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New York Law School ​you you I'd like if I made high-performance how does it happen and I want to argue that the way we conceptualize success the way we think about success radically shapes the behaviors that we deploy in order to achieve success in fact you can give a questionnaire to any group of people and this has been given to undergraduates primary school children fund managers Premier League footballers to probe the way they think about success how does high performance happen and broadly speaking you get two kinds of answer to that question over here people say well to be really good at my job or a dimension of skill within the job you've got to have talent you've got to have the gift you've got to have an aptitude there's no getting away from that this I want to suggest is a dominant view in Western culture and beyond and it's often called the fixed mindset over here you get a slightly different answer where people say well talent isn't irrelevant talent is a real phenomenon but in a complex world it isn't enough and they talk about hard work practice persistence resilience perseverance collaboration people over here say things like you get out what you put in I want to emphasize that this is a more subtle distinction that it sounds over here they're not saying that these ingredients are irrelevant but they think talent is dominant vice-versa over there the reason we know that is on this some versions of this questionnaire they're asked to rate the relative importance of these two things on the scale but having found out where people sit on this spectrum and what is effectively their answer to one question you can go and measure behavior and it turns out that the behavior is fundamentally different and I want to illustrate this by contrasting the behaviors of two different safety critical industries aviation and healthcare I want to argue that aviation is a growth mindset industry they hire talented people but they've realized that talent is not enough they have to learn they have to engage with the data with the opportunities that can drive them towards a better safety record so what happens when two planes almost hit in midair what sometimes called a near-miss event well both pilots voluntarily submit a report the totality of these reports are statistically analyzed to figure out what are the systemic weaknesses that are leading to these near accidents so they can make the relevant reforms to avert an accident before it's even happened and what happens if God forbid there is a crash they don't skirt around it they don't cover it up they see these accidents as precious learning opportunities every single aircraft is equipped with two almost indestructible black boxes they're actually now integrated in a single unit and colored bright orange to aid visibility but one of the boxes records the electronic information the other records how the pilot and co-pilot were interacting in the build-up to the crash so the investigation branch can go recover the black boxes from the rubble of the accident and deconstruct precisely what went wrong to ensure that the same mistake never happens again can I just give you one seminal example in the 1940s b-17 Boeing's were crashing inexplicably the industry commissioned the Yale psychologist to do an investigation and he found that the switch linked to the landing gear that's to say the wheels and the switch linked to the landing flaps were identical and side-by-side on the dashboard so under the pressure of a difficult landing snow sleet rain the pilots were pressing the wrong switch and the planes were belly-flopping onto the runway with catastrophic results he suggested adding a small wheel shape like a little tab to one of the switches and a small flap shape to the other so they now have an intuitive meaning easily identified under pressure what happened accidents of that kind disappeared overnight and almost incidentally it was a birth of ergonomics as a discipline but decades of institutional learning driven by this growth mindset this responsibility to learn in a complex world that talent isn't enough has driven an incredible safety record at the beginning of the last century aviation was one of the riskiest forms of transportation in 1912 more than half of US army pilots died in crashes in peacetime now don't about you but that doesn't sound surprising when I look at planes I think they look risky but decades of institutionalized learning has driven the accident rate to a place where in 2014 for the major airlines there was one crash for every eight point three million takeoffs I want to suggest that is a cultural and psychological achievement driven by this empowering dynamic mindset and I want to submit to you that this contrasts often quite tragically with health care which i think is in a fixed mindset place where doctors have long and expensive education they have letters after their name some of them have my words but in health care people think that talent is enough people who are at the top of the hierarchy are supposed to be clinically infallible and so when there is a mistake or a suboptimal outcome that's quite threatening so instead of saying how can we change the procedures to make sure the same mistake never happens again over here there is a tendency to become defensive to try and cover up the mistake because you don't want to look untalented or to become self justifying so doctors will often when somebody's been tragically killed so well it wasn't us it was a patient's unusual symptoms or well that's just a complication of the procedure or a classic one in health care


very well-studied it's just one of those things but if it's just one of those things where is a motivational impetus to make the reforms so that future patients are not harmed in the same way there is also a problem in health care of hi Blaine if clinicians think they're going to be sued or litigated or penalized for honest mistakes why would they be open about it the fixed mindset and high blame create very specific cultural and measurable dynamics the overall effect of which is to suppress the information that is a prerequisite for learning in a complex world and you can see the consequence of this in the hard data this is just one manifestation of it by the way preventable medical error and I want to really emphasize the first word in that formula preventable medical error these are the avoidable mistakes according to the Journal of patient safety in the United States every year in hospitals alone 400,000 people are killed that's like two jumbo jets crashing every day 9/11 happening every four days the problem is not the intellectual brilliance of the people in the industry the problem is when you're in the wrong culture the intellectual and creative energy does not go towards learning but towards self justification the statistics are also very damaging in the UK another example I would suggest of a fixed mindset culture to an extent is economics and it's a very interesting finding that the high reputation economists as measured by how often they visit TV studios make the worst predictions why is that the reason is when they make an error of prediction instead of learning from it instead of enriching and revising their theoretical assumptions they go on to television to come up those tortuous ex-post rationalizations for why they were right all along the low reputation economists can get their ego out of the way they can see the data in a clear-eyed way and therefore make the adaptations with a growth mindset that makes them better in the long term in terms of their predictive track record over here there is often a negative correlation between talent and performance over here the growth mindset liberates our talent enables us to engage with the world and to create that dynamic process of change which is a distinctive feature of all high performance institutions when Virginia Mason Hospital in C at all created a growth mindset culture was always looking to learn had talented people but they kept getting better continuously over time when a nurse gave the patient the wrong medication instead of covering up in self-justifying they did an investigation that found that there were two bottles side by side containing drugs with different pharmacological effects but with virtually the same label now you may say well shouldn't they've got the right labeling looked a bit closer but if you take too long the patient dies anyway so they change the labeling to make it clearer it's what you might call a marginal gain an incremental improvement they found that a patient came into the ward with the do not resuscitate wristband it was a wrong color because the nurse was color blind so they added text to the wristband another marginal gain they found that a clockwise turn of the doll was certain medical equipment in one half of the hospital increased some medication in the other half of the hospital it was anti-clockwise they didn't know that before because they hadn't learned so they made the ergonomic design consistent another marginal gain what happened their openness their honesty their commitment continual improvement drove the insurance liability premiums down by 74% it's now one of the safest hospitals in the world that is a culture we need in all of our hospitals but it can only happen when you get the psychological change first let me give one quick example from sport if I may Great Britain wasn't terribly good at cycling in the last century we're now the envy of the world it's not because the nation became more talented there wasn't a genetic mutation that hit the British nation it was because a coach came in Sir Dave Brailsford who said you know what we can improve we can get better we're going to create a growth mindset culture and he broke the problem of winning a bike race into all of its component parts if we can improve every single one if we've got the curiosity the inquisitiveness the tenacity to improve every single one by as little as 1% the cumulative effect could be transformative so we're going to test the bike design in the wind tunnel and he found that there were certain inefficiencies he found the way mrs. and then he made the tweaks for an aerodynamic game they changed the diet for another marginal game they figured out that some of the hotels in rural France were quite ropey so they started transporting the mattresses from stage to stage during the Tour de France for a marginal improvement in sleep quality they started to use antibacterial hand hand gel to cut down on the risk of infections now that may sound pedantic but the cumulative effect has meant that in the last century Britain never won the Tour de France but Britain has won the Tour de France Team Sky three times in the last four years they hire talented riders but it is a culture that has created this extraordinary success I want to maybe finish with the best example of all the most powerful one which is science is it not a striking thing the between the time of the ancient Greeks and the early 17th century Western science did a bit but not very much writing in 1620 the great philosopher Francis Bacon said science has done nothing in the preceding centuries to improve the material condition of mankind isn't that a curious thing that since that time since the Scientific Revolution science and technology has consistently changed our lives why this watershed was there a genetic mutation that made the human brain bigger was in an intellectual achievement I would argue that it was exclusively a psychological achievement in short the scientific community moved from there to there that's all that happened for a very long time scientists a bit like some senior doctors thought they were super talented and they had


all the answers the earth is the center of the solar system it's 6,000 years old and so on and if anyone came up with some interesting data that challenged those opinions an opportunity to improve their model of the world these people were killed this is a very extreme version of a high blame culture they don't want when Galileo is exactly the same psychological phenomenon that you see in hospitals and many other institution it when Galileo developed a telescope that you could look through and simplify a little bit verify that it is the Sun that is the center of the solar system and not the earth the existing scholars of that time instead of seeing that it's a wonderful opportunity to enrich their knowledge of the world they didn't want to look and Galileo was forced to recant his views under pain of death it was only when science moved over here and recognized that in a complex world one's intellectual capacities are not enough one has to be willing to learn to create a dynamic process of change and it was the anomalies in the existing theories where they were failing that set the stage for change in rather the same way that the accidents in aviation have created the biggest improvements to system safety that's what led from Galileo and Newton from Newton to Einstein the incredible mysteries of quantum theory and that is how sites will continue to improve because when you realize that you haven't got all the answers you start to do experiments you start looking for the data it Orient's the mind individually and collectively towards the learning experiences that always exist out there if we're open to them and that's some mindset revolution I would like to see in our schools at the moment children don't like to put their hand up in class because it might look as if they don't know the answer this a great deal of fear and defensiveness we need to liberate our children to ask questions to break the rules to find out more about this world that is so infinitely interesting and which we have to engage with thank you very much indeed you Bank Street College of Education.

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