Leading the Rounds
Caleb Sokolowski & Peter Dimitrion
Recent Episodes
Dan Dworkis, MD PhD FACEP is the Chief Medical Officer at the Mission Critical Team Institute, a board-certified emergency physician, and an assistant professor of emergency medicine at the Keck School of Medicine of USC where he works at LAC+USC. He performed his emergency medicine residency with Harvard Medical School at the Harvard Affiliated Emergency Medicine Residency at Massachusetts General Hospital / Brigham Health, and holds an MD and PhD in molecular medicine from the Boston University School of Medicine. Dr. Dworkis is the founder of The Emergency Mind Podcast , and the author of The Emergency Mind: Wiring Your Brain for Performance Under Pressure.
Questions We Asked:
- Why did you feel the need to create The Emergency Mind?
- Is poise under pressure a learned skill or innate?
- What are valuable skills you have learned creating The Emergency Mind?
- How does someone successfully improve through a performance loop?
- What are ways to decrease stress while performing procedures?
- How does the Emergency Mind address team dynamics?
- How do you build a well functioning solid team?
- How do you run a successful debrief?
- Advice for medical leaders under pressure?
- Book Suggestions?
Quotes & Ideas:
- Applying knowledge under pressure is a separate learned skill
- What happens when you are trying to intubate a patient and miss the first time? How do you recover and make the second attempt?
- Prepare-> Perform-> Recover-> Evolve
- “Create an environment that sets you up for success”
- Experiment and be a scientist of yourself: Build->measure->learn
- Exposing yourself to stressful scenarios outside of the hospital can help you build skills to help clinically
- Use self-talk to help yourself manage acute stress
- When debriefing, learn to separate outcome from performance. You can sometimes have a poor outcome with perfect performance and also a good outcome with poor performance.
- Debriefs can use outcome vs. performance on a 2x2 matrix.
- Never Waste Suffering. Both ours as providers and the patients.
- Harness the wisdom in the room around you
- Practice when you are outside of pressure and then slowly introduce it to stressful situations
Book Suggestions:
- Thinking Fast and Slow by Daniel
- Sources of Power by Gary Klein
- “A Failure to Disagree” paper by both
- Ghosts of the Fireground by Peter Leschak
COL (Dr.) Cristin Mount is an Army Critical Care Medicine physician currently stationed at Madigan Army Medical Center in Tacoma, WA. She graduated magna cum laude from the University of Scranton and completed medical school at the Uniformed Services University in Bethesda, Maryland in 2003. She did an Internal Medicine Internship and Residency at Madigan and moved to Walter Reed Army Medical Center in Washington, D.C., for Critical Care Medicine fellowship.
After fellowship, she returned to Madigan as the Director, Critical Care Services and promptly deployed with the 28th Combat Support Hospital to Baghdad, Iraq where she served as the sole Intensivist and the theater consultant for Critical Care and Internal Medicine. She is the only woman to serve as Chief, Department of Medicine and the Deputy Commander of Medical Services. Currently she serves as the Critical Care Medicine Consultant to the Army Surgeon General.
She is a Master of the American College of Physicians, and past Governor of the Army Chapter of the ACP. She is married to COL George Mount, an Army Rheumatologist, and they have three small boys under the age of 7.
Any views expressed during this interview reflect those of Dr. Mount and do not represent official views of the Army Medical Department, Department of the Army or Defense Health Agency.
We hope you enjoy this episode where we discuss her journey through medicine and leadership as well as leadership in the ICU. Welcome to Leading the Rounds.
Questions We Asked:
- How did you become involved in medical leadership?
- How did you adjust to becoming a leader out of training?
- What are some things that help you lead in stressful situations?
- Can you discuss your article Ten Leadership Principles from the Military Applied to Critical Care and why you felt writing it was important?
- What is unique about leadership in the Intensive Care Unit?
- How do you develop a good care team?
- How do you balance being firm in a stressful leadership moment vs. being aggressive and condescending?
- How do you practice adaptive leadership?
- Advice for medical leaders?
- Books?
Quotes & Ideas:
- When taking a new leadership position, “recognize that you’re going to feel overwhelmed, and then sit back, learn, and ask questions.”
- In moments of panic, “put your helmet on, put your kevlar on, and march in a straight line.”
- You can study leadership, but you also need to practice. Look for everyday small moments where you can practice your leadership skills so they are ready when you need them.
- “Every day there's an opportunity to practice a leadership technique in your personal or work life.”
- Ten Leadership Principles from the Military Applied to Critical Care
- Leadership in the ICU: contrasts between problem solving without assessment of why things are happening vs. paralysis by analysis
- To be a great leader in the ICU, you have to be able to make decisions without having all of the information.
- “The success of the team means the success of the patient.”
- In addition to placing yourself in stressful situations, you can rehearse in your mind what you would do if you would have been placed into that environment.
- “As you are in a position to set boundaries to which work is not allowed, you have to set them.”
Book Suggestions:
- Complications by Atul Gawande
- We Were Soldiers Once and Young by Lt. Gen. Harold G. Moore and Joseph L. Galloway
- The Liberation Trilogy by Rick Atkinson