Annex A > Chapter 14 - Care in the Operating Theatre and the `Learning Curve' > The `learning curve' > Retraining
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Retraining
96 Mr Wisheart stated in his written evidence to the Inquiry:
`The concept of "Re-training as routine" was not established during the period [of the Inquiry's Terms of Reference]. The routine was the continuous learning which was needed to maintain one's knowledge and skill and keep abreast of new thinking, understanding and development. This was done through the reading of journals, the attendance at meetings and courses and regular dialogue and interchange with colleagues both junior and senior. In the latter part of the period this would have become finalised under the label of Continuing Medical Education.' [113]
97 He told the Inquiry that "retraining" carried connotations which were punitive in nature, although there is more acceptance now of the idea of undertaking retraining. Mr Wisheart went on to say that `It was the philosophy of the team to consider together areas where there was room for improvement ... Mr Dhasmana, on his own initiative, sought re-training in the neo-natal switch operation in 1992-1993.' [114]
98 Professor Marc de Leval, consultant paediatric cardiac surgeon, Great Ormond Street, commented:
`I have never found the definition of retraining. I have used the word in my paper on the "Cluster of Failures", and I still do not know what it means. Obviously retraining may indicate training to understand or try to pick up some technical details of a procedure or the management of the perfusion, the bypass, so I think that if you are facing failures, by definition you do not know exactly where the figure arises from. I think as surgeons we have a tendency, at least most of us, to incriminate the skill or the actual technical performance of the procedure, which I think is very shortsighted. We all make the mistake. So I think when you have a problem, you are in the dark and it is very difficult to decide whether it is appropriate, not knowing exactly what the cause of the failure was, and, for example in my own experience, I decided to retrain by doing the same, going to see Bill Brawn and having him to help me to do one or two Switches, and I believed, when I started to do the Switches myself, that I had learned some technical tricks.
`Five years later, I had realised that the way I do the Switches is the way I did them before my "Cluster of Failures", not the way I learned it, and I am convinced that my retraining has given me back the confidence that I had lost and I think this is the most important point, to reach a state of mental readiness which is such that you cannot proceed with confidence and you have to regain it.' [115]
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Footnotes
[113] WIT 0120 0327 Mr Wisheart
[114] WIT 0120 0328 Mr Wisheart