Re: Comparative issues in aviation and surgical crew resource management: (1) are we too solution focused?

摘要

I read with interest the recent article by Hunt and Callaghan in the August issue of the ANZ Journal of Surgery.l The authors have taken a particularly simplistic approach, and assume that aviation-based CRM programs are simply being used in a different context, that is, the surgical environment. This sweeping generalization reflects a lack of appreciation of the different types of human factors training currently being conducted in the medical and surgical environments. It is disingenuous to argue that human factors training and CRM-style programmes currently in use in the healthcare setting are all simply lifted from the aviation context and thus reflect a single, generic aviation-specific CRM programme arbitrarily placed in a surgical context. Their argument assumes that no modification or context-specific adaptations have been made to these programmes, or that none of the healthcare human factors training programmes have been specifically created for that environment. There is a fundamental difference between aviation-based CRM courses and programmes designed for the surgical environment that apply well-known human factor concepts in order to improve both operator awareness and patient safety. Furthermore, the authors have ignored some of the more important aspects of human factors training used in aviation that are eminently transferable to the surgical environment (something readily acknowledged by many of the world's pre-eminent authorities on human factors), such as the underlying reasons for different types of errors, and effective team and communication skills." There is therefore much to be gained from the field of human factors, especially in relation to healthcare.