A lesson in respect for re-training

Revalidation, Skills maintenance, Minimum volume credentialing all things that will challenge us in the years to come.

This afternoon I flew again for the first time in 5 months.

Ive been away most weekends when not working in the practice, at Rural Doctors Association of Australia (RDAA), Australian College of Rural and Remote Medicine (ACRRM), political, educational and training events.

To say that I was rusty is an understatement.

Flying competently and safely is a synthesis of many skills and abilities often to the point of muscle memory or subconscious calculation and metacognition.

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The things that have to come together include:

1/. Situational Awareness – my first circuit was all over the place. It was a warm day and the aircraft performance was degraded (Density Altitude higher than normal), it was windy at 14 knots (not a problem for a 737, but the ultralight I was flying weighs 250kg or so without me in it) and the FK is a new aircraft I had only flown 3 times before. It is fascinating how quickly I had lost the ability to “know” I was too high or too low, that I was sinking too quickly or not enough.

2/. Technical ability – its salutary to acknowledge that checklists that I had committed to memory weren’t there anymore and having to keep processes front of mind (or running through available mnemonics and written protocols) created challenges for my responsiveness in the technical operation of the aircraft. Things happen fast and you need to be ahead of the aircraft; the extra cognitive load is easily underestimated. Even my use of stick and rudder in the crosswind landings was off.

3/. Communication – Emerald is a little airport and at this time of year the best conditions for flying are early in the morning or late in the afternoon. Of course this is also the time that the Regular Passenger Transports (RPT) like to arrive. While I was in the circuit I had to negotiate right of way with a Virgin Jet and a Qantas Q400; not the easiest thing with fast movers when you’re poking along at 80 knots for both pilots. There is a unique etiquette and language to aviation and you can quickly get bamboozled and pegged as a newbie with a few less than tight calls.

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By the 7th Touch and Go I was feeling more in control, I was holding the rudder and stick correctly in the crosswind and not wagging the stick around like crazy. I had my trim right for landing without flaps in the stronger winds. By the time I cleared the runway again I felt comfortable.

Should I have flown again after 5 months? How often should I be allowed to fly, or should I have just given up altogether? I fully admit I have been taking the instructor with me the last few flights for the exact reasons outlined above and will probably do so for a little while yet.

Frequently Aviation is held as an example of best practice in safety and one that should be modelled by the Health profession. There is no doubt that situational awareness, communication, technical competence coupled with use of checklists and team resource management are critical to conducting complex operations and procedures.

However Healthcare has its own unique complexity and challenges that others contest make the comparison that of “Apples and Oranges”. There are so many lessons to be learned by being challenged and so many issues to be considered when assessing doctors skills.

My experiences reinforce that regular practice with a colleague providing feedback are critical to safe and effective function. I wonder what the future for doctors will be in coming months as we face the issues of revalidation and ongoing concerns about skills credentialing.

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