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When we think about developing physical skills, we are familiar with the importance of practice to improve our skills to the point of expertise and mastery.
Anders Ericcson detailed this concept in the understanding of what he referred to as ‘deliberate practice’. Through his extensive work with high performers in different crafts, he found that the common ground was the necessity of deliberate practice. Ericcson described several factors which comprise deliberate practice, including use of an expert coach; practice outside of one’s ‘comfort zone’; integration of specific goals; full focus; timely feedback on performance; improving upon previous skills; and incorporation of ‘mental representations’ of the skill being developed.
When we are developing technical skills within healthcare, the concept of deliberate practice can and should be applied. For the most part, this is widely understood through the process of medical education and training. For example, surgical residents repeatedly practice procedures under supervision before being given the independence and autonomy to perform the procedure on their own.
What is, perhaps, less widely appreciated is that the concept of deliberate practice equally applies to the skills necessary to optimize human performance and allow us to be at our best. Regardless of whether we are considering the habits and skills of meditation, mindset training, recovery, nutrition, or sleep we need deliberate practice in order to maximize our abilities in each of these domains. These skills do not become proficient by chance or accident. Intentional application of the principles of deliberate practice is needed. For example, to become proficient and benefit from meditation, it is necessary to practice the skills of awareness and non-judgement while being mindful of thoughts and experiences. Similarly, to develop optimism, we need to develop a deliberate practice of gratitude.
Not only is deliberate practice needed to develop high performance skills, it is also essential to intentionally arrange our routines and, in many respects, our lives in order to optimize our minds and bodies for high performance in all areas of life. This can be readily applied to the development of new habits, such as improving nutrition or creating a recovery routine. In order to create alignment across all areas of life, we need to apply these concepts to all parts of our life. If we do not follow these principles in certain areas of life, then there can be a resulting negative impact in the other areas of our life in which we emphasize high performance. As an example, consider someone who wants to optimize athletic endeavors and then in certain circumstances engages in unhealthy activities, such as smoking.
Deliberate practice is needed so that our proficiency in the skills of high performance is sufficient to allow us to access these skills at times of high stress and demand. These are the times when we are most in need of these skills, however due to the elevated stress associated with these times, we have less cognitive resources that can be allocated to implementing these skills and strategies. At these times, due to the elevated stress, we have less prefrontal cortical activation, elevated sympathetic nervous system tone, reduced recall from long-term memory, and decreased working memory. These physiologic responses to elevated stress are not within our voluntary control and they collectively lead to a decreased ability to ‘think’ our way through the situation and intentionally utilize these skills. If we have adequately developed these skills in advance then we may still be able to initiate these skills even in the face of these responses and the accompanying reduced cognitive resources. Through deliberate practice we can, conceptually, automate these skills for use during periods of elevated stress.
In essence, the pursuit of high performance as it relates to both the physical skills and the internal skills necessary to be at our best in all areas of life can only be made possible through the application of the principles of deliberate practice. This includes developing proficiency with these skills and intentionally scheduling our routines in all aspects of our daily life. This ultimately allows a degree of automaticity in the activation of these skills when they are needed most.
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Ericsson, A; Pool, R: Peak: Secrets From the New Science of Expertise. Boston: Houghton Mifflin Harcourt; 2016.
Jha, AP: Peak Mind: Find Your Focus, Own Your Attention, Invest 12 Minutes a Day. New York: HarperOne; 2021.
Porges, SW: Polyvagal Safety: Attachment, Communication, Self-Regulation. New York: W.W. Norton & Company; 2021.