I thought you might be interested in the outcome of the blog I wrote the other week about medical students and their curriculum.
It related to my surprise that a student (actually, two students) who are in the middle of their medical degrees at a local university had not heard or encountered Martin Bromiley, cognitive biases, or heuristics.
If you want to know more about these, please read the blog.
It so happens that one of my readers, P, works for the medical school. She replied to me via email and, yes, it transpires that she does show the video to the students, and they are taught about biases, etc, although perhaps not the full Kahneman.
Following that email I had an exchange with P, the professor responsible for the curriculum and one of the clinician-academics who runs the part of the programme related to my students, let’s call him D.
I had a Google Team Meet with D on Wednesday (It’s Friday today) (Did I mention, I am writing this from the Ionian Island of Kefalonia?) (Can you hear the crickets? The Bouzouki?)
In the meet, we didn’t focus particularly on Bromiley, although we touched on him and his wife Elaine. I was keen to discuss the absence of community learning for medical students. (Most of learning to be a doctor focuses on the life in hospital with a smidgen allocated to general practice and none to community care, that is the care I provide, everything that is not hospital or GP – district nurses, community therapy, dietetics, audiology, heart-failure, and the like) (The vast majority of NHS clinical and all social care happens outside the hospital and the GP surgery).
We came to an agreement that I would develop a list of the potential opportunities a medical student might like to pursue in the community, and we would make them available (this is a little ‘second class citizen’ compared to hospital ward, but you take what you can get.)
We touched on biases.
D does cover some of this in the curriculum he teaches alongside P.
D and P were both very familiar with Martin Bromiley.
D suggested the students’ lack of knowledge (ignorance?) related to a cultural disconnect.
‘I used to refer to the solution that doesn’t have a problem, from the Hitchhikers Guide, I gave-up when I realised none of them had heard of it.’
I hadn’t heard of this Douglas Adamsism (It was possibly a reference distorted over time to Ford Prefect’s SEP) although I have referred repeatedly in the past to the Shoe Event Horizon where the planet’s economy collapses because of too many shoe shops.
I get this, to an extent.
Our (people in our late 40’s and 50’s) cultural reference points are very different to those early twenties. And vice versa (recall my Kendrick perplexity) (Sounds like Big-Bang Episode).
D felt that although he doesn’t necessarily always mention Martin and his wife and their tragedy, he does refer to the themes, the concepts, after all, Elaine died twenty years ago and there have been many other medical fuckups since that time.
Yes, I agreed, although was not convinced.
Personally, I feel the Bromiley story is timeless and of such cultural significance that it should be taught and repeatedly emphasised throughout doctor training.
The single-minded focus, the hubris, the short-sightedness that affected the anaesthetists in Elaine Bromiley’s care are present today and will be tomorrow, somewhere in a clinic, operating theatre, or ward near you.
The themes are those of being human. That is why this branch of learning is called ‘Human Factors’ – it is what it is to be human that makes us fail. Nietzsche 200 years ago described it as, ‘Human all too human’ and you can never get enough of learning that.
Incidentally, when discussing this with my children, son 19, biology student and daughter 15, they were both familiar with Martin Bromiley, they knew the story.
Perhaps it is the way it is taught or explained, as Frank Carson said, ‘It’s the way I tell ‘em.’ Or, perhaps like our DNA, there is too much irrelevant stuff to know what is important and what is junk. (Separate Adams’ reference)
Time to declutter the curriculum!