As a resident physician and new mom, I’m constantly learning. So, I was excited for our lecture in afternoon academics all about learning.
Dr. Joan Chan prefaced the lecture by saying that its content would help us to better understand our pediatric patients with learning differences. She highlighted that the same content applies to everyone – physicians included.
With help from the video Understanding Trauma, Dr. Chan distinguished the learning brain from the survival brain. The learning brain is:
OK with ambiguity
Calm, playful and curious
Not afraid of mistakes
In contrast, the survival brain is just trying to keep us alive. The survival brain is focused on threats, afraid of uncertainty, and wants to avoid making mistakes.
Learn Better with a Shift from Survival Brain to Learning Brain
In order to learn effectively, we need to help ourselves (and our patients) get into learning brain mode. This can be accomplished by feeling safe, keeping our brains nourished, and having sufficient time and space to make mistakes.
Let’s break each of these things down.
1. Safety
In order for us to feel safe enough to learn, we need to first feel physically safe.
As a healthcare provider, I’m reminding you to make your personal safety your top priority. You can’t help anyone if you’re hurt. This might mean getting a call room after an overnight shift instead of driving home, standing by the exit to a patient’s room, or walking away if you’re being yelled at.
Second, we need emotional safety. This article in Psychology today puts it perfectly:
“Emotional safety with at least one person and preferably with a group of others is what you need to feel OK in your own skin and to venture out into the new and the unknown.”
In order to learn, we need to feel safe enough to explore. Which means sometimes stumbling and making mistakes without the fear of being reprimanded or ostracized.
2. Nourishment
Learning brains need to be well-fed and well-rested. Well-fed means having access to a nutritious diet and eating enough food. Well-rested means getting adequate sleep and finding ways that you can relax on occasion.
During my overnight shift in the emergency department on Friday, I had a medical student with me. She asked me about what was causing our patient’s heart rate to be so high. I could only name two things. Two. When there are just about a million things that can cause a high heart rate.
So, at 2am, after the medical student had left (they go home at 11pm, lucky ducks), I found myself trying to re-learn the differential diagnosis for a high heart rate for someone with substance use disorder.
After reading the same paragraph on Up to Date for the third time, I thought to myself, “what am I doing?” My brain was depleted of all nourishment, and trying to learn at two in the morning was counterproductive.
3. Time & Space for Mistakes
I learn best through practice and by making mistakes. In medical school, this meant forcing myself to put my hand up even if I wasn’t sure about the answer – something I avoided at all costs in undergrad.
This goes back to emotional safety. At this stage of my training, I need to know that I’m supported in order to take chances, make mistakes, and improve as a physician. Thankfully, there have been very few times where I haven’t felt supported in my training.
Then, we need to talk about time.
In the emergency department, people wait for 8-10 hours in order to be seen by a physician. So, although I have my medical students take 30 minutes for lunch, I have yet to take a lunch break myself, instead choosing to chart with one hand and wolf down a sandwich with the other.
Don’t get me wrong – I enjoy a fast pace. But on my emergency medicine rotation, I’ve done less formal teaching than I’d prefer. The learning I've done on shift has been rushed and out of necessity for treating the patient in front of me.
When we feel we have enough time, we can explore, review, and importantly, think. Time affluence is truly a gift.
Have you noticed when your brain is in learning mode versus survival mode? Let me know in the comments.
Stay well friends,
Dr. Kuhnow
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