Training in Extremely Complicated Times

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“The volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably.”

Atul Gawande


Why we fail in what we set out to do

As frustrating as it may be to acknowledge, human beings are far from being infallible. Meanwhile, the causes of our failures are varied, and we can often act on them to avoid them or, at least, to reduce them.

The first cause of human failure is inability

There are things and situations that we simply cannot avoid. Either because they go beyond our ability to understand them, or because, even though we understand them, we cannot act on or change them.

Ignorance is the second cause of human failure

Unlike the previous cause, in this case we would be able to avoid failure, if we knew how. We fail because we do not fully or partially know what to do or how, to obtain the desired result.

The third cause of human failure is ineptitude

This is probably the most frustrating and painful of the three causes, since it is the easiest to avoid and paradoxically, the most common one. Ineptitude implies possessing the knowledge on what to do or how to achieve a certain result and having the aptitude to do so, and yet failing by not correctly applying what we know.

The causes of failure have changed

For most of the history of mankind, people’s lives have been affected mainly by failures to do with ignorance. Until very recently, we did not know what to do or how to achieve the results we wanted in critical areas such as health, to name one.

However, in just a few decades, the body of knowledge that science has conferred to us has been of such magnitude that this historic trend has completely bucked. This change has led us to an unprecedented situation in the history of humanity, in which the causes of failure attributable to ineptitude are as many as those attributable to ignorance, and even higher in many cases.

The social repercussions of this new situation are significant, and we are facing a challenge of considerable proportions. At the end of the day, failure due to ignorance is something that can be understood and forgiven, since it is hard to demand more from those who have done everything in their power, but failure due to ineptitude is unforgivable.

With greater knowledge, less ignorance and more ineptitude

Scientific and technological development has also meant that the world around us is becoming increasingly complex. Inevitably this is the price to pay. For example, the first airplanes were far less safe than the ones today, but undoubtedly simpler. In this case and in most, knowledge has been simultaneously translated into better prevention of failure, but also into a greater degree of complexity.

The problem with complexity is that it outstrips mankind’s capacity. Beyond a certain threshold of knowledge, the associated complexity of applying it is so sizeable that the risk of failing, due to badly applying what is known, becomes relevant.

Here we encounter a paradox in which increased knowledge reduces failure due to ignorance but increases failure due to ineptitude.

Given this conundrum, failure due to ineptitude in highly complex environments is generally not punished, because it is unavoidable. Instead, without trying alternative strategies, attempts are made to reduce it –albeit unsuccessfully—by increasing the body of knowledge and the experience of professionals working in these environments.

Training in times of extreme complexity

The most common way to tackle the challenge that extreme complexity poses is through hyper-specialization. That would be logical. If we narrow down the field of knowledge, then we are in some way compensating for the incessant proliferation of knowledge.

This trend moving towards hyper-specialization is growing. For example, early surgeons towards specialist surgeons and from these to the super-specialists, who no longer limit themselves to operating on a given organ, but only do so with specific types of interventions.

However, what was thought to be a solution has proved not to be one. The human limitations are still there along with complexity, no matter how much hyper-specialization there is.

The truth is that serious failures exist in all fields and they are committed by all professionals, even by the best prepared and most experienced people.

The solution to the problem of extreme complexity is explained by Dr. Atul Gawande in his book, “The Checklist Manifesto”, in which he documents all the above with numerous examples.

Solving this problem is not about more training or more specialization, but one that requires a profound paradigm shift. This is a change that tackles the extra challenge of a head-on clash with the egos of professionals, because of its simplicity. With greater specialization and command, the bigger the ego and higher resistance to welcome simple solutions to complex problems.

The key is to learn to use the top tool of anyone involved in knowledge work: the brain.

Learning to use it means knowing and understanding the brain’s limitations, because this allows us to counteract them by applying proven neuroscience strategies.

We are talking about adopting simple techniques such as externalizing memory, fragmenting results or developing various review habits. These practices are available to anyone and have helped in recent years to avoid air accidents due to human error or drastically reduce postoperative infections.

In a nutshell, this is about developing a new horizontal skill, personal effectiveness, in order to wrest the full benefit from our knowledge in an accurate, safe and reliable way.

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