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Imagining the Inevitable – Mental Drills for Emergency Skills

October 4, 2024

Written by Shannon Markus

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Mental practice, a cognitive rehearsal technique from sports psychology, can enhance skill retention and competency in emergency medicine, particularly for high-acuity, low-frequency procedures.

From sideline to lifeline…
The article highlights the parallels between the high-pressure environments of emergency medicine and professional sports, particularly in the use of “mental practice” for skill maintenance and development. Mental practice, the cognitive rehearsal of a task without physical movement, is widely used in sports to enhance performance, especially in tasks with significant cognitive components. The article reviews evidence from sports and neuroscience to support the application of mental practice in EM, particularly for high-acuity, low-occurrence procedures where physical practice may be limited. It suggests that mental practice, combined with physical rehearsal and spaced repetition, could help emergency physicians maintain competency in critical skills. The authors propose developing mental imagery scripts tailored to EM procedures to support ongoing learning and skill retention.

However, there is very limited empirical evidence that this actually works in medicine, and some might see the application from sports to medicine as a stretch. As studies have shown that mental rehearsal can help maintain current skill levels but not increase them, the article may overemphasize its role and potentially overlook the importance of physical practice and simulation.

How will this affect my practice?
Despite its limitations, this paper makes me want to increase my utilization of mental practice. I didn’t realize that I was already doing it with my intentional mental rehearsal of the steps of crics and transvenous pacing every time I hear that one of my colleagues has recently done one (is this just me?). It doesn’t require time, money, or materials, and could potentially help maintain my skills for other rare but important procedures, including neonatal resuscitation, lateral canthotomy, needle thoracostomy, and pericardiocentesis.

Source
Mental Practice: Applying Successful Strategies in Sports to the Practice of Emergency Medicine. Ann Emerg Med. 2024 Aug;84(2):159-166. doi: 10.1016/j.annemergmed.2023.12.011. Epub 2024 Jan 18. PMID: 38244027.

What are your thoughts?