True Grit: The Surprising, and Inspiring, Science of Success

The importance of perseverance

Angela Duckworth’s work suggests that perseverance is a predictor of success. During her graduate student days she created a “grit scale” which she subsequently tested throughout her career. She characterized “grit” as working hard and finishing what one begins and gives the example of Will Smith explaining in an interview that if he was in a competention on a treadmill, there would be only two outcomes: he would be the last one running or he’d die on that treadmill because he “will not be out worked.”


My Email Rules

Email can consume hours of your day stealing opportunities to do real work. Several people have devised plans to reclaim this time, so I stole the ones that work for me.

These rules have one main goal: to respect my time and that of the receiver.

1. Keep as short as possible.

“I’m sorry to write you a long letter, as I did not have time to write a short one.”

Mark Twain


π day & RPN

March 14th, or π-day, this year takes on additional numerical significance. Only once in a hundred years we are able to celebrate π to its billionth decimal place.


3/14/15 9:26:53

I wonder if Galileo Galilei geeked out on 3/14/1592 6:53:59.

In other mathematically geeky news, while doing several calculations on my Mac I was longing for my old HP scientific calculator with reverse polish notation. Looking through the Mac app store at all the emulators, I decided to see if the built-in calculator app had this feature. And guess what it does.


In the View menu, you can select “RPN mode” and now you get a calculator with a stack visible 2 deep. I don’t know if this was possible in previous versions of OS X, but I love the geeks at Apple that made this happen.

Happy π-day. Now we wait for May the Fourth.

Instructional Scaffolding in the Pre-Brief

  • students walked into the sim lab like wide-eyed deer in the headlights
    • their performance pretty much mirrored that analogy
    • did they learn anything just by being scared?
  • pre-briefs are defined as short sessions before the simulation
    • set expectations and roles (take this thing seriously)
    • familiarize students with equipment and debrief procedures
    • but teaching doesn’t usually happen here (or in the debrief for that matter)
  • simulation is often incorporated into the flipped classroom
    • watch a video (or read something) at home and then come to class to do simulation
  • we inserted a pre-brief using instructional scaffolding between the home module and the simulation session
    • students watch videos at home & complete a 1-page fill-in-the-blank worksheet
    • before simulation they learn their roles, expectations but also go through some mini-cases using that worksheet
    • then evaluated their performance on a checklist
    • their performance significantly improved on the checklist and their impressions of the sessions were better

Pulseless Arrest With Blanks


  • checklist
    • immediately (<10 seconds) started CPR upon determining patient is pulseless
    • initiated defibrillation upon observing a shockable rhythm
    • switched compressors every 2 minutes with brief (<10 seconds) pause in compressions
    • gave proper doses of vasopressors and anti-arrhythmic at the appropriate time
  • reflection
    • I feel confident in performing a resuscitation of a patient in pulseless arrest (strongly disagree…)
  • quiz
    • fill in the worksheet without a crutch
    • given scenarios, pick the next step

Left Ventricular Assist Devices


Left Ventricular Assist Devices confused the heck out of me, so I thought I’d go through some of the anatomy and physiology of these things. Then everything seemed to make a bit more sense.

Anatomy and Physiology of the Heart… with an LVAD

I misspoke in this video. Dick Cheney did not have ‘destination therapy’ but ‘bridge-to-treatment’ therapy. He eventually got a heart transplant.

Pathophysiology of the Heart… with an LVAD

Please let me know if things don’t make sense, if they’re flat out wrong, or whatever you’d like.

Finding Your Niche in Academic Medicine

Amal Mattu, who has appeared on many other posts I’ve put up here, spoke at the… well, he speaks at a lot of things. Despite being so accomplished he still comes off as being humble. Anyway, here’s a talk of his on finding your niche in academic medicine. It’s worth a listen. I usually listen to it once a year… and then procrastinate on doing anything about it.