Sunday, August 9, 2015

Scientist vs. Caveman: Why I can't be trained

James Yeager has an excellent video that explains everything I would like to say today.


He is of course talking about a gunfight, but also I show this video to people new to emergency medical services to help them understand the reactions they will face during their first couple/few years in the business. The stress is not nearly as intense as a deadly fight, but it is abnormal enough to cause people to freeze, and to fall back onto their training. 
"You are too smart for me to teach you. That's not a compliment."
- James Yeager
You will resort to your training. If you did not train, you will resort to your lack of training. This is why you must practice systematic dichotomies for troubleshooting medical emergencies. You will not be able to use your higher brain to its fullest ability until you have practiced working under stress for several years, and even then it may not work as well as you wish it would. That's it! Don't argue.

This underscores the importance of apprenticeship. EMS providers do not step out of school ready to work in the field. Apprenticeship eases the new provider into the stress they will face, and allows them to acclimate into using their higher brain. Agencies that do not or cannot place their new EMTs into apprenticeships with very experienced providers will suffer. 

There is no way to accurately replicate the stress of a high intensity situation where your or your patient's life is in jeopardy. The best you can do is to practice as consistently and as much as possible in the hope that your caveman brain gets it. So when your instructor makes you start an IV on a piece of oxygen tubing taped to a table 300 times, or intubate a mannequin 100 times, or your agency makes you practice these boring skills once a quarter, shut the hell up! Stop trying to be so smart, because you're not. None of us are. 


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