Surgeons and pilots: What do we have in common?

Pilots undergo intensive training in order to fly commercially or privately. However, this training cannot always predict who will commit errors and who will handle emergency situations effectively. Numerous factors play a part in how these situations are handled. Some of these factors include communication with other personnel, the technical skill and mental state of the pilot, and external factors such as weather. A key component is extensive training, so that when an emergency occurs, s/he does not have to think about the basic procedures for their job. Instead, the pilot is able to focus solely on the current emergency and how to handle it. Performing complex surgery is much like flying a plane. Both take an enormous amount of training, which at times can be grueling. Surgery itself can be dangerous, time-pressured, and while much of it depends on technical skills of the surgeon, other factors and non-technical elements have major effects and are required to effectively execute an operation. There are a number of common features that both of these high-pressure, high-demand professions share. This chapter seeks to review the commonalities and differences between the decision-making among pilots and surgeons, by incorporating the concepts of situational awareness and sense-making, and how these phenomena can be applied to understanding the process of dynamic decision-making.