Wednesday, December 7, 2011

Pattern Setting

The human brain loves patterns.
One of the things it does BEST is recognize and follow patterns.

Most of the time, this is a very good thing.

This strong tendency to follow patterns means that once a pattern is learned, it can be a challenge to break it. Who hasn't had a bad habit that they've struggled to change?

People talk about needing to "unlearn" something, if they've picked up a pattern that isn't what they want. You can't unlearn something, any more than you can not think about something someone tells you not to think about.

In order to break a pattern, you need to learn a new pattern.

Or, better yet, learn the right pattern in the first place.

THIS is where a lot of teaching goes wrong.
People need to learn a new skill at whatever rate they need to learn it.  Too fast, and they'll learn the wrong pattern. Too slow, and they'll lose focus.

One of the things that I've brought to learning EMS skills from the rest of my life, is knowing how to learn a physical skill. Understanding the importance of patterns.

For example, when I was learning to intubate, I practiced in a way different from those around me. Most people focused on the insertion of the tube, and pretty much ignored the rest of the process.  And it's true that learning to insert the tube correctly is important- so there is often a fairly strong desire to focus on that part of the process, over and over.

I resisted. :-)

Instead, I went through the entire process, from checking my equipment, through confirming the tube placement and securing the tube, in order, A-Z, every time.

In doing so, I recognized that one of the places in the sequence that was giving me trouble was that I'd lose track of my syringe. Inflate the cuff, and then... I don't know. Put it down? Drop it? Ignore it entirely, as I went to the next step?

So I purposely included the whereabouts of the syringe as part of my process. Inflate the cuff, pocket the syringe. Then, when I needed to know where it was later (Time to reset the exercise? Or, more importantly, bad tube placement, which needs to be corrected RFN?), I didn't have to look for it.

Once I had my sequence set, I went through it step by step, slowly.
And again.
And again.
Making sure not to miss any step, no matter how small. Start at the beginning. End at the end.

Speeding up comes of its own accord. There is never a need to try to rush, to keep it "under 30 seconds." Simply practicing the sequence correctly, with appropriate focus and attention, will make it so that the entire sequence can be done smoothly, unhesitatingly, and therefore, in as short a time as is possible to do it correctly. I'm quite sure that under stress, adrenaline will do all the speeding up as will ever be required.

Rushing during practice means skipped steps, and losing awareness.

Learning this way ensured that I fully appreciated the process, from beginning to end.  It isn't that I want to be able to do it without awareness, it's that I want to KNOW what the process is, and where I am in it. Having it be the same each time is important. Confidence is important.

How does that translate to the field?
A heck of a lot better than sporadic, aimless practice.

And then... they changed the pattern on me, no more color change ETCO2 detectors. Capnography!

Back to the drawing board... err... pattern setting.
Relearning a pattern that is substantially the same as an old pattern, with a few changes, can be a challenge.
But the process is simple.

Start at the beginning.
Go slowly.
Focus on the changes, until you don't need to.
Walk and talk it through.
Focus on accuracy, not speed.

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