The Beginner’s Mind

“The eyes cannot see what the mind does not know!”

Boomed a meticulously bearded clinical professor into the lecture hall microphone. Back in medical school this was a cue in the lecture hall to listen up and absorb the following teaching point.  The information could save a life in the future. The idea of “saving a life” felt unlikely to students neck deep in the pre-clinical years of medical school. Yet, having a knowledge deficit or a blind spot made a lot of sense.  We existed in one big blind spot at the time.  This professor’s mantra, “The eyes cannot see what the mind does not know!”, still rings true today over two decades later in my work at the patient bedside.  Certainly, the mantra has proven useful to many thousands of budding clinicians whom he educated.  Learning medicine is as much practical experience and learning from others wisdom (aka mistakes) as it is a science and evidence.  

Once upon a time becoming a doctor of medicine was an apprenticeship, much like any other skilled trade, requiring a few short years before transition to independent practice. In contrast, for over a century becoming a physician has required getting through years of medical schooling and years more of residency training.  It takes a long time and significant investment on behalf of the individual physician and society to create one doctor.  But in healthcare the challenges of a physician shortage grow. Creating more doctors, although arguably necessary, will just not get us to fill the gaps required for better bedside care.  At the risk of sounding like Captain Obvious, I will also emphasize patient safety outcomes cannot rely on the eye of doctors alone. There is a need for more training of minds and eyes on healthcare’s frontline. Perhaps, the art of apprenticeship in medicine need not be so dormant after all.

The eyes of a physician may not always be available. Those who spend the most time with patients, such as nurses, assistant nurses and an army of healthcare techs are often the most important set of eyes in all of healthcare.  When danger is imminent these allied health professionals are most likely to be present at a patient’s bedside. In the community setting those in a health crisis are first encountered by non-physicians, such as EMT’s, paramedics, or firefighters.  The role of allied health professionals is not just to deliver technically specific services.  Their role may also be that of a highly developed apprentices of patient safety.  Looking for patients either in trouble or those manifesting subtle signs and symptoms that are precursors to a poor outcome- let’s just call these red flags.  

 Healthcare could benefit from more eyes trained specifically at looking for red flags.  Conditions that may trigger high alerts and require mobilization of critical resources.  Developing apprentices of patient safety moves beyond just creation of rapid response teams. It requires a dedication of those on the frontlines of healthcare to evergreen training and learning. This sort of training requires innovative modalities capable of rapidly deploying expertise, knowledge and virtual experiences to those on the frontlines.  It may require physicians think a bit differently about the traditional physician to physician apprenticeship model.  It may require us to democratize medical knowledge.  It may require doctors teach consistently across traditional boundaries and it also means that physician’s must be willing to adopt the beginners mind. Physicians willing to learn from all who have something to teach us regardless of position in the traditional healthcare hierarchy. Doctors who can look past the way things have always been done and creatively innovate meaningful solutions to the panoply of challenges.

How can we can innovate our way to a better healthcare system?  

About The Writer:  Hector Caraballo, MD is a practicing Board Certified Emergency Physician and Chief Medical Officer at MedCognition.

MedCognition has developed a high-fidelity medical simulation teaching instrument, called PerSim™, that can be a powerful tool for teaching allied health professionals clinical red flags in an intuitive, immersive experience using holographic augmented reality technology.