In Part 3 we took 24 explanations of human error and asked, “Do you think this can be resolved through training alone?” Now we’ll give a little thought to the matter of memory.
Trainers love to quote the Ebbinghaus curve and the limitations of memory. Lapses of memory go unnoticed, when the consequences are slight. Even so trainers often use mnemonics and other types of memory aid. They can be fun and easy to devise. They are a classic example of a performance aid – a strategy to support and sustain required levels of human performance. Much use is made of video combined with music, rhythm and rhyme. A very good contrast can be seen between two approaches to raising awareness of how to deal with stroke victims using the acronym FAST. The UK Department of Health spent £12m on advertising and publicity designed to raise awareness of stroke among healthcare professionals and the general public. A video forms part of the materials and can be seen at Recognise Stroke F.A.S.T.
In the British video there is very high fidelity – a woman is shown having a stroke. A fire is burning in her brain. The images are very disturbing and, in my experience, take away attention from the core objective which is to embed the acronym FAST in my memory. Instead I remember the horror of the images and resolve to look away the next time I see it. In the USA, different approaches are used. In the Massachusetts Department of Health multi-lingual video Stroke Heroes Act Fast, much use is made of music, rhythm, rhyme and repetition – in the mode of one of history’s most successful intervention programmes, Sesame Street. After two viewings I found myself humming the catchy tune with the words of the rhyme firmly fixed in my mind:
Does her face seem a little bit uneven?
Does one arm drift down?
Is her speech coming out kind of strangely?
It’s time, time to call nine-one-one.
Most important – I found I had internalised the acronym F=Face, A=Arms, S=Speech and T=Time (to call for an ambulance). The National Stroke Association of America takes a similar approach, which is less appealing to me personally, but may well work best for the younger audience at whom it is aimed. It features a rap by Hip Hop star Doug E Fresh and a dance called “doin’ the stroke” under the title Stroke ain’t no Joke!
That is the end of Part 4. In Part 5 we’ll ask why health professionals in hospitals still fail to observe simple rules of hygiene to avoid infection and cross-contamination. We’ll look at performance in hospitals in Britain and the USA and we’ll profile three behaviour patterns: skill-based behaviour, knowledge-based behaviour and rule-based behaviour.