GRIT: A MARKER OF
ATTRITION?
ARGHAVAN SALLES,
GEOFFREY L. COHEN, &
CLAUDIA MUELLER
ASSOCIATION FOR SURGICAL
EDUCATION
APRIL 23, 2013
The authors have nothing to disclose
OVERVIEW
Background
Research Design
Methods
Results
Conclusions
Limitations
Background
Research Design
Methods
Results
Conclusions
Limitations
INTRODUCTION
Residency is challenging
Attrition in general surgery is ~20%1-4
Attrition is costly to both individuals and
programs2
GRIT
Why might people of similar intelligence achieve
different outcomes?
Grit is a measure of perseverance and passion for
long-term goals5
“Whereas disappointment or boredom
signals to others that it is time to change trajectory
and cut losses, the gritty individual stays the
course.”
“. . .individuals high in grit deliberately set
for themselves extremely long-term objectives and
do not swerve from them—even in the absence of
positive feedback.”
GRIT
Controlling for intelligence, grit is an independent
predictor of achievement
Grit and IQ are not positively correlated
Those with higher grit attain higher educational
outcomes and have fewer career changes
We examined the relationship between
perseverance and attrition in a longitudinal
study
Background
Research Design
Methods
Results
Conclusions
Limitations
RESEARCH QUESTION
Is there a relationship between grit and
attrition?
-Does grit predict burnout?
-Does grit predict psychological wellbeing?
OVERVIEW OF STUDY
DESIGN
Participants: surgical residents across nine subspecialties at one academic center (N=141, 52 female;
85% response rate)
Baseline Measure
of Grit, Burnout,
and Psychological
Well-Being
Repeat Measure
of Grit, Burnout,
and Psychological
Well-Being
Background
Research Design
Methods
Results
Conclusions
Limitations
DATA COLLECTION
Participation was voluntary
Residents were surveyed during mandatory educational
meetings
Residents who were not present were emailed a survey link
Residents were surveyed again 6 months later
MEASURES
Short Grit Scale6
“Setbacks don’t discourage me.”
“I often set a goal but later choose to pursue a different one.”
Maslach Burnout Inventory7
“I feel emotionally drained from my work.”
“I feel used up at the end of the workday.”
Psychological Well-Being8
“How often were you bothered by illness, bodily disorder, aches,
pains?”
“I woke up feeling fresh and rested during the past month.”
Background
Research Design
Methods
Results
Conclusions
Limitations
RESULTS
Grit was stable within the timeframe of this study,
(r=0.71, p<.01)
Grit was predictive of burnout (B=-0.63, p<.01)
RESULTS
*p<.01
*p<.01
*p<.01
RESULTS
Grit was predictive of general psychological well-being
(B=0.58, p<.01)
Background
Research Design
Methods
Results
Conclusions
Limitations
CONCLUSIONS
Grit is stable, at least over a short time
Those with more grit tend to have better
psychological well-being as measured by the
Maslach Burnout Inventory and the Dupuy General
Psychological Well-Being Scale
Grit may serve as a proxy measure for burnout and
psychological well-being
Assessing residents’ grit may identify those who
might benefit from counseling or other social
support
Background
Research Design
Methods
Results
Conclusions
Limitations
LIMITATIONS/FUTURE
DIRECTIONS
This is only a correlational study and was only performed at
one institution
The timeframe was too short to assess attrition itself
Qualitative data would help in understanding factors that
lead to attrition
Consider administering the grit survey to residency
candidates
ACKNOWLEDGEMENTS
This research was funded by the following:
• National Center for Research Resources and the National
Center for Advancing Translational Sciences, National
Institutes of Health
• Stanford University School of Education
• Stanford University Vice Provost for Graduate Education
• Clayman Institute for Gender Research
arghavan@stanford.edu
REFERENCES
1Bergen,
P.C., Turnage, R.H., & Carrico, C.J. (1998). Gender-related attrition in a general surgery
training program. Journal of Surgical Research, 77, 59-62.
2Longo,
W.E., Seashore, J., Duffy, A., Udelsman R. (2009). Attrition of categoric general surgery
residents: Results of a 20-year audit. The American Journal of Surgery, 197, 774-778.
3Yeo,
H., Viola, K., Berg, D., Lin, Z., Nunez-Smith, M., Cammann, C., . . . & Curry, L.A. (2009). Attitudes,
training experiences, and professional expectations of US general surgery residents: A national
survey. Journal of the American Medical Association, 302(12), 1301-1308.
4Yeo,
H., Bucholz, E., Sosa, J.A., Curry, L., Lewis, F.R., Jones, A.T., . . . & Bell, R.H. (2010). A national
study of attrition in general surgery training: Which residents leave and where do they go?
Annals of Surgery, 252(3), 529-536.
5Duckworth,
A.L., Peterson, C., Matthews, M.D., & Kelly, D.R. (2007). Grit: Perseverance and passion
for long-term goals. Journal of Personality and Social Psychology, 9, 1087-1101.
6Duckworth,
A.L, & Quinn, P.D. (2009). Development and validation of the Short Grit Scale (Grit-S).
Journal of Personality Assessment, 91, 166-174.
7Maslach,
C., & Jackson, S. E. (1996). Maslach Burnout Inventory–Human Services Survey (MBI–HSS).
In C.Maslach, S. E. Jackson, &M. P. Leiter, MBI manual (3rd ed.). Mountain View, CA: CPP, Inc.
8Dupuy,
H.J. (1984). The psychological general well-being (PGWB) index. In N.K. Wenger, M.E.
Mattson, C.D. Furburg, & J. Elinson (Eds.), Assessment of quality of life in clinical trials of
cardiovascular therapies (pp. 170-183). Le Jacq Publishing.