Das SMACC Day Three

And so Das SMACC ist fertig and I am sat in my office in Nottingham reflecting on an amazing three days.  Thank you to all who made Das SMACC happen and thank you to my colleagues for accompanying me on the ride, tolerating me and allowing me to convert their voices into MP3 format.

So, Day Three.  It's fair to say that I was not in the best of humours at the beginning of the day which may have had something to do with the Das SMACC party the night before.  Maybe.  

Chair: Simon Carley
Panel: Jenny RudolphWalter EppichChris NicksonVictoria BrazilSandra ViggersDaniel Cabrera

The morning however was worth the trek in.  An inspiration panel of educationalists (new word for me) on the future of education in Critical Care. There is a Storify thread which you can follow here as otherwise my succinct points below won't do it justice.

  • How do we train doctors now to deal with the future? - train the basics well and use these as the building blocks for the future, teach empathy and compassion as these will still be needed as automation increases
  • Interprofessional education should be the norm and used throughout medical school, teach the fundamentals (anatomy, pathology) together and then subspecialise later - I completely agree with this and think this should be the way all universities function, if I come to power...
  • We don't actually teach how to be a doctor at medical school, we teach students how to be a resident (F1) which is where they learn to be a doctor - Amen Walter!
  • Don't focus on learning from simulation, rather simulate to learn from work
  • The future will not be simulation centres but rather each hospital having a fluid, focused simulation team who will able to provide expertise to all departments within the hospital, we can't assume anyone can facilitate simulation, treat it as a skill like ECMO or REBOA
  • Look at your coaching conversations, tailor your approach, ask your students what they would like you to look out for at the beginning of the session - YES! Definitely going for this approach in the future, I regularly find it hard to discuss everything in a debrief
  • Always talk after simulation, whether good or bad or indifferent
  • Also a big discussion on the best time to give feedback and Work Based Assessments - a recurring problem I have!  
  • We don't train people to give or receive feedback - another recurring problem

How to Fail - Kevin Fong

Another new man crush!  Anaesthetist/Astronaut Kevin spoke about failure.  The old saying is true; it's not an option.  Failure will always happen.  We have to adapt to accept this and approach our safety mechanisms and responses to failure appropriately.  Hypercompetence is a myth.  Hubris is wrong.  We have to have 'graceful failure' otherwise human factors fails and we will let out patient down.  I also liked his point that maybe the only reason medical science began to see the heart as a pump was because mechanics had invented a pump and we had a frame of reference.  Makes me wonder what fundamental point we're currently missing because we don't have that frame today.  

Helping Without Harming - Jenny Rudolph

An inventive and entertaining talk.  Rather than being annoyed at someone and thinking WTF think another WTF (What's Their Frame?)  The hashtag #WTF2WTF is alive and kicking on Twitter and it will be interesting to see how this goes.  More about fundamental-attribution bias.  Thought provoking, something I will try.

The Global Refugee Crisis: Why it’s Critical that we Care - Vera Sistenich

The only talk to get a standing ovation.  I can't do it justice, watch it at the SMACC website.  The more people who watch the better.

How to Fail… Part Two - Martin Bromiley

We all know his late wife's story.  How he does it I don't know but another great talk.  A man with much to be angry about who actually chose to understand and help.  His thoughts were inspiring on human factors:

  • "I would't do what they did" - not helpful, next time you catch yourself thinking that think instead "Why did it make sense at the time?" 
  • Confident humility - no one is too senior to seek feedback
  • Look at our systems in place, do they make it hard to be right and easy to be wrong?

This isn't a cop out but I genuinely couldn't do the last session featuring Martin Bromiley and James Piercy justice so please check it out on the Das SMACC site.  Amazing human beings and it was a privilege to hear them.  I hope I don't have to go through what they did but I hope I could always be as kind.  

So that was Das SMACC.  Personally I love FOAMed and it was great to be with like minded people in an amazing city.  Berlin is an amazing mixture of beauty and horror and needs to be seen.  What about SMACC?  It is a bit cultish if I'm honest.  I can see the point of some of its detractors pointing out the swearing, the hashtags, how something is either great or sh*t.  And it has made 'celebrities' of medics - yes I know the irony as someone who blogs and records his voice in his spare time - which is something that may create challenges in the future.  But I loved it.  SMACC has challenged the old school.  Conferences where someone stands at the front and talks with no engagement are thankfully dying out.  It's been great to see the smart conferences adapt with workshops, social media and an open minded approach.  'Punk movements' like SMACC are the vehicle of such changes.  I hope I will always be so open minded. The focus on the next generation and innovation was a pleasure to see as well.  Danke Berlin.  Danke Das SMACC.

 - Jamie