10,000 hours and medicine

[andersenpa]

10,000 hours of deliberate applied practice has been suggested as a magical threshold to expertise.

This has been deliberated since the book "Outliers" came out. I read this piece from Outside magazine and got me thinking about it again.

 

http://www.outsideonline.com/fitness/bodywork/the-fit-list/The-Magic-Number-of-Training.html?utm_source=twitter&utm_medium=social&utm_campaign=tweet

 

True for athletic training, true for us as well perhaps.

 

Since we often compare the total hours for PA vs MD training it's worth mentioning that "hours" are not apples:apples for providers. I am not ready to make the leap about PA training = MD training since it's really an undebatable topic with the information we have now, but this certainly adds a spin on the topic to suggest that the hallowed amount of time spent in training may not be the primary determinant of competency.

[EMEDPA]

I think the 10,000 hrs is accurate if you are allowed access to the full scope of a specialty. 10,000 hrs of fast track does not make you an em doc, it makes you a master of the minor complaint.

[andersenpa]

...it makes you a master of the minor complaint.

 

Sorry couldn't help myself.....

[andersenpa]

I think the 10,000 hrs is accurate if you are allowed access to the full scope of a specialty. 10,000 hrs of fast track does not make you an em doc, it makes you a master of the minor complaint.

Assuming full scope, my guess is 10,000 is not needed for everyone. Some more, some less. It's how many SDs that swings left and right that makes the topic compelling!

[EMEDPA]

an expert is:

1.someone who knows more and more about less and less until they know everything about nothing (as opposed to a generalist who knows nothing about everything)

2. someone who has made every possible mistake in a given field

[andersenpa]

Reminds me of that Edison quote (paraphrase)-

"I haven't failed, I've found out 10,000 ways that it won't work"

 

Again, the magic #10,000!!!!

[EMEDPA]

Assuming full scope, my guess is 10,000 is not needed for everyone. Some more, some less. It's how many SDs that swings left and right that makes the topic compelling!

sure, lots of variables here- access to training and adequate #s, etc.

it's argued ad nauseum how many pts/yr must go through an e.d. to make it enough volume to host a residency and then further what the volume of trauma, MIs, CVAs, etc has to be.

[andersenpa]

sure, lots of variables here- access to training and adequate #s, etc.

it's argued ad nauseum how many pts/yr must go through an e.d. to make it enough volume to host a residency and then further what the volume of trauma, MIs, CVAs, etc has to be.

Interesting since I am working with my hospital's credentials committee on our privileging process.

Our group has decided strongly against setting benchmarks for case volume UNLESS it has been decidedly shown in the literature or white papers that there is a proven benefit.

There is data for high volume procedures like cardiac cath, and I bet things like colonoscopies (?), but it tends to get applied to EVERYTHING.

[Guest JMPA]

so approximately 5 years of 40hr work weeks in a given field. yeah that sounds about right, freedom after five could be the new PA motto

[EMEDPA]

Interesting since I am working with my hospital's credentials committee on our privileging process.

Our group has decided strongly against setting benchmarks for case volume UNLESS it has been decidedly shown in the literature or white papers that there is a proven benefit.

There is data for high volume procedures like cardiac cath, and I bet things like colonoscopies (?), but it tends to get applied to EVERYTHING.

for the em guys there is definitely a threshold for things like central lines, chest tubes, etc.

Some guys can do these in their sleep and lots of guys don't do them often enough so they just call surgery IR, etc anytime one is needed. at my rural job most of the docs do central lines on a regular basis, if not every shift at least weekly. at my urban trauma ctr job most of the docs go months between intubations, central lines, etc because there are teams who do all that stuff now (trauma team, stroke team, etc).

[whoRyou]

Reminds me of that Edison quote (paraphrase)-

"I haven't failed, I've found out 10,000 ways that it won't work"

 

Again, the magic #10,000!!!!

I think you are onto something Anderson, because Bruce Lee mentions the magic number as well ... "I fear not the man who has practiced 10,000 kicks once, but I fear the man who has practiced one kick 10,000 times."

[ventana]

for the em guys there is definitely a threshold for things like central lines, chest tubes, etc.

Some guys can do these in their sleep and lots of guys don't do them often enough so they just call surgery IR, etc anytime one is needed. at my rural job most of the docs do central lines on a regular basis, if not every shift at least weekly. at my urban trauma ctr job most of the docs go months between intubations, central lines, etc because there are teams who do all that stuff now (trauma team, stroke team, etc).

 

 

Funny how that works, if you don't forever try to climb back on the horse and function at the edge of your comfort zone the skills just evaporate