For the things we have to learn before we can do themwe learn by doing them.



If you were to require emergency knee surgery, would you prefer a surgeon with 2 years experience of doing nothing but this surgery, or a student intern that has only heard about the procedure during lecture?

While things like home based services might not be identical to emergency surgeries, they do share some things in common. Both require specialized skills that require some degree of precision in order to be successful. And, kind of like the same way Netflix gets better at guessing what you’ll like the more you use it, so it goes with practice skills. Intro: “The 10,000-rule.” This Gladwellian concept states that it takes about 10k hours to make someone an ‘expert’, at something. While this has faced some revision in recent years, few argue the role that repetition plays in creating professional habit scripts.

Split second [good] decisions

When we are forced into stressful, or unfamiliar situations, our ability to filter the ‘signal from the noise’ is compromised. The energy required to process the mental and physical information we are receiving affects us. So, we tend to act out of habit, relying on instinct to pull us through. And many believe that being a good (generalized) problem solver is way better in these situations than being a specialist (a la deductive thinking and Fermi Problems). But by nature, the unfamiliar is not something we prep for,and efficient and effective deduction is key… and efficient and effective takes PRACTICE.

So what is deliberate practice?

This is like the ‘focus group’ of practice… there are lots of rules, and this is the most stringent kind of practice. Rules include (adapted from Ericsson and Pool, 2016):

  • Repeating a known skill, with established training techniques
  • Learner is outside comfort zone
  • Clear, objective goals
  • Requires focused attention
  • Credible/professional instructors to promote modification/improvement efforts
  • Requires effective mental representations
  • Incremental – requires strong foundational skills that progressively build


VR and the future of practice

Research into the effectiveness of VR skills training has demonstrated its ability to improve learning outcomes. But many VR simulations tend to live in the realm of purposeful practice for one very specific reason: it is VERY difficult to articulate a clear, objective criteria for performance in VR sims. Think of bowling… the higher the score, the better the game, with a maximum score of 3oo (the almighty PERFECT GAME). But what is a ‘perfect score’ on a home visit/assessment? What does an A+ therapy session look like? Is expert performance in these human service activities absent of subjectivity? I honestly don’t know; but I think many VR simulations will continue to help users develop new skills, learned by doing them.