory that problem solving prior to instruction may be more effective than direct instruction when preparing novices to learn new knowledge in a related domain. Teaching strategies that maximize performance in the short term may not necessarily be the ones that maximize learning in the longer term. This study supports the idea that engaging students in solving problems that are beyond their abilities can be a productive exercise in failure.”

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