THE last 15 years or so have seen a complete change in the way I learn and approach challenges within practice.
Having been trained in university to absorb huge numbers of facts and then re-present them to “prove” my competence to practise, I found it somewhat disconcerting when I qualified and this approach just didn’t seem to work as well as I felt it should in practice.
In the first few years (I qualified in 1979) it did not matter a lot because there wasn’t really much alternative but in the mid-eighties along came the internet and then things really started to change and speed up.
Today, like for most people I suspect, the skill is not about just knowing “stuff ” but practising “just-in-time learning”, managing both self and knowledge, learning what/when it is required and avoiding information overload and burnout along the way.
These are profound changes that have seen the role and respect for the “expert” diminish in a world where anyone can become a pseudo expert in less than an hour or two, requiring no more than the will and an internet connection.
Interestingly for our profession, in this new order the skills of the generalist (GP) come to the fore and are beginning to be recognised, offering a major opportunity to the primary care arm of the profession. This may be 60 years after medical GPs were first recognised but is, nonetheless, something to be celebrated.
Of course, there will always be a need for experts who have detailed knowledge in limited areas but I suspect that the spotlight of opportunity will shine on the generalist in the next few years. An opportunity that will need either to be grasped and exploited or ignored at our peril.
Whilst an opportunity, this is also a significant challenge in that there will need to be a significant change to our ways of thinking, learning and changing. These all present particular difficulties to those of us in busy practices.
And so to the point of this article: I suggest we need to focus less on accumulating clinical knowledge and more on the solutions we want to see, improving our self-management/ learning and easing off on some of our resistance to change.
In a typical human population, the responses shown in Figure 1 are probably typical, despite our protestations to the contrary.
As is being ably demonstrated by RCVS Knowledge, the practising arm of the profession desperately needs access to good quality knowledge that is accessible to them in a form that they can use on a day-to-day basis. Otherwise, how are we to move from the opinion-driven profession of the past towards the practice of evidencebased veterinary medicine in the future?
All sectors of business and the professions are facing similar challenges and, to be successful, we will need to be prepared to think differently and look with new perspectives. Casting off the habits of cultural memory can be incredibly difficult but the alternative is likely to be much worse.
Focusing on the solution and being flexible about method and route can offer agile opportunities for success more likely to succeed than rigid application of knowledge-based approaches.
I shall use two scenarios to try to illustrate the point whilst also providing a brief introduction to one way of looking at solutions-based approaches.
Traditionally, “management” solutions have been used to “make” people do what they are required to do. They are often prescriptive and, as a consequence, resisted. Even if not resisted they can be difficult to implement.
An example of this might be a business’s HSE policy. Good intentions but because the pressure is there to cover every conceivable possibility, the product burgeons in size until it becomes unmanageable. I strongly suspect that many employees who sign their 600-page HSE manual either have not read it or, if they have, have not absorbed it or will have forgotten most of it within a matter of weeks. A situation where the solution is undermined by the complicatedness of the solution applied.
Solutions can typically be classified as “simple”, “complicated”, “selforganised” (“complex”) or “chaotic” (Figure 2). Simple solutions can be further separated into “simple and easy” or “simple but not easy”.
There are no end of people trying to sell us simple and easy solutions that will instantly transform our lives without effort on our part, which rarely work. The problems that cause most difficulty in veterinary practices tend to be complex and it is here that simple but not easy solutions come into their own. Unfortunately, these are frequently counterintuitive to our scientific training, which can be a challenge.
This highlights the importance of knowing whether the problem/ solution is simple, complicated or selforganised (complex) and focusing on the simple or selforganised solutions because as complexity increases so control/predictability decreases.
For a perfectionist profession such as ours, this presents a real challenge but one that needs to be addressed.
The second scenario will hopefully present you with an interesting challenge that helps make the point. The video shows a murmuration of starlings where more than 30,000 work together as a cohesive flock: www.youtube.com/watch?v=8vhE8S… (skip first 40 seconds) or www.youtube.com/watch?v=eakKfY5aHmY.
Two questions:
- How does a bird with a brain less than half the size of a pea develop these skills to this level and collaborate in such a spectacular way?
- Can you write a simple set of rules to control the flock behaving in this way?
- No more than seven rules.
- Each rule no more than a 10-word sentence.
- (Hint) It can be done in three rules.
E-mail your answers and observations to christopherwhipp@aol.com and I will look at some of the results next month. I would also mention that I have two places remaining for anyone working with me on a FOC case study as mentioned last time, so what is your most difficult/ frustrating problem in practice?
