Deliberate Practice in Leadership:
The Missing Link in Healthcare Leadership Development

Transforming Healthcare Coaching Podcast — Episode 104: Deliberate Practice in Leadership. An internal-team episode: co-host Klaus Grim, PA-C CPC ELI-MP interviews founder Lillian Liang Emlet, MD MS CHSE CPC ELI-MP. Published April 13, 2026.

Lillian Emlet: Expertise doesn't come from experience alone. It comes from a very specific kind of practice. It's intentional, structured, uncomfortable and almost always guided by someone who can see what you can't see in yourself. Deliberate practice is a structured way so that you can intentionally choose a path of action or a skill or a knowledge, and you push beyond your comfort zone and then get feedback. The problem is, I think most leaders don't have a strategist. Many healthcare leaders are like, "Yo, I am not a coder. I actually am not a data scientist. How am I supposed to know enough AI literacy so that I know how to make the right policy decisions and the group decisions? How do I remain supportive so that people can be innovative and yet at the same time make sure that we're safe because all organizations want to be safe?"

Lillian Emlet: Here's a question I've been sitting with. Think about the best clinician you've ever worked alongside. The one who seemed to read the room before anybody else. They're making the hard calls calmly. They're communicating in a way that got through to patients and colleagues alike. Now ask yourself, did they get that way just by showing up and putting it in the years? Or was that something else beneath the surface? Expertise doesn't come from experience alone. It comes from a very specific kind of practice. It's intentional, structured, uncomfortable and almost always guided by someone who can see what you can't see in yourself.

Klaus Grim: Today, my co-host, Lillian and I are going to dive into deliberate practice and what it actually means and why it's the missing link in leadership development for healthcare professionals and what it looks like when you commit to growing on purpose. If you ever felt like you're putting in the effort, but not quite breaking through, this one's for you. Welcome to the Transforming Healthcare Coaching Podcast. And again, I'm so excited to host this episode with Lillian, and we're going to dive into Lillian's experience with deliberate practice and get an idea of what healthcare leaders can be doing in their own world to really grow as both a leader, for themselves and for their teams, and maybe for their own lives as well. So, Lilly, thank you for joining.

Klaus Grim: And can you take us back to a moment in your career, maybe, it was early on when you realized that just showing up and doing the work wasn't enough to actually grow. What was that like?

Lillian Emlet: Yeah, so I think I've been involved in deliberate practice, probably the entirety of my professional career primarily because

Lillian Emlet: I entered into simulation education very early on. in my second year of fellowship, I went down a clinician educator track, and that's when I decided to take the deep dive into sim. Back then, I really had only experienced SIM as a way of educating, and most people now, whether you're a medical student, PA student, nursing student, you have some degree of simulation involved as a learner in your curriculum somewhere, and it's all weaved in now through medical education. and as a designer of those simulation programs, deliberate practice is a foundational theory and philosophy that sim educators take on because it is about crafting those simulated experiences allow people to fail in a controlled fashion with deliberate debriefing or coaching, basically, to help you perform as at a specific edge that the purpose of the simulation curriculum was designed to do. So, I guess I've been doing this since I was a fellow in 2006.

Klaus Grim: Did you know that it was deliberate practice? Like that was the term that you were using when you were starting off in your simulation practice?

Lillian Emlet: No, not back then. I think that only came through the deeper dives into the mentorship and the learning and the master's in medical education. And all along the way, the part of the structure of the graduate medical education degree program is to talk about theory. Medical education, you can just teach but the reality is, most teachers in the end find some kind of theory, and by going through those more structured programs, you take a deeper dive into like, "well, why do we structure things this way?"

Klaus Grim: That makes sense.

Klaus Grim: So as someone who's worked with a lot of healthcare professionals, what patterns do you see most often between kind of their clinical excellence and their leadership effectiveness?

Lillian Emlet: So let's be honest, people who are promoted into positions of leadership are often because they're the loved clinician. They are the ones who love clinical practice, who are well known, who live in the hospital anyways. And also their clinical expertise and their respect that you get from your peers naturally allows them to become a leader. they basically then end up leading their group, their division, and then their whole department eventually onto the hospital. Depending on whether you like alliances between specialties versus you want to look inward and make the group run more efficiently. So it's usually pure clinicians who really love the practice.

Klaus Grim: And Lilly, you practice in critical care, and I practice in emergency medicine, and I think you and I both can speak to that that we've been in the hospital systems for many years and we've seen people are promoted, as you just mentioned. they've put in the time, the experience, and they are excelling in their patient care and working great with teams. And then they're put into these leadership roles and from there it's like: "what happens? where do they get the training and the skills to be a leader?" And so I'm curious, when you hear me say that, what comes up to you with deliberate practice and how that can be kind of used, to become a better leader for them?

Lillian Emlet: Yeah, so I would say that most leaders, just wing it. Just like, we don't really realize how often we are wing it in daily life in terms of potentially a clinical case that's really challenging. A lot of times that's the situation we have or we consult a friend. So you ask a friend, and that's basically an advisor, or sometimes if you have a mentor, you'll ask that person. And so it really is just by trial and error. But how that differs, so trial and error is not deliberate practice at all.

Lillian Emlet: Deliberate practice is a structured way so that you can intentionally choose a path of action or a skill or a knowledge, and you push beyond your comfort zone and then get feedback.

Lillian Emlet: There's a feedback loop in deliberate practice, which is why the educators use it in simulation. Leaders often then go find knowledge. So it's great to go find knowledge. They'll get a executive MBA, they go get a certificate program. many healthcare institutions have leadership development pathways where they have a one year structured curriculum to teach them all of the finances and the backend. They need to have some knowledge of, in order to rise in the organization, to be able to work to the executive level, the business side of healthcare, for example. you're developed, you're groomed internally. that's still not deliberate practice, that's just education. And as you and I both know as educators, education has many different facets and components when you look at the entire program, some of it's knowledge, some of it's like you're listening to us right now. This is one auditory way to consume thoughts, perspectives, and it really doesn't become your knowledge until you put into practice. And so how are you going to scaffold even the things that Klaus and I are talking about? It takes action. And so deliberate practice really is about the action oriented phase of integrating your experiences and actually trying it.

Klaus Grim: So you got me intrigued now, and I'd love to get into deliberate practice itself now. So if you were explaining this to a healthcare professional who's never heard of this term, or the you that didn't hear of this term, when you were leading, deliberately, practicing as a simulator educator, what does it look like and feel like to be practicing deliberately?

Lillian Emlet: K. Anders Ericsson is the person who coined and named this concept "Deliberate Practice," and it really emphasizes very structured goal oriented training to achieve expertise. and that's usually relating to very specific micro goal and a really full focus beyond your own personal comfort zone, which means it's something different from how you normally practice and different from your usual, and then immediate feedback. And often sometimes, either a mentor or advisor or a coach to literally guide you to get a better mental representation of the skills. And it takes really purposeful practice. It is not just random, playing things because if left by our own devices, many of us have had this where if you're studying, you think you're studying for the boards, we just highlight the same thing over and over. Oh, we reread things to make us ourselves feel better. It requires stepping out of comfort almost intentionally. Well, it is intentional to step out of comfort and get immediate correction an immediate try again. And you know, we see this sometimes when we structure our simulations for an opportunity we're actually asking you go ahead and mess up and try something different. Try something different that we've told you that this is how the best way to do it, and the first time you ever do it, every medical student, every trainee, you've never done this before. It feels really awkward. It feels awkward to say things in a certain way. It feels awkward to do procedures in a certain way. I'll argue when you step into leadership, having a coach or a mentor or an advisor give you that same kind of opportunity means you're strategizing ahead of time. You're going in and doing the scrimmage, and you're stepping back out and you're debriefing. And so my question to the people who are listening is in real life. Do you do this on a relatively regular basis? And I'm not asking that every single staff meeting or every single department meeting is a opportunity to do something different, but you do need to find small ways you're going to build the skills and translate your MBA degree or your certificate program into true actions in the meetings and at the end of the day, as an administrative leader, it's in those moments. It's in those moments in the hallway. It's those moments in your meetings that you're trying to do something differently and strategically.

Lillian Emlet: The problem is, I think most leaders don't have a strategist.

Lillian Emlet: as we've moved on to this leadership plus wellbeing space at Transforming Healthcare Coaching. I've really thought about the fact that not only are we a Sherpa, we're a mirror, we're also the strategists behind most department chairs and leaders, CEOs, executive committees, to figure out how do they want to show up in the way they resonate with their own personal leadership style. So it is in alignment with the organization's needs and their team's needs.

Klaus Grim: That was a great, explanation.

Klaus Grim: And so for our listeners who may be the leader or stepping into new leadership roles, and this deliberate practice is intriguing to them and they're saying, "yes, I want this deliberate practice because I need to improve on my leadership skills and I want to be the best leader I can." How would you suggest somebody begin having an understanding of that structured way of intentionally moving forward in the best way possible as a leader to grow and be the best version of themselves for themselves, for their families, for their teams. how do you suggest that they begin this?

Lillian Emlet: So that's a lot about why our framework at Transforming Healthcare Coaching is "and". it's awareness, new action, and deliberate practice. And so with our clients, we do a lot in the beginning about the awareness, and we've covered this before, previously in our podcast, about all the different ways that you can become more aware and get assessments and 360s and feedback. But then in the end, it somehow eventually has to get to. It's not working, or I can even be more optimized. The reality is most of our clients are people who are pretty well functioning. I mean, you're not director for no reason. You're high functioning and so, there's definitely places to tweak. I'm still tweaking all the time, and so I love getting new ideas and trying something on, and it's really about that new action and then getting feedback. And so the question is, who do you find that feedback for the deliberate practice? Do you have a trusted advisor? Do you have someone who you're going to ask, can you come onto my advisory team just for like six months? Can you just help me out for a month? Because I'm trying to learn the most common thing right now is actually AI.

Lillian Emlet: Many healthcare leaders are like, "yo, I am not a coder. I actually am not a data scientist. How am I supposed to know enough AI literacy so that I know how to make the right policy decisions and the group decisions? How do I remain supportive so that people can be innovative and yet at the same time make sure that we're safe because all organizations want to be safe?"

Lillian Emlet: And so this is a place that most leaders right now are really struggling with, like, well, which courses do I take? What actions do I do? It requires deliberate practice. And so do you find someone who will come on, help you along and basically say, "I have a time limit to my goal." Be strategic about that. At the same time, for some people this may be a complete pivot where they're like, "this is the most amazing thing in terms of, in my particular team, we are going to go after a new partnership and you do it." And so then you have a much longer term person that you need to have with you. So that probably will be in the end of probably a coach because you're going to pivot to a whole new alliance. You're going to take over a new hospital, you're going to have a whole new group be absorbed, you're going to develop a whole new structure to how the team is staffed. That's going to take some longer term planning about how you're going to merge those cultures, those require, I mean, that's why most of our executive coaching is actually a year long that's going to take a strategic plan and it's going to take someone to think about what are your big goals, quarterly goals, monthly goals, and how do you now lose yourself along the way? And so, often in our sessions right, we talk about, "What's the foundation?" And that's usually the wellbeing piece for the leader themselves. Plus also, what's the micro move that you think is going to move your team forward or move yourself forward in your leadership practice?

Klaus Grim: So to summarize everything, it sounds like starting to have that awareness of: "is deliberate practice something that resonates with me and what I want right now? And if so, who is that person to help guide me to help be that reflection piece and strategist, in making that structured way of moving forward intentionally? So that's a great first suggestion for those listening here who are starting to resonate with deliberate practice and becoming the best leader that they can.

Klaus Grim: And one thing that I think you and I can resonate with Lilly is time to be able to meet with somebody and to deliberately practice, when you're focused on this new role or this role, you've been in a while that has so many demands that already takes up so much time during your day, and then when you go home, you have a family, you have all these things. How do you build time for deliberate practice?

Lillian Emlet: Yeah, so I think the question is it's foundational, So I think the biggest thing that has to be in your calendar is sleep. So this is ironic coming from the person who also works night shifts, but sleep is probably the most important thing. Your nutrition, your exercise comes second, and then after that the soul nourishing things that you need for your mental health. Whether that's, so sometimes you can combine these things, where you do a walk, you listen to a podcast where you go biking with your family. So you do the things that our foundation going to make you well, first. And then next I would say is actually the deliberate practice strategist. the very next piece in that pie actually is the coach — in between your foundational roots of what's going to keep you whole at capacity function like a high performance athlete, as a healthcare leader. And a family member and partner and all of the other things that you are, that's the most important thing. But the in-between thing is actually the coach, because if you don't have things organized or understanding, you just feel like other people are dictating what you're supposed to do. And then this is very, very common. I mean, we all have it. We love every identity we have. And when we look at our calendar, it's very full. and we're being told what to do by the school, the university, the hospital system, the administrators, the C-suite. We're being told what to do at all times. If you don't have a strategist, really think through and plan out each week, you're just going to let the week happen and you can be a victim to it. So I would say those are the, probably the foundational roots. And then from there. Then you can begin to tighten down what's necessary. And I know right now there's a lot of people listening like, "but I can't, they told me when I took this job. I literally have 20 hours of meetings per week." And then it's like, "okay, well we'll go back to assessment." Let's assess what is the purpose of these meetings. why are you there? How much do you contribute and are there ways to gain efficiencies? I mean, hopefully you're not running all 20 meetings. There is a chance you are running all 20 meetings, but it's unlikely.

Klaus Grim: Yeah, so what I'm hearing is working with somebody such as a coach can help almost buy back time because working on your wellbeing is challenging in the demands of healthcare, number one. So, getting you well as a human being in your everyday life and in your roles. Number one, the most important thing. If you're healthy and well showing up to your job, you're going to reflect that oftentimes in your team members as well to be doing the same thing. because we want that with our team members. And then secondly, again, is that structured way of moving forward. And so I think one thing that I can share is as somebody who's a coach and works with a coach very frequently, that buyback time is huge. How many of us have on our to-do list or some goal that we've had on our mind for a while, whether that be for your clinical practice, for your personal life, for your leadership team. You went into your leadership role to make positive changes, and a lot of that is your own authentic, unique way that you wanted to bring forward to your organization. But you're so busy working on so many other things that that gets pushed to the side. And when you deliberately work with a coach or somebody who is intentionally keeping you accountable to the things that are important to you, you'd be surprised at how quick you're able to make progress in that journey. When you have somebody just saying, "you got this. you said you wanted to do this, what's stopping you?" I think you and I can both speak to that, having clients, and then being coaches ourself. Yeah. And so, Time's a big thing.

Klaus Grim: And the other thing that I think you and I see Lilly, is people struggle with feedback, especially as a leader, You are like, "I got hired for this role." And they're afraid that by deliberate practicing or maybe making a mistake, they're going to get some feedback that doesn't resonate with them, or they only want the positive feedback. What would you say to this when in this practicing deliberately?

Lillian Emlet: feedback is hard, So I think the reality is all of us have received negative feedback at some point, and it's really hurtful to your heart because you take it so personally, so easily. And I think the reality is finding the right people to debrief with and finding people who you can trust to learn and figure out what can I find in the learning here? And also take things with a grain of salt. So I think the reality is, for those of us who are a little bit, the more you ascend into the public eye, the reality is there are going to be some haters. There's going to be some people who you don't really want or respect their feedback. Either it is how it's delivered or the content, and yet the reality is they're still potentially part of the team and it's still potentially a perspective. And so the question will be is: "how are you going to interact with that reality? You don't have to accept it. Again, other people's opinions. You can choose to pick it up and integrate it or you don't. And the question is: "if you don't choose to integrate it, the question is why?" and so really unpacking that with mentors, advisors, and coaches, people who've been there before. Everyone has received some kind of negative feedback. It is just shows the diversity of perspective and while you may see as a negative, the other person is just, "I'm just trying to express myself and the way I see the world and it is hard." It is hard to be in a place where there are diversity of perspectives. It doesn't mean that either or are wrong. It actually is a both and the both the other person's experience and also your intent are both true. And so it just makes you a better strategist again to figure out how can we make more people comfortable with a particular plan or decision because we do need many people on board. for the team to row forward on a boat. You do need as many people to come along for the whatever policy changes. Ideally, you're not having so many politically charged decisions within your team that you're going to lose half the staff because having disengaged staff, chronically and consistently over time is going to wear away at your leadership, abilities. And you do want to bring people with you. And while it takes is one sour person. The reality is you can't let that become 10 sour people, half the team. And so you do need to listen to it. So the question is: "where can you find the grain of either fact? And how do you hold the emotions and find a safe place to process those emotions? Because it is very hurtful. I mean, there's lots of times when we have received feedback that poeple just plain didn't like you for whatever reason. And so the question is: "is there something that you need to change? Is it really true? Is it just data and what's it also saying about their lived experience currently? because usually hurt people, hurt people.

Klaus Grim: Yeah. And we have a specific episode on feedback that you and Gillian, did I think a few months ago, and I'll put that in a link below for those who are interested to learn a little bit more about feedback, because feedback. I think you did a great summary of it, but it's very difficult to both receive it, but also to give it and some very unique skills that you can develop in that nature. And so you talk about feedback that something that with deliberate practice can actually help with.

Klaus Grim: Can you maybe walk us through, what else deliberate practices, actually looks like as a leadership skill? Something a little bit concrete, like a specific skill and how a leader can develop those reps to continue to use that skill?

Lillian Emlet: I think probably a really common thing that people come to, eventually comes up at some point, is: "I really wish meetings could be better, more efficient, tighter." Those relationships could be better. And you always wonder, is this the best way to run a meeting or not? You start to navel gaze and you start to ask for feedback from your administrators, the people who are in the meeting, you one-on-one, is there anything they could do improve? You'll get some varied opinions, but I would say that meetings is probably one place where people often want to try to do something differently because even there's some people who as leaders, they're like, "I really don't even like my own meetings." So when that's the case, then it's "oh, perfect opportunity. Have you ever been to a meeting that did go really well?" Or that just had a different vibe or culture, or was actually so much more productive than yours? "Well, yes." "Well, what were the characteristics about it?" Then you identify those characteristics. Oftentimes, it's like a time very scheduled agenda with pre-agenda things sorted out for pre-review before coming for discussion. sometimes it's people who really like time structured so that it's very clear what to expect. for others it's really ending on time. 10 minutes to go so that everyone can do their action item within the last 10 minutes of that hour that's blocked off. For some people, it's the connection piece.

Lillian Emlet: It's really about having a place to sing people's praises and do the thank yous and the gratitude at the beginning of the meeting to really change the culture of like how we meet and how we come together. For other people's just having your video camera is on the cultures of people with video camera off is the most concerning to some degree without a disclaimer about "if you are able to, we'd love to see your face, and yet we also understand for flexibility, it's also okay that you have your video camera off for X portion of this meeting." So also to be clear with expectations. So these are all micro skills. As a leader, you can decide how do I want to change from how it is? Two ways I think might be better. And these are all things I've heard, right, in terms of, "I would love to have X because I've seen it over here and I like to be that kind of person." "Great, well. Let's try it. Let's see what happens." And then after a couple months you're like, "oh, it's just normal now." But it does take that commitment, noticing a committing to it, and then actually doing it and then again getting the feedback. And who do you get the feedback from as a leader? Actually, the people in your meeting. You again, you're going back one-on-one. "Hey, how was that? Was that okay? Was that weird? Did you not like that?" And determine the culture. And then you report back to your coach a month or two months later and it's like, it's amazing. And it's "yay! Yay for you." So it's those types of things that we work on as micro skills with, how deliberate practice gets actioned.

Klaus Grim: And I think one thing that came up for me too is sometimes when, as you mentioned, awareness is oftentimes the first step to making changes that you want, and sometimes you're just not aware, especially when you're jumping into this new leadership role that these are small skills which may sound very basic because they are, but the basics are the foundation of how we show up every day. And if we're not working on some of these things, we're just inviting ourselves to be the same person that we were and we're not showing up to the leader that we want to be. So it does really take that feedback loop, that consistency, I think consistency is the biggest thing. because as you and I can probably speak to, oftentimes if you just do it for a couple days or a couple weeks and you don't have the accountability, oftentimes it can just drop off. Because then you may be drowning with more paperwork or more tasks and you really need that structured, set up and strategy to really have that room to play and when I say play, do it in a fun way that it's not boring I think you and I as coaches, if you are transforming healthcare coach and we try to incorporate fun into everything that we do, because some of this stuff can seem so boring, "Oh, feedback. Feedback, okay." But if you're doing it in a way that you can enjoy, you're more likely to be more consistent and going to follow through on some of the actions that you're looking for.

Klaus Grim: And so, Lilly, what shifts for healthcare professionals when they actually commit to this kind of intentional practice, what are you seeing change.

Lillian Emlet: I would say probably the first thing is just, getting wins, meaning that you just see a tiny low success and you're like, "oh, I can do that, and then I did it." And so then you just move on to the next. You just move on to the next, and things sometimes get bigger. And you also start to realize, even though it may seem really overwhelming when certain things happen, when you can slow down and break it down into what action can I take you? You realize, one, you have more agency, and then two, you realize that it's not the end of the world. But I just, I do need to do something. I can't just let things happen to me. And so having commitment and having someone secretly by your side. Working on those particular leadership skills that you, again, have learned in potentially maybe other courses you see and you read and you listen. I mean, you're listening to us, right? You hear and see and listen to these things, but it's only until you try something that any of it makes any type of difference. And so I suggest that just try something, commit to something small. And let me just say it's really

Klaus Grim: sad

Lillian Emlet: when you just do it by yourself and you just listen privately and nobody knows you're learning anything. This is the reason why. There's weight loss groups, there's exercise groups, there's Peloton. I mean, people like to do things together, even if it's a virtual. So I do think that's part of the reason why we created a medTHRIVE Connect and we have our private medTHRIVE group, and we're actually changing it to be a little bit more intensive. general, it people thrive being together because it's so gratifying to be able to say, I tried this and it worked and I did it to tell someone and all, always people who are also on that same journey. So, people who are interested in leadership and wellbeing and want to commit to, "yeah, I'm doing tiny experiments all the time and I did it and it's a win." When you're a community with those kinds of people, you're pretty surprised, like what kinds of things their people are working on.

Klaus Grim: Self care still gets a bad rap in our community in healthcare, but it doesn't need to be. Having a community, having the development is so important for yourself. At home, but also at work. And everything that you said, that word 'self-care' just kept shining through. it's important to surround ourselves around the people that motivate us, or positive and fun and help us grow in the ways that we want to grow as human beings. So that's a great suggestion that you had there.

Klaus Grim: So Lilly, if you could distill everything that we talked about today and maybe. Into one insight, what's one thing you'd want every healthcare professional and leader listening to the hold on to this week?

Lillian Emlet: You can find one small thing to practice and commit to yourself and find one person to commit with. So, no one's going to notice whether you did something differently unless you say it out loud. So unfortunately, this is a moment when your, little journal and your commitment, when you write your mission for the week, or your vision for the week, or your goal for the week isn't enough. When you commit to someone externally, you're not only more likely to succeed. You'll also get potentially the feedback and debriefing that you need, which is the deliberate practice that you need to grow as a leader.

Klaus Grim: I love that. Thank you for sharing that.

Klaus Grim: We know your days are full. We know healthcare asks a lot of you. And we also believe deeply that you deserve a practice that's designed to help you grow. And so our call to action this week is to join our medTHRIVE Connect community so we can meet you, get to know you, we can fill out your profile, and you can start to build that community with other leaders and healthcare professionals who are on the same journey. And if you're able to pick one leadership skill, just one name it specifically. and, before responding in difficult conversations, set one micro goal and find someone to give you real feedback after you try it. And if you want to go deeper, feel free to reach out to Lillian. I'll put a link in the show notes to reach out, and we'd love to hear what you're going through, what you're interested in, and how to grow as a healthcare professional and leader. Thanks, Lilly