The ‘Dark Side’ and ‘Bright Side’ of Personality: When Too Much Conscientiousness and Too Little Anxiety Are Detrimental with Respect to the Acquisition of Medical Knowledge and Skill

David James,J Edward Fitzgerald,Janet Yates,Anya Skatova,Eamonn Ferguson,Manabu Sakakibara,Heather Semper

doi:10.1371/journal.pone.0088606

David James, J Edward Fitzgerald + Show 5 more

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https://doi.org/10.1371/journal.pone.0088606

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Abstract

Theory suggests that personality traits evolved to have costs and benefits, with the effectiveness of a trait dependent on how these costs and benefits relate to the present circumstances. This suggests that traits that are generally viewed as positive can have a ‘dark side’ and those generally viewed as negative can have a ‘bright side’ depending on changes in context. We test this in a sample of 220 UK medical students with respect to associations between the Big 5 personality traits and learning outcomes across the 5 years of a medical degree. The medical degree offers a changing learning context from pre-clinical years (where a more methodical approach to learning is needed) to the clinical years (where more flexible learning is needed, in a more stressful context). We argue that while trait conscientiousness should enhance pre-clinical learning, it has a ‘dark side’ reducing the acquisition of knowledge in the clinical years. We also suggest that anxiety has a ‘bright side’ enhancing the acquisition of skills in the clinical years. We also explore if intelligence enhances learning across the medical degree. Using confirmatory factor analysis and structural equation modelling we show that medical skills and knowledge assessed in the pre-clinical and clinical years are psychometrically distinguishable, forming a learning ‘backbone’, whereby subsequent learning outcomes are predicted by previous ones. Consistent with our predictions conscientiousness enhanced preclinical knowledge acquisition but reduced the acquisition of clinical knowledge and anxiety enhanced the acquisition of clinical skills. We also identified a curvilinear U shaped association between Surgency (extraversion) and pre-clinical knowledge acquisition. Intelligence predicted initial clinical knowledge, and had a positive total indirect effect on clinical knowledge and clinical skill acquisition. For medical selection, this suggests that selecting students high on conscientiousness may be problematic, as it may be excluding those with some degree of moderate anxiety.

Highlights

There is a growing awareness among psychologists, economists and biologists that personality traits play an important role with respect to predicting major life outcomes, economic markers (e.g., GDP) and social capital [1,2,3,4,5]
There is a growing realisation that at a domain level, traits like conscientiousness have a ‘dark side’ [8] and traits like anxiety and other negative traits, like narcissism, have a ‘bright side’ [9,10]. This is consistent with the theoretical position that personality traits evolved with high scores manifesting both costs and benefits and that a trait’s effectiveness depends on how these costs/benefits match with the on-going context [11]
The second aim of this paper is to extend this literature on knowledge and skill acquisition in medical training [14] by examining if clinical knowledge and clinical skills are psychometrically separable and if so how these are influenced by personality, intelligence, knowledge and demographics [15]

Summary

Introduction

There is a growing awareness among psychologists, economists and biologists that personality traits play an important role with respect to predicting major life outcomes (e.g., educational attainment), economic markers (e.g., GDP) and social capital [1,2,3,4,5] Conclusions in this literature often take the form of validity generalization statements and examine associations at a general domain level of the trait ( work examining traits at the facet level is emerging), concluding that certain traits, like conscientiousness (C) are beneficial and others, like anxiety, are not [2,3,6,7]. The second aim of this paper is to extend this literature on knowledge and skill acquisition in medical training [14] by examining if clinical knowledge and clinical skills are psychometrically separable and if so how these are influenced by personality, intelligence, knowledge and demographics [15]

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