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    “Don't quit on a bad day”

    Angela Duckworth spoke to a crowd of nearly 4,500 leaders in academic medicine on Saturday, November 3, during the Opening Plenary Session of Learn Serve Lead 2018: The AAMC Annual Meeting.
    Angela Duckworth spoke to a crowd of nearly 4,500 leaders in academic medicine on Saturday, November 3, during the Opening Plenary Session of Learn Serve Lead 2018: The AAMC Annual Meeting.
    Richard Greenhouse

    When the daughter of Angela Duckworth, PhD, tells her mother that her own math skills are inferior to those of her classmates, Duckworth has the perfect response.

    “Amanda, talent counts,” she says. “But effort counts twice.”

    That effort is a piece of the equation that gives someone grit — the combination of passion and perseverance that Duckworth says will largely determine your success.

    “You can’t do anything with talent unless you apply it,” Duckworth said. “You take that skill and you apply effort and you make things happen.

    Duckworth, a professor of psychology at the University of Pennsylvania and author of the New York Times best-selling book Grit, spoke to a crowd of nearly 4,500 leaders in academic medicine on Saturday, November 3, during the Opening Plenary Session of Learn Serve Lead 2018: The AAMC Annual Meeting.

    Joking with the crowd that her father — who had encouraged her to go to medical school — would be pleased to learn she was speaking now to a room full of the highest achievers in academic medicine, Duckworth went on to explain the science behind what makes someone successful and how anyone can learn to have more grit.

    On her website, Duckworth has a 10-question survey that produces a total grit score. Those who take it can agree or disagree with statements including, "I often set a goal but later choose to pursue a different one," and "I have overcome setbacks to conquer an important challenge.”

    During her talk, Duckworth took examples from sports and Hollywood to illustrate what exactly grit means.

    She played a clip from an interview of the actor and musician Will Smith, in which he talked about his own version of grit.

    “The only thing that I see that is distinctly different about me is I’m not afraid to die on a treadmill,” he said. “I will not be outworked, period.”

    Duckworth has studied determination and hard work in diverse settings, including the 2006 national spelling bee, where she documented the practices of participants leading up to the competition.

    She spoke about the importance of “deliberate practice” — actively strengthening qualities that need improving.

    “This is not the same as leisure reading,” Duckworth said, nor is it the same as being quizzed on knowledge of a topic. “It’s working on weaknesses. … Deliberate practice is not necessarily the easiest and not the most fun work that you do.”

    She presented a quote from renowned dancer Martha Graham, who summed up the difficulty of deliberate practice: “Dancing appears glamorous, easy, delightful. But the path to paradise of the achievement is not easier than any other. There is fatigue so great that the body cries, even in its sleep. There are times of complete frustration, there are daily small deaths.”

    But the capacity for hard work is only a fraction of grit, she said. Aside from deliberate practice, there are three other factors that can help someone becoming “grittier,” components that leaders of academic medical institutions can pass on to their learners, she said. Leaders can help trainees cultivate their curiosity, help them find a purpose and set goals, and encourage a “growth mindset” as opposed to a “fixed mindset” — in other words, an acknowledgement that abilities can grow over time.

    People also need endurance to avoid quitting when things become too difficult — because dropping out can result in loss of skill.

    “If you are engaged in a human skill whether it’s medical practice, leadership, or violin, you can of course drop out,” Duckworth said. “What happens to human skill when you stop doing it is it atrophies.”

    To understand grit, she said, it is important to understand what leads people to quit. No matter what the skill is, people will inevitably be tempted, at one time or another, to stop.

    In an attempt to understand this better, Duckworth went to a place where people are compelled to quit on a daily basis: The United States Military Academy at West Point.

    But it wasn’t the hard work that drove students to drop out, she found — it was the unfamiliar sense of inferiority.

    “It’s the first time in your life you’re not the shining star,” she said. “Maybe you’re even below average. And that is what makes people quit.”

    Duckworth noted that grit is “not entirely DIY.” It is crucial, she said, to have someone in your life who can push you on the tough days.

    She even experienced this herself when she wrote her book.

    “When I wrote Grit, I cried more days than I didn’t. It was so hard for me,” she said. “My husband would literally dry my tears. And make me a very large cup of coffee.

    “I did quit that book but no one here knows about that, because I only quit it to him. He’d say ‘Lovie, lovie, I totally understand if you want to quit this project on a good day but this is a bad day. You’re not quitting on a bad day.’”