I love this quote, dished out today by one of my children’s music teachers, but it applies to Grade 3 piano as much as it does to surgery or any skill. There are many scientific papers and masses of anecdotal evidence that frequent practice of a skill leads to improved performance. I watch junior trainees practicing and learning and they quit far too early. Many of them can’t tie knots and they don’t understand that the only way to get good at it is to do it thousands of times.
As a medical student I decorated every mug in my flat with long tails of black, silk, braided, surgical knots. When I was in theatre I would open and close clips and scissors with my non dominant hand endlessly, to practice being slick and good.
When I tell them this, that I took scissors and clips and out of date surgical ties home to practice on all the time they look at me like I am mad. I had no shame about my desperation to be good, I wanted to impress my trainers and do well and getting a job depended on me being good with my hands. I was in a constant state of preparation for the moment I would get to tie a knot, I was terrified of forgetting how to do it so I kept on doing it.
There needs to be a shift in the mindset of surgical trainers and trainees that practice in simulated environments (especially crap ones like your commute or your kitchen) is very much worth doing. For a start, it works, but new recruits also need to practice and prepare in a way that my generation did not do. I had a one in four on call rota as an SHO and a 70 or 80 hour week was standard. I had more learning opportunities than hot meals during those years but still sat for hours with little cuts on my fingers from tying so many knots.
Another lesson I have learned, from my own amateurish sporting efforts, is that you seldom perform better than you practice. I can’t run a sub 48 minute 10k under the best of conditions, I won’t do so the next time I race one on a hilly course on a windy day. If you can tie a perfect knot sitting down in your kitchen then great; but can you do it with me watching, the nurse watching, on an actual vessel, standing in an awkward position down a deep, dark hole?