{"id":8414,"date":"2019-05-25T06:12:15","date_gmt":"2019-05-25T05:12:15","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=8414"},"modified":"2019-05-25T06:12:20","modified_gmt":"2019-05-25T05:12:20","slug":"human-factors-part-3","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2019\/05\/25\/human-factors-part-3\/","title":{"rendered":"Human Factors (Part 3)"},"content":{"rendered":"

By <\/strong>Peter<\/span> Dzendrowskyj<\/strong><\/em><\/p>\n

This is Part 3 of the\u00a0human factors in sports medicine<\/em><\/strong> blog. If you haven\u2019t already done so, read Part 1<\/a> and Part 2<\/a> first! In this blog, I\u2019ll go into the different human factors needed in clinic vs on the pitch.<\/p>\n

Communicating in clinic<\/i><\/span><\/span><\/strong><\/p>\n

An unclear message on the treatment and rehabilitation of common extensor tendinopathy may delay a return to play by several months. Or, more seriously, if the prognosis and differential diagnoses of potential stress fractures, concussion or spinal stenosis are misunderstood, there may be more significant and catastrophic complications. Being able to gauge the level of understanding and also the drive for rehabilitation plays a role in overall outcome \u2013 this skill is known as \u201c<\/span><\/span>emotional intelligence<\/span><\/span>\u201d. Whilst lack of these skills may not make any immediate and obvious change to a patient\u2019s clinical status, it does make a difference in the long term. A lack of these skills is the leading cause of patient complaints in the USA – with \u201ca lack of listening\u201d often cited as the major complaint toward the doctor concerned (3). No matter how busy the clinic is, or how difficult the patient, the patient is the doctor\u2019s primary concern for the time they are in the consultation room and the patient deserves the best clinical care possible.\u00a0<\/span><\/span><\/p>\n

Part of being adept in human factors is also being able to recognise in oneself when one\u2019s professional self is not optimal. No matter how many times people deny it, personal and everyday stressors are brought into work (e.g., personal, financial, medical). Being able to recognise this \u2013 set aside a few minutes to settle a cluttered mind for example – can make all the difference between a successful or a disastrous consultation. Being able to recognise this in others \u2013 patients certainly, but more importantly, work colleagues \u2013 can also help to create a more fulfilling work environment.<\/span><\/span><\/p>\n

Communicating on the pitch \/ during competition<\/i><\/span><\/b><\/span><\/p>\n

If a rare event such as a pitchside cardiac arrest or – less rare – collapse during competition occurs, there is a real need to be able to organise, optimise and effectively manage the critical situation professionally, ensuring that the team operates at full capacity. Using simple styles of communication (such as closed loop communication \/ using individual\u2019s names \/ a calm, clear vocal tone when issuing instructions etc.) can calm the team down and allow individuals to work within their knowledge base without panic. The lack of a clearly identifiable leader and the lack of clear, concise instructions from that leader are two of the most important factors that may differentiate between success and failure of a critical incident (4). By default, the leader is usually the doctor on the scene, and he or she must be familiar with the basics of leadership and communication to ensure the best possible outcome may prevail.\u00a0<\/span><\/span><\/p>\n

Lack of communication and poor information sharing between team members during competition can also lead to disastrous results (5,6). For example, if personal physiotherapists or doctors to individual sportspeople do not share information regarding injuries or rehabilitation until a few days before competition, then suboptimal treatment options may occur. This can be particularly prevalent in competitions such as the Olympic and Commonwealth Games.<\/span><\/span><\/p>\n

Being aware of such vital skills as our ability to interact with other members of a team, to organise and plan appropriately and to alter those plans according to an ever-changing clinical picture is the first step in improving the functioning of our team as a whole. In addition, certain medical specialities (critical care, anaesthesia and surgery for example) all now teach human factors as part of post-graduate training. There are validated teaching methods for this (e.g., Non-technical skills for surgeons\/ anaesthetists tools), which can be modified for sports medicine training (7,8). Categories that are taught and assessed are divided into:<\/span><\/span><\/p>\n