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Plus/Delta: Learning to Heal in a Complex World
Hello, World. Welcome to Plus / Delta!
By Shannon McNamara • Issue #1 • View online
If we already know each other, great to see you here! If we haven’t met yet, hello!
While we all settle into this unpredictable, pandemic-adjacent future, I hope that starting a newsletter will help me connect with folks like you - people who are curious, people who love learning, people who love finding questions that we don’t know the answer to (yet). You may be a doctor, you may be a nurse, you may be someone who hates hospitals but loves learning. Welcome, all.
Thanks for joining me here!

Why Plus / Delta?
Debriefing is the common theme that ties much of my work together. Plus/Delta (or +/Δ) is a foundational debriefing method. Debriefing is a reflective practice, where we learn directly from our experiences in real life or in simulation.
Book learning can be great, but learning from real life is essential.
In a plus/delta debrief, a team talks about what happened, what went well (plus), and what they’d like to see change in the future (delta).
Plus / Delta
Plus / Delta
What to expect from this Plus / Delta.
I love debriefing - in sim lab, outside the resuscitation room, or at the kitchen table. Debriefing is both incredibly simple and highly complex, all at the same time.
I spent the last decade learning how to save lives and learning how to do that better. Learning how to debrief has been a big part of that. It’s been a wild ride through intensive study of Emergency Medicine, Medical Education, and Simulation-based Learning.
Though my experiences with the institutions of Academic Medicine have been profoundly disillusioning (more on that later), the science that I learned has been wonderful and life changing.
There are some amazing, transformative mindsets and techniques out there that can help us all learn better and get better at doing what matters. I look forward to sharing reflections on those strategies with you here.
Plus / Delta will start as an every-other-week publication. Issues will also be archived on the main page so that you can reference them there.
Real talk.
I do not have all my ducks in a row. I am in the midst of a job transition while parenting small children who enjoy partying in the middle of the night. We’re all navigating a global pandemic from a novel airborne virus. It’s a lot.
Part of me wants to wait to make a nice outline of all the things I want to talk about here in an order that makes logical sense before hitting send. But that may never happen.
They say the best way to get something started is to get something started, even when it’s not totally fleshed out and feels a little scary.
So! Here we go.
Next time on Plus / Delta...
Patient Safety is Dead, Long Live Patient Safety.
Did you enjoy this issue?
Shannon McNamara

Reflections on learning in medicine and beyond.

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