Mental Practice for High Acuity, Low Opportunity Procedures

Dr Jamie Riggs¹

¹University of Toronto, Toronto, Canada

Abstract:

Pre-hospital and retrieval medicine practitioners need to be comfortable with a broad range of high-acuity procedures, many of which we rarely see in practice. Maintaining competence and confidence in these procedures is difficult due to limitations on training time, resources, and clinical opportunities. Here I introduce the concept of mental practice, and explore how we can use it to improve our performance of such high-acuity, low opportunity procedures. By the end of this presentation, those in attendance will be able to:

1. Define mental practice and how it can apply to pre-hospital and retrieval medicine
2. Identify procedures and clinical situations where mental practice may improve performance
3. Develop their own mental practice script(s)

Mental practice, defined as the “cognitive rehearsal of a skill in the absence of overt physical movement”, has been shown to be as effective as physical practice in several areas, including athletics, music, team-based resuscitation, and surgical skill acquisition.

We will describe how to develop tools for effective mental practice using scripts. Using semi-structured interviews with people experienced in performing a bougie-assisted cricothyrotomy, a rare but lifesaving procedure, we developed a script to facilitate effective mental practice. We will use this example to provide a framework for anyone to develop their own mental practice script to enhance their performance in rare procedures. We will also explore how to use mental practice to maintain competence in rare procedures, and how such mental practice may help reduce stress and improve performance in high pressure situations.

Biographies:

Dr Jamie Riggs is a resident in emergency medicine at the University of Toronto, and currently a fellow with Auckland HEMS. Clinical interests lie in trauma, prehospital medicine and medical education. Jamie’s research interests are in human factors and simulation, and he has shared his research on mental practice and HALO procedures nationally and internationally. Outside of work he spends his time on a variety of bikes or searching for the perfect cup of coffee.