Applying sport psychology to improve clinical performance^*

Abstract

Preparedness for practice has become an international theme within Medical Education: for healthcare systems to maintain their highest clinical standards, junior doctors must “hit the ground running” on beginning work. Despite demonstrating logical, structured assessment and management plans during their undergraduate examinations, many newly qualified doctors report difficulty in translating this theoretical knowledge into the real clinical environment. “Preparedness” must constitute more than the knowledge and skills acquired during medical school. Complexities of the clinical environment overwhelm some junior doctors, who acknowledge that they lack strategies to manage their anxieties, under-confidence and low self-efficacy. If uncontrolled, such negative emotions and behaviors may impede the delivery of time-critical treatment for acutely unwell patients and compound junior doctors’ self-doubt, thus impacting future patient encounters. Medical Education often seeks inspiration from other industries for potential solutions to challenges. To address “preparedness for practice,” this AMEE Guide highlights sport psychology: elite sportspeople train both physically and psychologically for their discipline. The latter promotes management of negative emotions, distractions and under-confidence, thus optimizing performance despite immense pressures of career-defining moments. Similar techniques might allow junior doctors to optimize patient care, especially within stressful situations. This AMEE Guide introduces the novel conceptual model, PERFORM, which targets the challenges faced by junior doctors on graduation. The model applies pre-performance routines from sport psychology with the self-regulatory processes of metacognition to the clinical context. This model could potentially equip junior doctors, and other healthcare professionals facing similar challenges, with strategies to optimize clinical care under the most difficult circumstances.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes on contributors

Helen R. Church, MBChB MRCA, is a PhD student in Medical Education at The University of Sheffield and an Anaesthetics & Critical Care Doctor at Chesterfield Royal Hospital, UK. Her multi-centre interventional study based on the PERFORM model aims to optimize Foundation Doctors? management of acutely unwell patients.

James L. Rumbold, PhD, is a Senior Lecturer in Sport and Performance Psychology at Sheffield Hallam University, United Kingdom. He regularly consults with elite athletes and professional sport organizations on facilitating effective performance environments. His research focuses on applying psychological routines aimed at optimizing well-being for individuals and groups who operate in pressurized occupational contexts.

John Sandars, MSc MD MRCP MRCGP FAcadMEd, is Professor of Medical Education in the Postgraduate Medical Institute at Edge Hill University and was previously Professor in Medical Education at the University of Sheffield. His research adopts a practical transdisciplinary approach to understand and improve academic and clinical performance, with insights from self-regulated learning and metacognition.