• Malcolm Gladwell
• The New Yorker
• Exams
• Dental school
• Practical

In 2000, Malcolm Gladwell wrote a great piece for the New Yorker called “The Art of Failure — Why some people choke and others panic.” The thesis here is that choking is a reversion to basic instruction — the mechanical, poorly-coordinated, unadaptable precepts from one’s basic instruction in a skill. Sports is a great example: as one choke’s, one shows less and less of the practiced grace that come with experience and more and more of the mechanical, simplistic movement characteristic of the novice. The second part of the thesis is this: panicking is a reversion not to basic instruction but to basic instinct. A panic surpasses all training and heads right into lizard-brain survival territory. Here’s a great quote:

But Steele says that when you look at the way black or female students perform under stereotype threat you don’t see the wild guessing of a panicked test taker. “What you tend to see is carefulness and second-guessing,” he explains. “When you go and interview them, you have the sense that when they are in the stereotype-threat condition they say to themselves, ‘Look, I’m going to be careful here. I’m not going to mess things up.’ Then, after having decided to take that strategy, they calm down and go through the test. But that’s not the way to succeed on a standardized test. The more you do that, the more you will get away from the intuitions that help you, the quick processing. They think they did well, and they are trying to do well. But they are not.” This is choking, not panicking. Garcia’s athletes and Steele’s students are like Novotna, not Kennedy. They failed because they were good at what they did: only those who care about how well they perform ever feel the pressure of stereotype threat. The usual prescription for failure—to work harder and take the test more seriously—would only make their problems worse.

This almost perfectly describes my problems taking exams in school. Let me explain.

I’ve found that tests have become easier as I’ve gotten further away from my brush with academic destruction — I remember more, I perform better. Why? Partly because of the incredible power of the computerized flashcard system I have slowly learned to use. Now, I realize that there is a hugely important attitude component: third year of dental school is easier because I continually tell myself that third year of dental school stakes are lower (because we’re in clinic) and because I tell myself, third year of dental school is easier.

These testing scenarios where the pressure to perform destroys one’s practiced abilities describes my experience on lab practicals so well. As I was cutting a tooth down to the tenth of a millimeter, all the practiced, thoughtless fluidity I tried so hard to cultivate went right out the window. My desire to be careful ruined my ability to succeed. Recently, up in clinic, I finally relaxed during an amalgam prep on a patient. The inferior alveolar nerve block went fine, the rubber dam placement was good, and I told myself “this is an easy prep.” I really believed it because, in a lot of ways, it was an easy prep. However, relaxing made the entire process go unbelievably smoothly. A lot of the reason it was easy was because I had convinced myself it was easy.

For me, my success in dentistry isn’t dependent just on gaining the hand-skills necessary to tackle a variety of experiences — it is equally important that I gain the confidence required to get out of my own way and let myself do good work.

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