Andrew Petrosoniak Profile picture
Mar 30, 2020 3 tweets 3 min read Read on X
Work hard. Train harder. ED team training for protected intubation using purposefully designed cognitive aids. #covid19. #insitu #simulation @UnityHealthTO ImageImageImageImage
And please quality was "harmed" or used in this process!

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More from @petrosoniak

Nov 16, 2023
I've started teaching my daughter effective learning techniques. Here's what the evidence tells us

Best: practice testing, distributed practice

Moderate: self-explanation, interleaved practice, elab interrogation

Worst: summarizing, highlighting, rereading, mnemonics

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I'll briefly mention the techniques that I utilize and teach

1. Distributed practice - spreading out study activities over time
- far more effective to study 1hr for 5 nights than 5hrs on 1 night
- this approach benefits long term retention
- basically cramming doesnt work!

In one study, spaced practice where students had 1 or 30 day between sessions produced better results than 0 days betw sessions when evaluated on the final test

Notably, 30d betw sessions was worst at the beginning but overtime was best strategy

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Read 12 tweets
Sep 6, 2023
Make no mistake the recent words of the premier touting the strength of our healthcare system are not anchored in reality.

The many amazing healthcare workers battle a dysfunctional system to continue to deliver care despite the govt

Let me help the premier understand better
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Working in our current healthcare system is like running on treadmill with no end, no food, no water and the pace continues to increase. It’s not sustainable and eventually bad things happen.
A summary
- there aren’t enough nurses
- rural EDs close regularly (that’s crazy)
- EMRs aren’t compatible across institutions and govt is complicit in this - wasting money, time and harming pts
- there aren’t enough family physicians and those remaining want out

Read 6 tweets
Jun 22, 2023
What's the best way to practice to improve skill performance?

We studied this.

TL;DR – No difference betw deliberate practice vs self guided practice

BUT more efficient/faster 6months later for deliberate practice

My thoughts & reflections

A 🧵
First, we pulled off one of the largest randomized trials looking at practice in the #meded literature.

We enrolled 176 emergency medicine residents across North America at 5 sites. It was a huge undertaking and not an easy study to complete, esp the retention testing.
Key to this conversation is, what is deliberate practice & mastery learning?

Deliberate practice, long studied by Ericcson requires several elements with a primary goal of improving.

Also referred to as 10,000hr rule (from Gladwell) but this is rather a misrepresentation

Read 18 tweets
Mar 26, 2023
Starting March 31st @ONThealth announced they will purposefully & systematically reduce healthcare access to those who are marginalized or under resourced.

Ont govt will end a program that provided healthcare access to the uninsured.

Here’s a 🧵 on what this means.

At first glance, this might seem to only affect visitors or travellers (which it will) however it will deliberately negatively impact many Ontario residents who have lost, can’t renew or have an expired OHIP card.

These are people who are in fact OHIP-eligible.

At our hospital, this will represent 1000s of pts per year.

The vast majority are patients who lack the resources to sort out the process required to apply for or renew an OHIP card.

A process made easier with a drivers licence, home address or collateral forms of ID.

Read 14 tweets
Mar 14, 2023
In honour of upcoming St. Patrick’s Day and the luck of the Irish, here’s a post on the importance of luck in decision making.

What is luck? Well, it can be either good or bad and it’s the result of chance. By definition it's out of our control.

Here's a thread: 🧵
Luck is a funny thing when it comes to decisions and our interpretation changes depending on who made the decision.

This week we saw an example of bad luck for clients of SVB. The bank run was completing out of their control.

It wasn’t an unreasonable decision to have money deposited there, at least based on all available information. Its easy to criticize others for putting all their money there without diversifying (not luck but bad decison) which this isn't an investment!.

Read 11 tweets
Mar 11, 2023
Every organization will encounter a crisis.

Here’s how we used the concept of pre-mortem to improve.

This week we @Sim_UnityHealth conducted a multi-disciplinary #simulation of a complete loss of IT infrastructure.

Goal: crash test our processes & ensure ongoing care


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Frequently organizations develop policies for crises but we know that work as imagined is never the same as work as done. @StevenShorrock

Orgs guess how ppl respond.

They hope ppl will remember the procedures.

They 🤞 that the system under stress will work.

But there’s a better way to know with greater certainty how the system and people will respond. And what strengths and deficiencies exist.

We use #simulation to support a pre-mortem.

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Read 6 tweets

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