The St.Emlyn’s Podcast

What separates an expert from someone who simply knows a lot? Sara Crager argues that expertise is less about accumulating facts or hours of experience and more about developing better mental models: structured ways of organising knowledge and approaching difficult problems.

Iain Beardsell speaks with Sara about deliberate practice, how experts can make their thinking visible to learners, and Rapid Sequence, the clinical simulation game she developed with Ryan Ernst to let clinicians practise complex decision-making, cognitive load and critical care physiology without putting real patients at risk.

In this podcast:

• Why the familiar idea that expertise comes from simply accumulating 10,000 hours misses the importance of deliberate practice, feedback and progressively refining how you think.

• How mental models allow experts to organise large amounts of knowledge into practical approaches they can use at the bedside.

• Whether expert ways of thinking should be taught earlier in medical education, rather than expecting learners to develop them through experience alone.

• Why teaching the H's and T's of cardiac arrest may be less useful than showing learners how experienced clinicians structure a differential diagnosis around respiratory, haemodynamic and metabolic problems.

• The challenge for experienced clinicians of recognising and explaining what they actually do, rather than simply teaching medicine in the way they themselves were taught.

• How Rapid Sequence combines simulated clinical cases, interruptions, competing priorities and expert debriefing to create a safe environment for repeated practice and failure.

• Why “multitasking” may be better understood as rapid task switching, including deliberately pausing, bookmarking and returning to clinical problems as interruptions occur.

• Why gamification is not intended to replace clinical experience, podcasts, simulation or teaching, but can add another way to practise applying knowledge under realistic cognitive load.

About Sara Crager

Sara Crager is an emergency physician, intensivist and medical educator with a particular interest in making complex critical care physiology understandable and clinically useful. She created ICUedu and co-developed Rapid Sequence with emergency physician and educator Ryan Ernst.

Links and resources

Explore Rapid Sequence and play a sample case

Visit ICUedu

More from St Emlyn’s

St Emlyn’s provides free, evidence-based education for the emergency and acute care community. Explore our blogs, podcasts and other resources.

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Learning from podcasts?

If podcasts form part of your CPD, MedPod Learn helps you turn listening into documented learning. You can use it across all your podcasts — not just St Emlyn’s — to record your listening, make notes, answer questions, reflect on what you have learned and create a record of your CPD.