After Podcast 211 with Anders Ericsson, I promised my thoughts on deliberate practice and expertise…
But first, something sad:
Bob Wears has died
Read a wonderful obituary
Reality behind 10,000
let's think about that… Innate non-physical talent doesn't really matter that much. Can't alter your height, but can alter your brain
Driving a car for 10000 hours doesn't make you an expert driver. We do exactly zero hours of deliberate practice. We have no coach.
Procedures
My fellows filming themselves
Microskill breakdown
Why Purposeful much less deliberate practice is tough in Emergency Medicine
Experts vs. Experts @ Teaching
EM & Crit Care Lacks Feedback
Mental Representations/Mental Models
experts have very good memory of what has happened
verbalize thinking
sob low sat tachypenic
pt looks bad, start thinking airway
SCAPE, mental status good, pt will respond to BIPAP
CHF
Surgical Scripts Book Abernathy & Hamm
Mental Models Article from Michael Simmons
Shadowboxing
watch stimuli
commit to a course
listen to the expert
Thought Experiment on Computer Based Ratings
Are Experts Actually Experts?
How to Create Purposeful/Deliberate
right time of day
plenty of sleep
deliberate practice is deep work
patience 15-20 minutes, not 4-5 hours at least at first
need a coach or if you can't find an expert performer and ask them how they got good
good teacher builds representations
Mental practice
cric training
given videos
smacc airway workshop
no place your hands here
The Diamond Age
We need a primer
Update:
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Professor
Nassau University Medical Center
No conflicts of interest (coi).
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Scott, As I told Mike, after hearing podcast #211, I had to go get this book and see exactly what was inside. Was there going to be an epiphany? I took several notes and highlighted several passages. I truly did find it interesting and how could you not want to grow or be inspired after the read. Deliberate practice truly does have it stake in skills and overall in expertise. This could come about several ways as you had mentioned with utilizing video, utilizing purposeful practice techniques, and ultimately you need that “expert” to provide coaching and feedback. What I… Read more »
thanks for those comments, Jeremy
This podcast is probably the best thing I’ve listened to in a very long time. Anyone who passed over it because it was not a “medical podcast” is truly missing out. Don’t get me wrong, the medical content on EMCrit is of course amazing, but it’s episodes like this that keep me listening week after week. I applied this theory of micro skills immediately after listening. I started with central lines because it seemed like the most obvious place for improvement. After ~50 lines I consider myself to be very good and relatively efficient. But I wasn’t great. And I… Read more »
fantastic stuff. the way it applies to med knowledge is through the development of illness scripts and treatment scripts. Good place to start would be
https://www.amazon.com/How-Doctors-Think-Jerome-Groopman/dp/B0029LHWKY