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Some of the topics we discuss in the Practice Perfect editorials are “hard and fast” topics such as certain surgical treatments or practice management issues. On the other hand, some of our topics fall into the softer “psychological” aspects. These are some of my personal favorites. I enjoy reading about topics such as logical fallacies, critical thinking, and skill building.
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And that, colleagues, is what we’re going to talk about today: Skill.
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I recently read an excellent book called Skill by Christopher Ahmad, MD1. Dr Ahmad is a clinical professor at Columbia University and the team orthopedic surgeon for the New York Yankees. His resume rivals the bible for length, so let’s just say this guy is accomplished and qualified.
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Dr Ahmad’s book describes 40 tips for becoming highly skilled at our endeavors. As an orthopedic surgeon, many of his tips and recommendations are couched in medical examples and anecdotes, but anyone can apply these principles to become better at what they do. Dr Ahmad applies current principles from modern research and popular culture, which makes this a quick and easy read. The book is divided into three primary sections: defining skills, improving skills, and achieving mastery, and is presented in a very approachable format.
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We don’t have the space to discuss all 40 of his recommendations, but let’s take a look at a sample of some of the biggies. These are the ones that while reading, I thought, “My most successful students and residents do these.”
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“Don't fall for the prodigy myth – talent is not bestowed.” Those who appear to be naturally gifted at something often turn out, on closer examination, to have spent many hours in deliberate, focused, effortful practice.
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“Your first step toward mastery is accepting responsibility.” I have heard many give excuses for their failures rather than realizing they are in control of both failure and success.
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“Seek out and steal pearls – steal it, work it into your toolbox, and then modify it to create your own enduring personal skill.” There are so many resources today to find a better way of doing things. Let’s take advantage of our opportunities to get better.
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“Always carry a notebook.” This is my personal favorite quip for students and residents. It drives me crazy when trainees don’t take notes and then not use those notes to become better.
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“Put in focused and effort-filled practice early in your career/training to experience the compound effect.” Too many of our trainees want learning to be easy, like watching a movie or playing a video game. Learning anything worthwhile takes deliberate practice.
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“Isolate the sweet spot – push to find your sweet spot with every aspect of any skill you wish to improve upon.” The sweet spot is the point where something you’re doing is difficult enough to require effort, but not too difficult that you’re guaranteed to fail. This is the point in which we learn best.
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“Engage deeply and embrace the struggle – get comfortable with the uncomfortable.” In order to learn and grow we have to push beyond our current capabilities and knowledge, which is often scary. Enjoy the fear of the unknown in order to advance your knowledge and skills.
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“Leave your ego at the door and make self-critique your most powerful surgical mastery tool.” Ego always gets in the way. In order to learn we have to put ego aside and honestly examine our failures.
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“Mistakes are building blocks for growth – cherish your greatest tool for improvement– your mistakes.” Medicine is a tough trade since mistakes may have catastrophic results. However, we learn nothing from our successes.
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“To achieve true mastery – teach it.” What more can be said about this? In order to truly know something, you have to teach it to others.
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Dr Ahmad also teaches us how to be good coaches, teachers, and leaders. Some of his suggestions are so topical I can’t help but point out a few.
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Use the first few seconds to connect on an emotional level.
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Avoid giving long speeches – instead, deliver vivid chunks of information.
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Be allergic to mushy language (do not be vague).
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Make a scorecard for your students.
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Maximize reaching fullness. Learners should be working hard to improve.
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Aim to create independent learners.
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The last suggestion is for teachers to praise effortful practice rather than good results. This is based on the important work of Carolyn Dweck who coined the psychological idea of the growth mindset2. Instead of thinking of ourselves as fixed, we should consider looking at life from an attitude in which we aim to change and grow. In order to improve our skills and become the best version of ourselves we must remain open to our own ability to change.
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Ahmad C. SKILL: 40 Principles That Surgeons, Athletes, and Other Elite Performers Use to Achieve Mastery, June 2015. Lead Player LLC.
Follow this link
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Dweck, C. Mindset: The New Psychology of Success, Dec 2007. Ballantine Books.
Follow this link
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