The great learning dilemma for doctors

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Let’s step away from your medical practise for a few moments.

Ask yourself: When do I learn the most?

How did you develop your ability to play that musical instrument/play that sport/bake that cake/do that card trick or whatever else you are capable of?

Do you believe in natural, god-given talent with instant brilliance or that we learn through making mistakes?

In the words of Oscar Wilde, “Experience is simply the name we give our mistakes“.  The sentiment here is simple, clear and difficult to argue with. However, does this pose a dilemma in relation to supporting the development of other doctors? Are the  consequences of mistakes in healthcare such that they are unacceptable?

How then to support the progress from novice to expert?

A great mentor and teacher will recognise that mistakes are an essential, integral element to develop knowledge,  skills and attitude. This concept is referred to across history, culture and literature. Through his characters in Journey to the Centre of the Earth, Jules Verne imparts the wisdom that, “Science, my lad, is made up of mistakes, but they are mistakes which it is useful to make, because they lead little by little to the truth.

Of course, there is a fundamental difference between the acceptance that mistakes are essential to progress and that they should be allowed to go unchecked. A starting point must be a recognition that something has indeed gone wrong. In the words of martial arts master Bruce Lee, “Mistakes are always forgiveable if one has the courage to admit them.” How forgiving is the environment that you work within? Truly forgiving cultures, with openness and honesty, are highly dependent upon the attitude of the leaders, teachers and mentors involved.

When 60’s rock icon Jimi Hendrix pointed out, “I’ve been imitated so well I’ve heard people copy my mistakes.” he was expressing awareness that he, a virtuoso, could have performed more effectively. When a teaching doctor is unaware or unwilling to recognise their own shortcomings, the risk is that these are repeated by the learners.

No-one benefits from a Dr Britney Spears regularly declaring, “Oops, I did it again!” or a witty Dr Peter Cook version who dryly quips, “I’ve learned from all my mistakes, and I’m sure I can repeat them all exactly.” The point of being open and honest about errors is that they are explored in a manner which leads to changes – changes which are the stepping stones to expertise.

So how, where and when is it acceptable to allow doctors to make mistakes for learning?

We regularly discuss these challenges in our Teach the Teacher and Mentoring Skills Courses for Doctors. There are many options. This is where development activity overlaps with risk management, planning and supervision in all its forms.

Talent takes us so far. Expertise takes conscious practice, pushing forward, recognition of mistakes and taking action to change.

How are you supporting your learners in making their own mistakes?

Stephen McGuire – Managing Director