“Success is a lousy teacher. It seduces smart people into thinking they can’t lose.” -Bill Gates
“You’re Going to Lose More Often Than You Win”
In a recent New York Times op-ed, Ashley Merryman, co-author of NurtureShock: New Thinking About Children and Top Dog: The Science of Winning and Losing, rails against the use of “participation awards”. That is, awards which are given out to all children simply for showing up, regardless of performance. (I’ve got a bunch of participation awards strewn around my basement from my early Tae-Kwon Do years.) It turns out that the science is on her side; Ms. Merryman cites research that shows:
- Nonstop praise can cause students to collapse at the first sign of difficulty
- Praising a student for having innate talent can lead them to fixate more on their mistakes
- Excessive praise can create an expectation of success without real effort
In life, “you’re going to lose more often than you win, even if you’re good at something,” says Jean Twenge, author of Generation Me. “You’ve got to get used to that to keep going.”
True Grit
Incidentally, the reason this article caught my eye was because that same day, the MacArthur Foundation announced its 2013 MacArthur Fellows (journalists love calling them the “Genius Grants“, although the Foundation is loath to do so for reasons that will soon become clear). Among them was Dr. Angela Duckworth, Associate Professor of Psychology at the University of Pennsylvania, whose research focuses on grit: “sticking with things over the very long term until you master them.” Consider some of her lab’s findings:
- Among cadets at West Point, grit was a better predictor of performance in a rigorous summer training program than intelligence, leadership ability, or physical fitness.
- Among Scripps National Spelling Bee contestants, grit was a better predictor of advancing to the finals than intelligence.
- Among Penn students (the perennial test subjects of Penn researchers), grit was a better predictor of GPA than IQ. In fact, those with higher IQs actually had less grit than their peers with lower IQ.
This last point suggests an interesting phenomenon: innate talent–and the frequent early success that comes with it–may reduce the opportunities for an individual to develop his or her grit. This means two things. First, that grit is something that is malleable and can be developed over time (while theories abound over ways to maintain self-control in the short-term, evidence on ways to build grit over the long term has been much harder to find). And second: Bill Gates was right.
A Patient Grit Measure?
And of course, since I’m a health care nerd, I can’t close without connecting this all back to health care in some way. And what got me thinking was the “Grit Scale”, an 8-12 item questionnaire developed by Dr. Duckworth and colleagues that assesses your grit. It’s freely available, and you can take the 12-item version here. I haven’t heard of the Grit Scale being used in health care, but there are other questionnaires that are regularly used. The Patient Health Questionnaire (PHQ-2 and PHQ-9), for example, which has been validated for screening for depression in a primary care setting. Or the Patient Activation Measure (PAM), which gauges a patient’s knowledge, skills, and confidence in managing his or her own health.
I’m venturing into the realm of speculation, but I wonder if the Grit Scale–or some component of it incorporated into existing health questionnaires–can give us a useful measure of which patients are likely to succeed in sticking to a treatment regimen and which patients need extra support. Given that behavior change may be one of the most promising ways to address the coming chronic disease crisis, I think it’s certainly worth exploring.
In the closing minutes of her MacArthur Foundation video, Dr. Duckworth describes the next two areas of her research:
- Exploring better ways to measure grit–in particular, “objective measures that don’t require people to measure questionnaires…but looking at their behavior.”
- Evaluating interventions to improve grit.
I greatly look forward to seeing what her team finds.
Meanwhile, halfway down their FAQ page, the MacArthur Foundation explains its rationale for avoiding the term, “genius grant”:
“We avoid using the term ‘genius’ to describe MacArthur Fellows because it connotes a singular characteristic of intellectual prowess. The people we seek to support express many other important qualities: ability to transcend traditional boundaries, willingness to take risks, persistence in the face of personal and conceptual obstacles, capacity to synthesize disparate ideas and approaches.” (emphasis mine)
Maybe they should have called them “Grit Grants”.
In Sight 