|
|
|
|
Truffle Hunters and Parachutists:
Situational Awareness
|
|
|
|
|
|
|
Do you hunt truffles? Or are you a parachutist? How is your situational awareness? Do you know what that is?
An Example
The other day, I was doing surgery with one of my residents and during the case, he had not realized how much time had gone by. He was so involved in the case that it had seemed like only minutes had gone by. This is very common with residents learning surgery.
|
|
|
Another Example
This is also somewhat common with other providers. Let me tell you a quick story about my wife. Don’t worry, she gave me permission to tell you her history. She suffers from hypothyroidism and takes medication to control the disease. A while back, she started complaining of unusual symptoms including dizziness, vision changes, palpitations, and a general feeling of not being well. She went to one doctor who ordered a bunch of tests including sending her to a cardiologist. That cardiologist placed her on a Holter monitor thinking that she had a cardiac arrhythmia. Despite all the testing, they could not figure out what was wrong. Eventually my wife went to the emergency room, where they performed a very quick TSH test. They realized instantly that she was taking too much medication and was suffering from iatrogenic hyperthyroidism. A simple adjustment in the dose of her medication completely resolved the problem.
|
|
|
|
|
Focus In On Situational Awareness
These two examples demonstrate a lack of situational awareness. I think you might realize now what this concept is. However, just to be complete, a definition would be in order. Here is how our good friend Wikipedia defines it: “Situation awareness involves being aware of what is happening in the vicinity, to understand how information, events, and one's own actions will impact goals and objectives, both immediately and in the near future”.1
|
|
|
The Polar Extremes
Some of us have a broad situational awareness and some of us have a narrower one. The historian Emmanuel Le Roy Ladurie said it best when he was talking about history:
“All historians are either truffle hunters, their noses buried in the details, or parachutists, hanging high in the air and looking for general patterns in the countryside far below them.”
Clearly, the doctors treating my wife were truffle hunters.
|
|
|
Increase Your Awareness of Your Surroundings
As in many things with the medical profession, we have appropriated (some might say stolen) this phrase from the military. Obviously, if you are in the middle of a battle, you need to be aware of everything going on. Miss that sniper on the roof, and you could end up dead. In medicine, we have adopted this idea to refer to our awareness of various aspects of patient care. These aspects might include the physical environment such as in the operating room or intensive care unit or the intellectual environment, such as the details of what is going on with a patient.
|
|
|
At home, my four-year-old daughter loves to take advantage of my occasional lack of situational awareness. The other day, for example, I was relaxing on the couch. The next thing I heard was the doorbell ringing. My daughter had climbed onto a step stool, unlocked the bolt (which is supposed to keep her in the house), opened the door, stepped out of the house, and rang the doorbell. Thank God she didn’t go out further! My first action was to compensate for my lack of situational awareness by raising the bolt to the top of the door where my daughter can’t reach it.
|
|
|
For we podiatrists, the classic educational example we teach our students is about a patient being attached to the foot. When we say this, we are trying to remind our students that they need to maintain a global view of their patient, understanding the entire patient affects the extremity and vice versa.
|
|
|
Nature vs Nurture ?
So, is situational awareness ingrained in all of us? Do each of us have a certain amount of this? Or is it something we can learn? I’m not sure of the scientific answer, but I think this is a skill we can all pick up with some practice. We can train ourselves to be more situationally aware.
|
|
|
|
|
Zoom Out to See the Big Picture
First, it is obvious that as we gain experience in our respective fields, we become more capable of broadening our awareness to other things around us. My resident’s lack of time awareness was partly because he was focused so hard on what he was doing. Similarly, my students often miss a diagnosis in clinic because they are focused so intently on a particular exam finding that they fail to look at the bigger picture. With experience comes situational awareness.
|
|
|
Practice, Practice, Practice
Second, practicing situational awareness can help broaden one’s perspective. For example, while doing whatever that activity is that requires a broader perspective, force yourself to look up every five to ten minutes. Take stock of the situation. If you’re a surgeon, force yourself to periodically stop for a few seconds, look up, and view the room. Remind yourself about the time and what is occurring in the room.
|
|
|
I think you’ll find that it’s easier than you think to increase your situational awareness. You’ll have a broader view of the world around you and will be a parachutist rather than a truffle hunter.
|
|
|
|
Get a steady stream of all the NEW PRESENT Podiatry eLearning by
becoming our Facebook Fan.
Effective eLearning and a Colleague Network await you.
|
|
Grand Sponsor
Major Sponsor
|
|
