This is a FOAMed (Free Open Access to Medical Education) story told through a graph.

In preparing for a presentation called “When Things Get Wicked,” I came across the best resource available on the topic of human performance in emergency medicine.

…And it was free.

It is called “Performance Under Pressure” and is authored by Canadian EM Physician Dr. Justen Morgenstern. His references are spectacular and allowed me to launch a deep dive from his one article. I first came across it when Michael Lauria shared it on twitter. It is extremely comprehensive and includes this graph comparing arousal state and performance.


Justen Morgenstern – First10EM


In his article, Dr. Morgenstern explains:

“The Yerkes Dodson law suggests that for any activity there is an optimal level of arousal for peak performance. The common illustration is a simple curve that demonstrates that performance suffers both in states of high and low arousal.”

Wanting to play with the concept, I drew my own version on a whiteboard. I’ve used the graph at conferences to explain the concept. You can hear a recording of the presentation on the podcast… for free.


Ginger Locke- Medic Mindset


After going to the Metro Atlanta EMS Conference, my FOAMed friend in Georgia, Jimmy Apple, made his version and offered for me to use it… for free.

Jimmy Graph
Jimmy Apple


And then I found a 4th version of the graph. Jurgen Gollwitzer in Germany posted this free blog post and included his version of the graph. In his post, he sends his readers to the Medic Mindset episode where I posted the “When Things Get Wicked” talk from the Wisconsin EMS Conference. 

I can’t read the whole post because it is in German, so I sent it to my FOAMed friend Michael Herbert who offered to translate it for me… for free. 


Jürgen Gollwitzer – #FOAM Rettungsdienst


This is #FOAMed. It’s free and collaborative and focuses on the sharing of information.

Dr. Morgenstern, thank you for getting this FOAMed graph-party started. Your article was spectacular.

Much respect,



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