Healthcare Practitioners and Performance Psychology

By Bonnie Hutchinson

You know at least some of their names…

*    The head of a national cycling team that’s dominated Olympic and Tour de France cycling events since 2008;

*    A world-renowned musician who plays one or more instruments (possibly including voice), composes new music, and changes the genre;

*    A leader in a country with a powder keg of internal strife who has been able to guide a peaceful way forward;

*    A multi-billionaire entrepreneur philanthropist who tackles global social and health challenges;

*    A health care practitioner whose diagnostic and care-giving abilities heal and uplift (this person may not be famous, except locally, and is probably someone you know personally).

What do these individuals have in common?

They’re at the top of their game, the best of the best in their field. Some don’t just dominate their field, they have changed the field.

What else do they have in common? At least two things:

  1. They’ve worked passionately and purposefully to hone their abilities.
  2. Consciously or not, they’ve used performance psychology principles to move from competence to expertise to mastery.

A peak performer at helping others become peak performers

The name of the first person mentioned is Sir Dave Brailsford. In 2002 he took over as head of the British cycling team. British Cycling had won only one gold medal in its 76 year history, and had never won a Tour de France. Despite that dismal record, by 2008 the team dominated Olympic cycling events and has done so ever since. Not only that, a British cyclist has won the Tour de France cycling event six out of the past seven years, most recently in 2018.

So how did Sir Dave manage to orchestrate that spectacular turnaround? In an interview with Eben Harrell, [1] he explained their “podium principles.” One of them was, “…human performance. We weren’t even thinking of cycling, but more about behavioral psychology and how to create an environment for optimum performance.”

Turns out the same “performance psychology” principles that helped British Cycling achieve spectacular results can be applied to health care practice.

30-plus years of peak performance research

The most quoted name in the study of performance is Swedish psychologist K. Anders Ericsson. He’s the world’s foremost expert on the acquisition and maintenance of skills and expertise. His work is so influential that his 2004 paper, “Deliberate practice and maintenance of expert performance in medicine and related domains,”[2] is one of only 36 works referenced in the American Heart Association’s 2015 ECC Highlights. His research directly influenced the American Heart Association’s 2015 Core Educational Concepts.[3]

In April 2016, Dr. Ericsson, along with science writer Robert Poole, published Peak,[4] which summarized Dr. Ericsson’s 30 year career studying performance and expertise.

The main point was this: all expert performers in every arena of human endeavour attained their expertise through the same common pathway, one that works because of human beings’ common psychology.

Dr. Ericsson named this pathway “deliberate practice.” It is based on the practice methods of elite and world class performers, and an analysis of a number of factors the most skilled people in the world have in common.  Scott Weingart conducted an excellent interview with Dr. Ericsson on his EMcrit podcast in October 2017.[5]

Deliberate practice characteristics

Deliberate practice is most possible when a clearly defined pathway to expertise has been developed. Someone has identified the sub-skill sets involved. A variant of deliberate practice called purposeful practice can be used in areas where no clear pathway has yet been developed. In purposeful practice, you have to figure out yourself, or with others, what the specific sub-skill sets are (an extremely useful team project).

Among the components of deliberate practice are…

Focus on a specific sub-skill in each practice session.

Take yourself out of your comfort zone. Dr. Ericsson says,[6] “It’s not deliberate practice unless it stretches you. Be prepared to sweat mentally and physically,” BUT…

Start slow and allow yourself time to recuperate before the next practice session.

Understand it’s going to take time. Don’t push too far too fast in the beginning. “Bite size pieces” and gradually increasing challenge will lead to significant improvements over time.

Shorter focussed practice periods are often more effective than long practice sessions. Depending on the skill, sometimes even just 15 minutes of intense focussed practice is the optimum amount.

Ideally, you have access to an external source of expertise that can check in with you at regular intervals, as well as tools that provide instant feedback and allow you to track your progress.

Deliberate practice in health care

Medicine, paramedicine, nursing or any other health care practice is considerably more complex than the practice of, say, cycling. Not every aspect of health care practice has yet been analyzed to identify the reproducible superior behaviours of each sub-task.

However, Dr. Ericsson has identified areas of diagnosis and treatment that lend themselves to deliberate practice. He says, “This prospect is particularly exciting because in medicine, unlike sport or other competitive domains where the expert performance approach has been more widely applied, the beneficiaries of improved performance are not only the performers themselves, but also society at large.”[7]

He mentions simulation training as being extremely valuable in providing opportunities for deliberate practice of diagnosis and treatment tasks. Among other benefits, simulation training makes it possible to practice without fear of doing harm to a patient.

Hone Cue Recognition simulation training modules increase mastery

Hone Virtual Education’s mission is “to help practitioners perform at peak levels, capable of rapidly and correctly identifying diagnostic cues, enabling correct clinical decisions.” The over-arching mission is to save lives.

Hone is combining mastery learning psychology with augmented reality technology to create simulation training modules you can download to your augmented reality smartphone or tablet.

Hone Cue Recognition is a medically accurate cue recognition training platform that allows you to deliberately practice diagnostic cue recognition skills and receive immediate, expert feedback.

Different simulation training modules focus on sub skills of identifying cues related to Airway, Breathing, Circulation, Disabilities, and Exposure. Each module allows you to practice specific observations and skills again and again, as often as you like, whenever you like. Once your accuracy is assured, the modules increase the speed with which cues are presented, so you learn to make assessments and decisions more quickly.

Find out more

The first Hone Cue Recognition virtual simulation training modules will soon be released. In the meantime, you can…

  • Learn more about Hone Cue Recognition virtual simulation training;
  • Be notified of updates and launch dates;
  • Apply to be a beta tester as new modules are developed for health practitioners in high-pressure environments.

P.S. Those other “names”

Oh yes. About the names of those other peak performers listed at the beginning. Whatever names you thought of are almost certainly correct.

Musicians Sir Paul McCartney, Yo Yo Mah and Thao Nguyen are among those who come to mind. Multi-billionaire philanthropists could be Bill Gates, George Soros or Anne McKevitt. Leaders who have guided peaceful revolutions include Mahatma Gandhi, Martin Luther King Jr. and Nelson Mandela.

Each of the descriptions could also apply to other individuals who have been peak performers in their field.

And of course, a peak performing health care practitioner could be any of several people you know and respect – maybe even you!



Bonnie Hutchinson is a freelance writer and lifelong learner with degrees in Education and Whole Systems Design as well as extensive training and experience in adult learning and teaching. She’s the author of bestselling Transitions: Pathways to the Life and World Your Soul Desires.


[1]   Harrell, Eben (2015): “How 1% Performance Improvements Led to Olympic Gold.”

[2]   Ericsson, K. A. (2004): “Deliberate Practice and the Acquisition and Maintenance of Expert Performance in Medicine and Related Domains,” Academic Medicine, Vol 79, No. 10/ October Supplement.

[3]   American Heart Association (2015): “Highlights of the 2015 American Heart Association Guidelines Update for CPR and ECC.”

[4]   Ericsson, K. A. (2016): Peak: Secrets from the New Science of Expertise. Eamon Dolan/Houghton Mifflin, Harcourt CT, USA

[5]   Weingart, Scott (October 30, 2017): “Expertise with Anders Ericsson.” EMCrit Podcast 211). Retrieved from

[6]   Dr. Ericsson made this comment during the interview with Scott Weingart, op. cit.

[7]   Ericsson, K. A. (2004), op. cit.


Hone CUE Recognition on the App Store

The Hone CUE Recognition App will soon be available on the App Store for early adopters. When it is available - you will be able to download it via the link below.