What does it really mean to become an expert in resuscitation and critical care?

It is tempting to think that expertise comes from accumulating enough facts, passing enough exams or simply spending 10,000 hours at work. In this episode, Iain Beardsell is joined by emergency physician, intensivist and medical educator Sara Crager to explore why expertise is less about how much we know and more about how we think.

Sara explains how experts develop high-quality mental models that allow them to organise information, recognise patterns and approach difficult clinical problems. Crucially, these mental models do not have to remain hidden inside the heads of experienced clinicians: they can be identified, explained and deliberately taught.

The conversation moves from the limitations of mnemonics and assessment-driven education to the value of deliberate practice, feedback and safe failure. Sara describes how an expert might organise the differential diagnosis of cardiac arrest into respiratory, haemodynamic and metabolic problems, rather than relying solely on a memorised list of Hs and Ts.

Iain and Sara then discuss Rapid Sequence, the gamified clinical-learning platform Sara created with emergency physician Ryan Ernst. Learners work through realistic cases in a simulated clinical environment, managing several patients while dealing with interruptions, competing priorities and the consequences of their decisions.

After each block, Sara and Ryan deconstruct the cases, make their clinical reasoning explicit and introduce mental models that learners can immediately apply when they try again. It is a cycle of practice, failure, teaching and repetition—without putting a real patient at risk.

They also explore why attention, storytelling and visual design matter in medical education; how “multitasking” may be better understood as rapid task switching; and what Sara has learned from turning an educational passion project into a working product.

• Why expertise is about cognitive strategies and mental models—not simply knowledge
• Why experts are made rather than born
• The limitations of the “10,000-hour rule”
• How deliberate practice differs from repetition
• When learners are ready to be taught expert ways of thinking
• Foundational knowledge versus clinically useful organisation
• Moving beyond mnemonics such as the Hs and Ts
• How experts can make their implicit reasoning explicit
• Why acquiring a new mental model can produce a sudden leap in performance
• The importance of inspiration—and giving learners an achievable pathway
• How Rapid Sequence creates a safe place to make mistakes
• Managing several patients, interruptions and cognitive load
• Teaching shock, respiratory failure and acid–base physiology
• Why engaging design is part of the educational method
• The role of games alongside podcasts, lectures and clinical experience
• Reframing multitasking as rapid task switching
• The “pause and bookmark” technique for managing interruptions
• The realities of building an independent medical-education project
• Why partnership, persistence and a genuine belief in the project matter

Learning from podcasts?

If podcasts form part of your CPD, you can log your listening time across all podcasts on MedPod Learn — not just St Emlyn’s — and generate structured reflection. The app is free to download, includes a one-month free trial, and offers globally adjusted pricing.

In this episode of the St Emlyn’s Podcast, Iain Beardsell and Simon Carley catch up on the February blog posts, recorded in the rather unseasonal context of a UK heatwave. They begin with congratulations to Simon on his reappointment as Dean of the Royal College of Emergency Medicine, before reflecting on recent conferences including IFEM in Hamburg and Don’t Forget The Bubbles in Glasgow.

The clinical focus this month is trauma team leadership, with practical tips on interpreting trauma CT reports, maintaining momentum after the scan, performing safer log rolls, and making feedback more useful for learners and colleagues.

• Look at trauma CT images yourself as part of your own clinical learning and to integrate the scan with your examination findings.
• Treat the first CT report as a primary survey, not necessarily a definitive final report.
• Speak to the radiologist and share clinical concerns or uncertainties.
• Do not lose momentum after CT; this is a vulnerable phase in trauma care.
• Log rolls should have a purpose and should minimise movement, pain and physiological risk.
• Use clearer team communication: “Is anybody not ready to move?” and “ready, steady, move.”
• Feedback sticks when it is specific. Add “because” to positive feedback so the learner knows exactly what to repeat.
• Leadership and followership skills apply everywhere, not just in formal trauma team leader roles.

Learning from podcasts?

If podcasts form part of your CPD, you can log your listening time across all podcasts on MedPod Learn — not just St Emlyn’s — and generate structured reflection. The app is free to download, includes a one-month free trial, and offers globally adjusted pricing.

In this episode of the St Emlyn’s Podcast, Iain Beardsell speaks with Anna Dobbie, consultant in emergency medicine and pre-hospital care, and Clinical Lead for London HEMS.

Recorded at Trauma 2030 at the Royal College of Surgeons in London, the conversation explores what it means to lead exceptional teams in one of the most high-pressure areas of emergency medicine. Anna reflects on six years as Clinical Lead for London HEMS, sharing lessons on leadership, culture, psychological safety, difficult conversations, managing strong personalities, and supporting clinicians to do their best work.

The discussion also touches on the unique nature of pre-hospital care, where teams move rapidly between downtime and high-intensity clinical decision-making, and where trust, openness and mutual respect are essential. Anna describes the importance of making sure all voices are heard, not just the loudest, and explains why leaders need to be consistent, approachable and willing to have honest conversations when things do not go as well as they should.

Anna also reflects on learning leadership on the job, the value of formal leadership training, the challenge of maintaining boundaries when you care deeply about a service, and the relationship between London’s Air Ambulance and its supporting charity.

Finally, Iain and Anna look ahead to the future of trauma care and pre-hospital medicine, including research, ECMO, marginal gains, quality improvement, and the continuing ambition to reduce preventable deaths from trauma.

Learning from podcasts?

If podcasts form part of your CPD, you can log your listening time across all podcasts on MedPod Learn — not just St Emlyn’s — and generate structured reflection. The app is free to download, includes a one-month free trial, and offers globally adjusted pricing.

Trauma 2030

TRAUMA 2030 united experts and innovators to shape the future of trauma care. Over two days, it explored breakthroughs in science, systems, and frontline practice, fostering collaboration across disciplines. The symposium aimed to inspire research, inform policy, and build a bold roadmap for trauma care worldwide.