Why read when I can see?

 

A common misconception is prevalent among many students and trainees that they can learn by just seeing something. In their day-to-day work/training since they are getting exposed to a variety of situations, they will learn passively by just seeing these things. One example is a surgical trainee assuming that if he/she will watch his professor operate on a patient, he/she will automatically understand and learn to do that operation. Or, if see your superior making a sales pitch you will understand and learn all the subtle psychological tricks/techniques he is employing. If you see your boss negotiating a deal you will pick up the fine points of negotiation skills.

  By the way, almost all of us are trainees no matter how old or experienced we are. There is always room for learning something new and improving ourselves.

These trainees and students forget that experience is not what happens to you; it is what you learn from what happens to you. With the same incident, two different persons may learn in different quantities or qualities of things. And one of the reasons for this is:

The Eyes Only Sees What the Mind Knows

It is only the most gifted among us who can see something and comprehend what exactly is happening. What we observe, understand, and learn is dependent on our background knowledge and information already in our brain. This may be clear from the following examples:

A junior resident doctor in AIIMS, New Delhi was doing an operation of inguinal hernia repair under the guidance of Dr. Dev (fictional name) who was a senior resident at that time. Suddenly the patient’s inferior epigastric artery got injured and started to bleed profusely. Dr. Dev quickly took an artery forceps and clamped the bleed point. Taking a surgical suture he quickly tied off the bleeding part thus controlling the bleeding. 

Once everything was under control, Dr. Dev asked the junior resident what had happened? The junior resident replied that there was some bleeding which is now controlled. 

Injury and bleeding from the inferior epigastric artery is a known complication of the inguinal hernia and if not controlled can cause serious complications to the patient. But since the junior resident had not read about it, he was not able to recognize it and understand the disaster that has been averted. So even thou he was actively involved in the operation yet because of a lack of background knowledge he did not learn to recognize and deal with the complication of that surgery.

Another time a young lady came with a large lump in the breast which needs to be taken out (excised) by operation. It is a simple task to make a cut (incision) in the skin over the lump, separate/dissect it from surrounding tissue, and stitch the wound. But the ugly scar remaining after the surgery is a problem for such young ladies. Dr. Dev decided to do a different approach (the Gillard Thomas approach) for this particular lady. In this approach instead of making a cut on the front of the breast, a cut/incision is made below at the junction of the breast with the chest wall and the surgeon goes behind the breast and removes the lump from behind. The scar of this cut is hidden below the breast.

Dr. Dev started the operation. The final year junior resident (JR) assisting him watched with interest as he had not seen this method of doing operation before. After the operation was over, the resident was impressed with the well-hidden scar with this approach.

A few days later, Dr. Dev saw the same junior resident operating on a patient with a breast lump while being assisted by another consultant. Dr. Dev’s interest was piqued when he saw the resident had made the same Gillard Thomas incision/cut instead of the usual skin cut. Dr. Dev. went to the adjoining operation theatre (OT) where he had a surgery scheduled. After he finished that operation, he came back to see what is happening in the JR’s OT. He found that the JR was still struggling to get to the lump. With quite some time and lots of struggle, he was able to get the lump out.

The problem arise that the junior resident had never read about that particular operation before and therefore he was not able to observe and note that Dr. Dev with the Gillard Thomas approach had first gone up and behind the breast and then removed the lump. So although he had seen and assisted in the operation, he was not able to learn the proper technique because of his lack of background knowledge. 

These are not isolated incidences. Time and again whether it is examining patients in wards or OPDs or assisting in the operation theater, students and resident doctors fail to observe and notice important points because they did not know what to look for as they have not studied about it before coming to the ward or operation theater. 

So before assisting in an operation, procedure, important deal, sales pitch, or even before your routine lectures and classes, study about it one day beforehand either by books or through internet videos and resources and make a note of what you should try to observe and learn from that lecture, class, negotiation, deal, operation, procedure or occurrence so that you actively learn and achieve your maximum potential.

Once again, remember first prepare your mind before seeing something new so as to turn your looking into observation and learning experience as:

The Eyes Only Sees What the Mind Knows

— ND

(Based on allegedly true incidents.)

© Author. All rights reserved. 

 Tit-Bits — Theodore Gaillard Thomas, misspelled ‘Gillard’, who described this incision was a gynecologist and not general surgeon.

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to NMC and other Board norms.