How EM Experts Think: Strategies for Pre-Shift, Arrival Ritual, Staying Focused, Managing Interruptions, Cognitive Load & Negative Emotions, Resuscitation Mindset, Post-Resuscitation Recovery

Which elements of your current pre-shift preparation contribute most to your mental clarity and performance, and what new practices might further optimize your readiness? With interruptions shown to increase task errors and decision fatigue, how can you strike a balance between being approachable to colleagues and safeguarding your focus for patient care? When confronted with a particularly challenging or emotionally charged case, what strategies have you found most effective for maintaining professionalism and clear decision-making under pressure? How often do you debrief after high-stakes scenarios, and what impact has debriefing—whether formal or informal—had on your team’s learning, emotional recovery, and future preparedness? What strategies do you use to foster open communication and ensure all team members feel empowered to provide input during high-stakes situations? How do you mentally and emotionally shift from managing a critical resuscitation to treating lower-acuity patients without compromising your focus or energy? When faced with a complex case where diagnostic clarity is elusive, how do you prioritize your next steps while maintaining confidence in your decision-making process? How can apps, personalized workflows, or EMR tools be better utilized to minimize cognitive load and enhance clinical decision-making during shifts? These are just some of the questions we pose in this 2-part podcast series on How the Experts Think with Dr. Reuben Strayer, Dr. Scott Weingart and Dr. Mike Betzner... Podcast production, sound design & editing by Anton Helman; Voice editing by Braedon Paul Written Summary and blog post by Anton Helman December, 2024 Cite this podcast as: Helman, A. Weingart, S. Betzner, M. Strayer, R. Episode 200 How EM Experts Think: Pre-Shift Preparation and Arrival Ritual, Staying Focused on Shift, Managing Interruptions, Managing Cognitive Load, Handling Negative Emotions, Resuscitation Mindset and Execution, Post-Resuscitation Recovery. Emergency Medicine Cases. December, 2024. https://emergencymedicinecases.com/how-the-em-experts-think-part-1. Accessed January 2, 2025 Résumés EM CasesPre-Shift Preparation and Arrival Ritual Effective preparation ensures you start your shift focused and ready. The chaos of the ED demands that clinicians arrive mentally and physically ready to handle high decision density, frequent interruptions, and unpredictable challenges. By developing pre-shift rituals, emergency providers can start shifts with clarity and confidence. Think of yourself as an elite athlete who requires both physical and mental training to maximize performance. Key Tips: * Mental and Physical Routines: * Ride a bike or run to work or perform a quick exercise routine to clear the mind * Take a cold shower to invigorate the body and mind * Consume protein-rich foods to sustain energy levels * Set up your workspace the same way each shift to reduce cognitive strain * Arrive early to establish a flow without interruptions * Establish a ritual to leave your personal issues at the door and mentally commit to the shift * Mental Framing: * Listen to medical podcasts or inspirational music during your commute to set a positive and engaged mindset * Practice gratitude by reflecting on the privilege of being a physician * Use positive self-talk to reinforce your readiness and confidence * Visualize success and mentally rehearse procedures and challenging s...