The Trusted Senior: How Attendings and Residents Can Co-Create Success

Growth mindset, the belief that one's abilities are changeable, is a valued attribute in medical education. Developing a growth mindset is also in direct tension with systems that evaluate performance, such as in medical training. The senior resident role is a microcosm of this tension because it is a pivotal transition time from training to attending. A recently updated framework for clinical competency places trusted as the highest goal for trainees, defined as self-awareness that is bolstered by humility, integrity, and reliability. We provide strategies for both the senior and attending to foster a senior's goal of trusted status. This requires intentional work by both the senior and attending, but we posit that the attending role is paramount in first creating a learning environment that celebrates a growth mindset. The strategies work to promote self-reflection, active problem solving, and exploration of the gray areas of medical decision making to maximize the learning experience.