 Hi everyone,
This week I have been thinking a lot about human error. This is such a key factor in many of the problems that occur in medicine. What strikes me most about it is that many of our approaches to thinking are active in their nature. We focus on what we can do and what we can influence. However, there is often a much more important negative dimension. By this, I mean the things that we fail to do, or do without cognitive intent. Despite the relative lack of focus, this is probably the mechanism behind most of our problems. It is much less common that we actively make bad decisions. Instead, it is the mistakes, slips, lapses, and other forms of error that lead to the problem. This is why they often sneak up on us, occurring out of the blue. But despite their ‘negative’ nature that doesn't mean that they are out of our control. It does mean that we have to think quite differently about them. I do believe that we are excessively focused on the rational and conscious mind, and give it far too much respect and credit. This is part of the way we train - we are educated to be effective clinicians that are skilled and knowledgeable enough to not make errors. But this runs against many of the things we know about human psychology, not to mention the evidence of reducing error. Instead, we need to be very aware of the many other contributing factors.
0 Comments
This is a copy of my first Substack newsletter. This will be a new modality for sharing some of my writing, although they will also be published here on the blog. You can sign up to get it through to your email inbox here.  Hi everyone,
Welcome to the first edition of the Critical Newsletter! I’m really pleased to have you join me here and excited to start this new project. To help you understand my plan here, I wanted to spend a couple of minutes outlining what the goals of this project actually are. But first, let me take you back a few years and tell you a bit of a story of how I got here. In the distant past of 2013 (yes, I’m feeling old!) I first started my writing journey. I was preparing to start my anaesthesia training and fascinated by many of the challenges that I was about to face. To help me try and make sense of some of this, I started writing. After a short while, I realised that I was actually quite enjoying it. Indeed, some of the content I thought was actually half decent. As such, I decided I would start a blog (I think it was a bit of a thing back then). In honour of my chosen speciality I named it Rapid Sequence. The writing was sporadic, and the quality variable, but I continued it for a number of years. On reflection, I have never really stopped. My focus has drifted over the years - I have started new projects and let old ones slide. The pressure of exams led me to focus more on creating useful learning material, and I started sharing my notes at thegasmanhandbook.co.uk. This project took on greater centrality and my blogging faded away, although I came back to it from a different direction. As I got further into my training, aspects of cognition and psychology began to fascinate me, and my writing targets moved to more adjacent topics. The medical writing drifted. I'm currently in the process of reading the book “Outliers” by Malcolm Gladwell. In it, he looks at some examples of extraordinary human behaviour of one kind or another. Much of this is fascinating but there was one chapter really struck home whilst reading it. This was the chapter on plane crashes. Throughout my anaesthetic training it was fairly common to draw parallels between the aviation industry and anaesthesia. The analogy is not perfect, and sometimes overstated, but I think there are some interesting similarities. What struck me about this chapter is the centrality of human factors in these disasters.
Hello, and welcome to critical. This is the new home for a collection of all my different medical writings, bringing together a number of previous projects. Recently, looking at my educational and medical writing work I realised that it was scattered across a number of different websites. Whilst I enjoy doing these projects, I have found it very difficult to maintain momentum whilst they were so widely spread. I found myself moving from one to another, with some getting almost abandoned. As such I decided that it was probably best to consolidate them altogether in one single place - hence the project that we have here: critical.
|
Dr Tom HeatonReflecting on aspects of clinical practice and training. ArchivesCategories |
RSS Feed
