Today, I interview Mike Lauria on the concepts of toughness and resilience.
The Rationale of Selection Courses/Indoc
80-90% Attrition for the PJs Indoc
One of the things that people, I think, find distasteful about selection programs in the civilian word is that it uncovers fundamental weaknesses and shortfalls. This is no commentary on the intrinsic worth of the individual. It doesn't necessarily mean that they are smart or dumb. But it is indicative of some inability or failure to meet a standard. While it is hard for many civilians (and military members for that matter) to swallow, perhaps not everyone is cut out for a particular discipline. Maybe we shouldn't be forcing training, pushing people along, coddling individuals to maintain the outward appearance that a program is “successful” if an individual can't make it through some sort of initial pipeline. Perhaps a benefit of selection is making sure that the right people are there to begin with and the individuals that were simply not made for it are directed elsewhere.
I lost the source for the above quote, but I think it describes the process well. If anyone has it, please send me the attribution.
Builds an innate Espirit de Corps and a common thread of self and team-reliance
Residency as the Pipeline
Should we have culmination tests and exercises at the end of residency?
Stress Inoculation/Cognitive Tempering
Mike discusses four stages to do this right:
- Conceptualization-give a background of stress responses, why they happen, and what to expect.
- Train and educate on the skills and tasks we want to see performed under stress. Then give the tools to deal with the expected stress. The latter is where we may be failing our learners
- Do a dry run to train in simulation without added stressors
- Run the same training with stress inoculation
How can we make #4 work in EM/CCM?
Sound, distractions, equipment failures, and deliberate poor communications
So what tools can we offer for #2?
Mike offers an acronym: Beat The Stress, Fool
- B is for Breathe. Breathe tactically. See the On Combat Podcast for a description (and there is an app for that too: Tactical Breather App)
- T is for Talk. Self Talk. Positive self-talk is used by athletes and any elite performance group.
- S is for See. Visualization. Visualize yourself performing the task exactly how you want to see it done.
- F is for Focus. A key word to activate the state you want. Mike has chosen “focus” as his word. We then had a brief discussion of the book, the Art of Learning by Josh Waitzkin. The author creates an entire relaxation and mindset ritual that eventually gets boiled down to a key word or short set of actions. You'll be hearing more about this book on the podcast.
When Mike asked if I had anything to add to this excellent set of tools, I discussed this TED Video by Dr. Amy Cuddy:
So maybe…Beat the Stress, Foolish Padawan with a P for posture??
Too Much Macho Militarization?
Mike posted a Youtube Video Addressing this question
Cliff Reid's Resus.me Post on Self-Defense
During the intro, I discussed the contentious self-defense post on resus.me
First10EM Magnum Opus on Performance Under Pressure
Some Anesthesia programs are already doing a modified interview process–thanks Lauren!
Here is the article: (non-tech-skills-interview-process)
Now on to the Podcast…
- EMCrit 289 – Ketamine Only Intubation Paper with Brian Driver - January 12, 2021
- EMCrit 288 – Neurogenic Shock & Should we be Using Vasopressors for Hemorrhagic Shock? - December 29, 2020
- EMCrit 287 – Thoracotomy Masterclass with Dennis Kim - December 10, 2020