High demand jobs (like fighter pilot, emergency medicine, trauma surgery, etc.) require continued exposure to the field of operations for maintenance of top level sharpness. In today’s episode we explore the phenomenon of skill decay and ways to mitigate its effects.  Guest Bio:  Joshua Russell, MD is clinician, writer, and educator.  Since completing residency training in Emergency Medicine, Dr. Russell has had a varied career including supervising PAs and NPs as a medical director for a regional Urgent Care network, contributing to various Hippo Education podcasts, and serving as the Editor-in-Chief of the Journal of Urgent Care Medicine (JUCM). Most recently, he has completed fellowship training in Hospice and Palliative Medicine at the University of Chicago Medical Center. This episode is in support of World Bicycle Relief -- delivering specially designed, locally assembled, rugged bicycles for people in need. They’ve developed an efficient, innovative, and scalable model to empower students, health workers, and entrepreneurs in rural developing regions with life-changing mobility. Donate  here.  ﻿Awake and Aware | Our 2024 Live Event Join us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots. Website: Awakeandawarebend.com 16.25 Hours Category 1 AMA CME The Flameproof CourseThis is the hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets   For full show notes of this episode and all sorts of other goodies, visit our podcast website We discuss:       Skill decay sets in rather quickly following an absence from the emergency department [03:50];  Motor skills, like riding a bike, decay much more slowly than cognitive skills [05:20];        The principles behind skill decay: cognitive load theory and cognitive overload [07:66];  Strategies for combating skill decay [09:30];  Rob’s approach after a short absence which centered around visualization [12:50];  And more.   


48. Skill Decay | How to get back in the game

We break down ideas, strategies, and tactics to help you improve your mindset, overcome burnout, excel in leadership, prioritize your well-being, get unstuck, de-stress, and thrive in your career. If you are a doctor, nurse, paramedic, medical student, physician assistant, nurse practitioner, administrator, or even tangentially related to healthcare, this show is made for you. Hosted by emergency physician and executive coach Rob Orman, MD. 

Don't just suck it up, think differently.

Education

Training

Language Courses

Higher Education

K-12

Educational Technology

Medicine

Science & Medicine

Health & Fitness

Self-Improvement

Understanding cultural context in healthcare can seem overwhelming, especially when time and resources are limited. Why should clinicians invest energy in learning about different cultures? In this pod, we break down the differences between cultural competence and cultural safety, explaining why the latter is essential for patient care. We share practical examples of how understanding cultural context can improve interactions, strategies for making patients feel seen and heard, and the pitfalls of the term ‘non-compliant’. We also touch on how these practices can make your job more rewarding and prevent burnout.  Guest Bio: Raj Sundar, MD, is a family physician and community organizer in Washington state. His podcast, Healthcare for Humans, “is dedicated to educating you on how to care for culturally diverse communities so we can be better healers.” For full show notes of this episode and all sorts of other goodies, visit our podcast website The Flameproof CourseThis is the hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets   We DiscussWhat does it mean to care for diverse communities effectively?An argument for why it’s not the patient’s job to teach clinicians about their cultureUnderstanding the cultural context of frustrating behaviorsShifting from 'why me' to 'of course'How to create a framework for cultural knowledgeWhat happened to Raj's practice when he started interviewing local Pacific Islander community leadersHow to have patients feel seen, heard, and known in the point of careCultural competence vs cultural safetyWhat does cultural safety look like?Why should I spend my energy on learning another's culture? If they've moved here, shouldn't they be the ones to assimilate into this culture?The language of noncompliance vs nonadherence vs nonjudgmentalWhy social determinants of health in documentation might be a good thingRumi's The Great Wagon
Mentioned in this episode: Out On Time Course Finishing shifts with a stack of charts to complete gets old fast. It also contributes to burnout.
Join us for 'Out on Time,' a comprehensive 10-week six-session course where you'll learn how to walk out the door unencumbered.

This is the only Out On Time that will be fully live, so don't miss out!

The course begins on August 15, 2024. Out On Time Course 1 on 1 Physician Coaching Love medicine, but the job itself leaves a lot to be desired? I work with many doctors in your shoes and help them rediscover the joy of being a physician.  Learn more about 1-on-1 coaching 4 Free Resources specifically designed to address pain points in medical practice Scripting your least favorite conversations | 
The Driveway Debrief | 
My 4 favorite documentation templates | 
The quick and dirty guide to calling consults  Free Resources Link

Why Cultural Context Matters in Patient Care and Clinician Burnout

"Kicking the can down the road" is a common behavior that manifests in various ways, from delaying difficult patient decisions to avoiding complex tasks. We explore the reasons behind on-shift procrastination and strategies for overcoming it. Our discussion includes practical steps to recognize and address decision deferral, techniques for managing aversion to some decisions, and pre-loading accountability. We also highlight the importance of building decision-making resilience and creating systematic pathways to streamline the decisional process.  For full show notes of this episode and all sorts of other goodies, visit our podcast website We Discuss:What does it mean to kick the can down the road?How procrastination shows up on a clinical shiftWhy does procrastination happen?It doesn't take much dread for can-kicking to occurAvoidance AwarenessDecisional InterrogationKicking the can because deciding will set off a cascade of more workAvoiding the infinite test of timeIdentify how, when, and where you’ll make high-level decisionsLong term guests | How is it that decisions can finally be made when the shift is over?ChunkingZero in on your critical decision pointsKicking the can at work: pick one thing and identify YOUR decision pointsPreloading accountabilityPerfectionists get caught in a tree when they're actually in a tunnel
Mentioned in this episode: Out On Time Course Finishing shifts with a stack of charts to complete gets old fast. It also contributes to burnout.
Join us for 'Out on Time,' a comprehensive 10-week six-session course where you'll learn how to walk out the door unencumbered.

This is the only Out On Time that will be fully live, so don't miss out!

The course begins on August 15, 2024. Out On Time Course 4 Free Resources specifically designed to address pain points in medical practice Scripting your least favorite conversations | 
The Driveway Debrief | 
My 4 favorite documentation templates | 
The quick and dirty guide to calling consults  Free Resources Link 1 on 1 Physician Coaching Love medicine, but the job itself leaves a lot to be desired? I work with many doctors in your shoes and help them rediscover the joy of being a physician.  Learn more about 1-on-1 coaching

Kicking The Can Down The Road | How to break up with deciding not to decide

How do you build a team in the critical first moments of a crisis? The balance between rapid response and thoughtful planning is delicate, especially when understanding what defines a crisis and acknowledging when you're in the midst of one. This conversation delves into the complexity of emergency team dynamics, emphasizing that the composition and organization of these teams are deeply influenced by their members' specific skills and contexts, with lasting implications long after the crisis has passed. We introduce 'Name, Claim, Aim'—a straightforward, three-step framework designed to streamline team organization under pressure. It's about rapid situational assessment, clear role delegation, and setting concise objectives. The discussion extends to effective leadership in high-stakes situations, including establishing command, ensuring effective communication from the start, and striking the right balance to encourage team input without compromising decisiveness. Exploring the subtleties of crisis leadership, we'll discuss the strategic balance needed for effective oversight and the practicality of 'Name, Claim, Aim' as a distilled version of more complex crisis management theories tailored for the immediacy of emergency care. The conversation will also cover the practical implementation of this framework, from team huddles to understanding the profound impact of the first few seconds on the trajectory of team success. This episode builds on episode 115 - Zero Warning | Frameworks for no notice critical patients Guest Bio: Lon Setnik, MD, is an emergency physician practicing in New Hampshire and the associate director of clinical programs at the Center for Medical Simulation. Lon is a Stimulus fan favorite. Here are some of his most popular episodes:Listening to Understand versus Listening to WinFeedback can be hard to give and harder to receive. Here are techniques to do both betterTake the Suck out of Documentation | Making the most of scribes, documenting in the room (and in front of the patient), efficient workflows
For full show notes of this episode and all sorts of other goodies, visit our podcast website We discuss:The tension between planning and actionWhat defines a crisis?How do you know when you're in a crisis?Teams are contextual in their skill setsHow you organize a team in a crisis has ripples after the event has endedThe three steps to organizing teams in a crisis: Name, Claim, AimHow to declare yourself as a team leaderModeling closed-loop communication from the first moments of team formationThe balance between being a tyrant vs an effective leader and how to avoid suppressing speaking-up behaviorsThe two pillars of Aiming what we want to achieve and who is going to do what to get us thereName, Claim, Aim needs to be fast and efficient; otherwise, people will just start getting to work without organizingBalancing the balcony and the dance floor | The impulse in crisis is to do. The leader does not have to be the primary operator, but it's hard to hold back!As a team leader, it's ideal to keep your hands off the patient during the beginning of a resuscitationDistributing decision-making across time and space, explicitly transferring authority when you need to put your cognitive load elsewhereResetting Name, Claim, Aim at the first lull in actionCrisis resource management transformed how teams function, but it has a lot of steps and can be hard to deploy in a flash. Name, Claim, Aim is a simple distillation of CRM that can be used in the point of careA graded introduction of Naming, Claiming, and AimingPracticing Name, Claim, Aim in team huddlesTaking 10 seconds for the next 10 minutes | Time is not linear and every second is not worth the same amountThe consequences of not getting the first 10 seconds rightTeam success is an emergent property
Mentioned in this episode: Out On Time Course Finishing shifts with a stack of charts to complete gets old fast. It also contributes to burnout.
Join us for 'Out on Time,' a comprehensive 10-week six-session course where you'll learn how to walk out the door unencumbered.

This is the only Out On Time that will be fully live, so don't miss out!

The course begins on August 15, 2024. Out On Time Course 4 Free Resources specifically designed to address pain points in medical practice Scripting your least favorite conversations | 
The Driveway Debrief | 
My 4 favorite documentation templates | 
The quick and dirty guide to calling consults  Free Resources Link

How to Create a Team in 10 Seconds | Why time is not linear and every second not worth the same

Will you have enough money to retire? What does that even mean? In this pod, our guest physician financial coach, Elisa Chiang, M.D. Ph.D. breaks down Trading time for money and money for timeWorking harder vs creating valueThe FIRE (Financial Independence Retire Early) movement and why it doesn't always mean living by austerity rulesThe risk of relying solely on retirement accounts to fund your post-career lifeHer biggest financial mistakeHow identity influences spending habitsIncorporating real estate into an investment portfolio
Guest Bio: Elizabeth ‘Elisa’ Chiang, M.D. Ph.D. is a board-certified ophthalmologist and fellowship-trained oculoplastic surgeon who found her way into personal finance and real estate investing during her MSTP program, aspiring for FIRE long before it became mainstream. Battling burnout from her work in a hospital system, she turned to real estate as her avenue to financial independence, complemented by her newfound passion for life coaching. With active involvement in rental properties and passive investments in syndications and real estate funds, Elisa now helps others achieve financial independence while embracing life's journey. Learn more at https://www.growyourwealthymindset.com/ For full show notes of this episode and all sorts of other goodies, visit our podcast website We discuss:Why a high income does not equate to wealthWorking harder vs creating valueOnce debt is gone, attention to money can dwindle Finding a place to start investing can be overwhelming and lead to inertiaHow to navigate a scarcity mindsetHow identity influences spending habitsMoney can buy time, but there's a catchElisa's biggest financial mistakesHow to decide if a real estate investment is a good (or bad) dealElisa’s big-picture financial strategyReal estate investing for positive cash flowIf you only think about maxing out your retirement account, you probably won't retain the same lifestyle when you stop workingBeyond real estate investing, what are other areas for investment to produce cash flow?F.I.R.E Financial Independence Retire Early | Survival, Regular, and Fat FIREHow to figure out how much FIRE money you'll need to stop workingWill my retirement funds actually last? Rate of withdrawal and sequence of returns risk Fat FIRE | Spending more in retirement than you did while working
Mentioned in this episode: 4 Free Resources specifically designed to address pain points in medical practice Scripting your least favorite conversations | 
The Driveway Debrief | 
My 4 favorite documentation templates | 
The quick and dirty guide to calling consults  Free Resources Link The Flameproof Course. Sept 10, 2024 Real-time instruction with Rob Orman, MD, and Scott Weingart, MD. 
Specific tools and strategies for anti-burnout, career longevity, and self-mastery.
From a recent Flameproof graduate, "I went from constantly dreading work and thinking of quitting to being able to enjoy shifts on a regular basis." Flameproof Course

Thinking Outside Your Retirement Account | working harder vs creating value

Phantasia Kataleptike, a lesser-known gem from Stoic philosophy, offers a transformative approach to life's challenges. This practice of 'objective representation' strips away the layers of subjective judgment that often cloud our perceptions. Imagine the power of viewing a setback not as a disaster but simply as a fact of life, a moment ripe with potential for growth. How does this shift affect our inner turmoil? The Stoics had insights that might surprise you, blending ancient wisdom with actionable strategies for modern living.  In this pod, we break down the essence of Phantasia Kataleptike and multiple methods for employing it as a tool for equanimity and de-catastrophization.  For full show notes of this episode and all sorts of other goodies, visit our podcast website The Flameproof CourseThis is the hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets   We Discuss:Defining Phantasia KataptikeAcceptance of what isA dog and a cart | Epictetus’ classic simileWhy the words we use impact us as much as (or more than) they impact othersThe lost shipThe A-hole in a JaguarOperationalziing Phantasia KataleptikeValence | Awareness of emotion and narrative The Dichotomy of ControlHow to Think Like a Roman EmperorActively de-catastrophizing Shifting from ‘what if’ to ‘why did’ to ‘so what?’ to ‘what’s next’The threat-challenge seesawWhat to do when the emperor banishes youThe counterarguments to Phantasia Kataleptike
Mentioned in this episode: 4 Free Resources specifically designed to address pain points in medical practice Scripting your least favorite conversations | 
The Driveway Debrief | 
My 4 favorite documentation templates | 
The quick and dirty guide to calling consults  Free Resources Link Out On Time Course Finishing shifts with a stack of charts to complete gets old fast. It also contributes to burnout.
Join us for 'Out on Time,' a comprehensive 10-week six-session course where you'll learn how to walk out the door unencumbered.

This is the only Out On Time that will be fully live, so don't miss out!

The course begins on August 15, 2024. Out On Time Course

48. Skill Decay | How to get back in the game

Download our free app to listen on your phone