These are the slides and references used in my talk at the Wisconsin EMS Conference on Jan. 26, 2018.

Video Feed from FOAMfrat on Facebook

Thesis for talk: The skills necessary to mitigate the ill-effects of stress are not intrinsic and can be taught/learned. The tools mentioned in this lecture should be taught as part of the standard paramedic curriculum.

“Don’t believe everything you think.” Allan Lokos

Michael Lauria’s Cognitive Paths Through Chaos

Michael Lauria et al reference studies supporting their recommendations. Link to full article here.

3 key conditions for situations getting “wicked”:

  1. We must care about the outcome,
  2. Novel things, and
  3. How we appraise our resources compared to the demands of a situation

“Wicked” is a term I first heard Dr. Pat Croskerry use in this article.

“The oldest and strongest emotion of mankind is fear and the oldest and strongest kind of fear is the fear of the unknown.” H.P. Lovecraft

Richard Lazarus’ Appraisal Theory

To decide if a situation is a challenge or a threat, we compare our resources to the demands of the situation.

If we perceive our resources to meet or exceed the demands, we call this a challenge and the stress response is low.

If we perceive that the demands are greater than our resources/abilities, we define that as a threat and the stress response can be high.

How John Smoltz changed his self-talk and changed his pitching performance.

Dual Process Decision-Making Theory outlined in Thinking Think Fast and Slow, by  Daniel Kahneman.

Medic Mindset Microsode 1 explains the value of overlearning.

Warning about improper overlearning in Dave Grossman’s On Combat.

Michael Phelps use of visualization

Don Norman emphasizes the importance of design to decrease risk of error.

The Design of Everyday Things and Living with Complexity

Books mentioned in the lecture:

Deep Survival, Laurence Gonzalez

Thinking Fast and Slow, Daniel Kahneman

Streetlights and Shadows, Gary Klein

Mindset, Carol Dweck

The Design of Everyday Things, Don Norman

On Combat, Dave Grossman

Another key reference in making this lecture was a FOAM resource written by Justin Morgenstern from First10EM called “Performance Under Pressure.” If you liked this lecture, you will love his paper and all of the references and resources he cites.

Arousal State’s relationship to Performance


Importance of design


Square Breathing



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