The Hack That Doctors Should Take From Pop Stars and Quarterbacks

Imagine a pro quarterback stepping onto the field without his coach running pregame drills or a pop star taking the stage without vocal warm-ups. In sports and music, such last-minute preparation is generally nonnegotiable. Coaches review and refine performance, address weaknesses and ensure readiness.

Yet in medicine, where the stakes are often life or death, the idea of warming up with a coach before performing a high-stakes medical procedure is virtually nonexistent.

In a recent study conducted by us and others at the Harvard-affiliated Boston Children’s Hospital, we sought to assess whether coaching inexperienced clinicians within an hour of a procedure could improve their performance and, most important, their patients’ outcomes.

We focused on a procedure performed in the United States more than a million times a year: infant intubation. Intubation is a delicate procedure requiring the insertion of a breathing tube into a trachea or windpipe. Infants requiring surgery or those whose breathing is compromised by infection, premature birth or other causes frequently need intubation. The procedure is high stakes: A single error can lead to complications from low oxygen to cardiac arrest.

We studied trainees who had little experience with intubating infants: anesthesia residents, new fellows (physicians who recently completed residency and were pursuing advanced training to become pediatric anesthesiologists) and student nurse anesthetists.

We randomized these trainees into two groups. The first group received supervision from senior clinicians while intubating infants, which is routine. The second group — the “coaching” arm of the trial — also received supervision while intubating infants, but in addition, they got targeted coaching by a senior clinician within an hour of that intubation. This warm-up took only five to 10 minutes and involved the trainee reviewing and practicing on an infant manikin the steps required to intubate a baby safely.