Training for Stress by Chris Nickson

The talk in this podcast discusses:

• the acute stress response and how it affects performance
• strategies and techniques for maintaining and improving performance in stressful situations

This talk is based on the ‘Learning to take the heat’ workshop held as part of the SMACC conference over the past few years (see Learning to the heat at #SMACCUS.) Since then, a superb post was published at St Emlyn’s on Robert Lloyd’s experience working in South Africa, titled An Englishman in South Africa: Robert Lloyd. This reads as a case study in how anyone can succumb to the acute stress response when they perceive a threat to exceed their ability to cope. It is also a case study in how to go about rectifying the issue using stress training techniques. Hats off to Robert for sharing his experience, it is a must read!

Key review articles:

• Leblanc VR. The effects of acute stress on performance: implications for health professions education. Acad Med. 2009;84(10 Suppl):S25-33. [pubmed]
• Petrosoniak A, Hicks CM. Beyond crisis resource management: new frontiers in human factors training for acute care medicine. Curr Opin Anaesthesiol. 2013;26(6):699-706. [pubmed]

Other great FOAM resources include:

• EMCRIT stuff by the brilliant Mike Lauria, as well as Scott Weingart and Cliff Reid (who are also brilliant of course!):
  • Imperturbability: William Osler, Resilience, and Redefining Mental Toughness by Mike Lauria (2014)
  • Podcast 132 – MoTR – Toughness Part I with Michael Lauria (2014)
  • Podcast 118 – EMCrit Book Club – On Combat by Dave Grossman (2014)
  • Part I: Going with the Flow by Mike Lauria  (2014)
  • Part II: The Tao of Resuscitation Performance by Mike Lauria (2014)
• TED talks:
  • Grit is the key to success by Angela Duckworth
  • How to make stress your friend by Kelly McGonigal
  • Your body language shapes who you are by Amy Cuddy
• … and an excellent summary of mental practice on Podium, Enhancing Sports Performance Using PETTLEP Imagery by David Smith (2010)
• Finally, Justin Morgenstern from First10EM has compiled much of the above information into a seamless, comprehensive blogpost on Performing under pressure.

Also of relevance, as the inevitable sequela of excessive chronic stress, is the overview of Burnout I wrote as part of the LITFL Critical Care Compendium.