NRP 2014 Current Issues Seminar October 10, 2014

San Diego, CA

Gary Hamill, Ed.D.Researcher: Human Performance Optimization

hamill36@comcast.net

Lou Halamek, M.D.Stanford University School of Medicine

halamek@stanford.edu

Achieving Peak Performance During High Stress

In the past 12 months, I have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider(s)

of commercial services discussed in this CME activity.

I do not intend to discuss an unapproved/investigative use of a commercial product/device in my presentation.

Faculty Disclosure Information

• Introduce the psychophysiological processes of stress and anxiety

• Introduce strategies that can help you perform better under pressure

Presentation Goals:

Peak Performance = The balance among challenge and skill characterized through adaptation and team synchronization

What is Peak Performance?

What is Stress?

What is Anxiety?

Stress = The imbalance among challenges & skills with high

consequences

Anxiety = Debilitative cognitive and somatic arousal

• When we are alert and feel safe, modest levels of arousal chemicals like norepinephrine and acetylcholine help PFC cells to communicate efficiently, giving us the power to think, remember, and plan.

• Under stress, very high levels of these same chemicals drive a vicious cycle inside the PFC cells, weakening synaptic connections and disrupting communications.

Freeze, Fight, or Flight Response

http://directorsblog.nih.gov/2014/03/18/creative-minds-making-sense-of-stress-and-the-brain/

Because stress and anxiety are psychophysiological processes, they require psychophysiological solutions…

Mental practice is one of the few, effective performance enhancing strategies

Druckman, D., Swets, J.A., 1988. Enhancing human performance: issues, theories, and techniques. Washington, DC: National Academies Press.

How is mental practice being used by other disciplines?

Russell Wilson, Quarterback, Seattle Seahawks2014 Super Bowl Champions on his use of Visualization

• Prime and orchestrate your thoughts and actions to bring the brain online quicker to perform the resuscitation

• Diagnosis / Pattern Recognition

• Teamwork = Anticipatory Schemata

• Dexterity

• Improve learning - it performs direct operations on your memory. The procedure comes alive in your mind to learn new aspects of a resuscitation.

How Can Mental Practice Help Resuscitations?

Guided Imagery Demonstration - developing your mind’s eyes, ears, and dexterity

Guided Imagery - Begin by listing important resuscitation steps

The Mental Edge: Developing Your Training Program

Video Assisted Guided Imagery - Incorporating a resuscitation video w/guided imagery