Thread by @TChanMD

@LaraVarpio HI Lara:
I will attempt to explain via a thread.

Rule #1 - one must acknowledge there is NEVER enough time for anything. Prioritization is key. Having a system to triage things (as an emerg doc) is important. Having internal rules for who needs to do what is also important.

@LaraVarpio Rule #2 - Have a SYSTEM that allows you to juggle multiple things at once: AT A GLANCE helps you adhere to your triage. In the Emerg Dept, we have electronic tracker boards (look at this simulator virtualer.org/TC_start.html) that allow you to determine who's taking care of whom.

@LaraVarpio For this, I use a series of Dropbox Folders, which are numbered. I have a folder for each project, and a series of project stages that are container folder. Each project moves through the stages with assoc materials.

Used to use an excel spreadsheet to track, but this is easier.

@LaraVarpio Here is a screen shot the folder system. Note that I have separate folders for:
0 - Abandoned projects
1 - Active projects (see below)
2 - Submitted Projects (which has sub folders too!)
3 - Projects Accepted Awaiting Proofs
4 - Completed Projects (which is org by year)

@LaraVarpio Rule #3 - Keep clear lines of communication with all your team members: w/ @Brent_Thoma, @MGottliebMD many of my frequent collaborators, we use a blend of - Email, GChat, Slack, and Zoom. I often will call up BT and request to "round" on our projects. He keeps me accountable.

@LaraVarpio @Brent_Thoma @MGottliebMD Rule #4 - Have Standard Operating Procedures (SOP) for your teams. I have different rules of engagement for different teams, but generally most:
1. Collaborate on G-Docs
2. Eventually move to a Shared Dropbox for final refinement (and for review process, usually requires docx).

@LaraVarpio @Brent_Thoma @MGottliebMD Rule #5 - Invest in onboarding & orienting all NEW jr members. Even Spiderman needed Ironman to orient him to becoming an Avenger. Once they are onboarded, empower them to LEAD. Often jr members left to sideline, but since they know less of everything else, use their org skills!

@LaraVarpio @Brent_Thoma @MGottliebMD Rule #6 - Determine YOUR comfort w/ team structure, but learn/grow/expand.

I have evolved to use a collaborative, non-hierarchical model for engaging with my teams. My student/resident colleagues boss me around and nudge me AGGRESSIVELY (@jassy_liu) to get things in.

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu Example of this? The @METRIQstudy research collaborative is very much LIKE the AVENGERS. Not every paper has every team member. But we do assemble to get the job done.

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy Rule #7 - Start small, but challenge yourself to slowly do more. When you're a clerk on wards, you start with you 1-3 patients you care for each day. In PGY1 on an EM shift, you have your 8-10 pts. By PGY5 I was handling an ED full of 16-20 pts. Now more. Same for projects.

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy Over time you create adaptive strategies... With my research in how EPs learn to flow departments, I've learned that keys to being able to juggle lots of stuff is ability to anticipate workflow.
journals.lww.com/academicmedici…

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy But also, you need to continue to weigh projects, think about them, ROUND ON THEM. Similar to in the ED, I "run the list" of all the projects I have on the go each week. Been doing this with @YusufYilmazPhD lately, I think it really helps.

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy @YusufYilmazPhD Even projects where you're NOT actively doing stuff, and say... are waiting of @Brent_Thoma to get you some data, or for @MGottliebMD to make a call about a decision, are ON THE LIST, so they don't get lost.

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy @YusufYilmazPhD And when rounding on them... I use the same rules I use for email:
Do
Decide
Delegate
Defer
Delete

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy @YusufYilmazPhD Every project (EVERY) gets an action from that list EACH week. Yes, fellow emerg docs, deferring till later is an action... ;)

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy @YusufYilmazPhD Rule #8 - Harness the power of collaborative tools. Some authorship groups still work like it's 1990. Remember, with Google Suite you can all work on a paper TOGETHER. In REAL TIME. No longer does the poor first author have to suffer alone.

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy @YusufYilmazPhD My teams will essentially write together asynchronously over many weeks. Three stages:

Stage 1: Organizing thoughts, making a coherent outline. First author often does take lead on this, but asks for feedback before writing begins. Ensures coherent message. Citations suggested.

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy @YusufYilmazPhD Stage 2: Divide and Conquer for your FIRST and WORST draft! Remember mostly all of us are better editors than writers; blank pages beget more writers block. By having an outline and simply turning the point form with references into paragraphs (even bad ones) gets you 1st draft!

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy @YusufYilmazPhD (Bonus: everyone also meets criteria two of ICMJE criteria by participating in steps 1 & 2!! Not sure what I’m talking about? Read more here icmje.org/recommendation…)

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy @YusufYilmazPhD Step 3: Ruthless Renovations! The first and last authors in my team now absolutely rake the worst draft over the coals. We redline this to smooth out language, voice... but the bones and arguments often are intact and good. All of this is about readability, style!

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy @YusufYilmazPhD Rule #9: Revisions get reassessed first. In submission phase, it’s out of my hands the timing - like tests in the ED. So when the editors/reviewers invite a revision, that is the priority since I can reassess, revise, and arrange disposition (back to the journal!)

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy @YusufYilmazPhD Rule #10: Protecting YOUR OWN writing time. Just like time at the spa, you need to treat yourself to writing time and deep work. Can train with Pomodoro to task switch better, and storyboarding/outlining can make it easier to pick up where u left off, but still need that time!!

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy @YusufYilmazPhD Pomodoro technique is a way to train your brain to more rapidly task switch. en.wikipedia.org/wiki/Pomodoro_…

I operationalize this often with having a deep task and a shallow task I bounce between.

Thinking too hard? Go to menial task.
Menial take annoying? Go back to your challenge

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy @YusufYilmazPhD Storyboarding is what they do at @Pixar or @Disney to bring teams together. I described g-doc outlining before, but when in trouble I go back to sharpies & stickies! Read a bit more here:
aliem.com/5-tips-battlin…

@LaraVarpio @Brent_Thoma @MGottliebMD @jassy_liu @METRIQstudy @YusufYilmazPhD @Pixar @Disney Just like going to the gym, or the spa. If you enjoy writing, make sure to make time for it! If you don’t like writing - all the more reason to make it enjoyable and more like a “treat”. Buy that $10 fancy latte, incentivize w donuts!