ALPHA OMEGA COFFEE BREAK WITH PROF SIMON WRIGHT & CAPT. STEVEN HAWKINS

03/02/2021

Diana Spencer talks to Professor Simon Wright and Captain Steve Hawkins ahead of their lecture for Alpha Omega discussing ‘Human factors in clinical practice’ register now at alphaomegauk.co.uk/our-events.

PROF WRIGHT WHY DID YOU CHOOSE DENTISTRY?

My dad was in the air force and I was brought up on air force bases. I always assumed I would be a pilot as I was surrounded by aeroplanes.

However, I asked my father what he would do if he had his time again, and I distinctly remember his answer: ‘I love being an engineer but the most fascinating machine is the human body so I would have loved to be a doctor or a dentist.’

This struck me a good idea. Furthermore, I am very practical in my outlook: I wanted to be hands-on more than desk-driven, so dentistry seemed to be the logical choice, and I haven’t looked back since!

WHAT EXCITES YOU MOST ABOUT THE BUSINESS/PRACTICE OF DENTISTRY?

Obviously, I love the clinical side of dentistry, but what really excites me is human factors. I am fascinated by understanding how we can increase patient safety and performance by investigating how we interact with our environment and our team. We can also use this to deal with the pressures of practice. The whole science of human factors is amazing and I am looking forward to talking about it on the Alpha Omega webinar.

HOW DO YOU UNWIND?

I don’t really unwind so to speak… I’m always working, but I do enjoy going for a run, where I can put the world to rights. I also have two Labradors who need walking, and I enjoy skiing and sailing, but to be honest, I just love my work!

I see dentistry moving more towards the style of the aviation industry, which is a more supportive culture, where they share and learn from errors and operate a system-based approach to fixing problems rather than blaming individuals.

WHAT ADVICE WOULD YOU OFFER AN UPCOMING DENTAL STUDENT? 

Expose yourself to as much as possible to different areas in dentistry – but then my advice would be to focus on one area only that you enjoy. Then become really good at it rather than trying to be a dental jack of all trades.

HOW DO YOU SEE DENTISTRY IN 5 OR 10 YEARS?

I thought a lot about this… firstly, with the work that I am doing with the General Dental Council (GDC) and the regulators I hope that we are going to start moving away from the medical ethos of infallibility where we can’t make mistakes, and if we do these are all dealt with by blame and punishment. Instead, I see dentistry moving more towards the style of the aviation industry, which is a more supportive culture, where they share and learn from errors and operate a system-based approach to fixing problems rather than blaming individuals. So I see dentistry becoming more open and supportive. This is a big change and I feel it will take longer than 10 years.

I also believe that private dentistry will go more towards the style of the US, where a general practitioner will be the gatekeeper for patients and refer them as necessary to specialists. There will, therefore, be much more of a development of the specialities.

WHAT HAS BEEN YOUR GREATEST CHALLENGE TO DATE?

For me, being a part of a profession means being a professional, which is not a nine-to-five job, so fitting downtime into that can definitely be a challenge. Luckily, I have a very understanding partner!

Private dentistry will go more towards the style of the US, where a general practitioner will be the gatekeeper for patients and refer them as necessary to specialists.

WORST/MOST EMBARRASSING THING THAT EVER HAPPENED TO YOU?

Well, I don’t get embarrassed easily, but once a patient came in requesting an implant as he had a post crown that had fallen out. He handed it to me in my bare hand and said: ‘The reason why I want an implant is that I keep swallowing this crown!’

WHO WAS YOUR MENTOR?

There were two really influential people. Professor David Speechley has been with me since I qualified and was my foundation trainer. We developed the practice together and he supported everything I have done. He has also been a great friend for many years, and I miss him now he is retired. Professor Cemal Ucer has really been there and helped me develop my implant practice and surgical dentistry. He is now my partner at our teaching hospital in Salford Quays. He is my go-to man if I need any help or advice.

FUNNIEST THING THAT HAPPENED TO YOU IN A DENTAL SURGERY?

Taking an impression on a partially dentate patient with plaster of Paris by mistake. Fortunately, I managed to get it out, and the patient was very understanding though I think I was a pool of sweat by the end! Credit to my supervisor at the time as well.

MAIN PIECE OF ADVICE FOR SOMEONE SETTING UP THEIR OWN SURGERY

This is probably not really relevant to me, but a related piece of advice is to consider what kind of life do you want to live? And then set up your career with your goals in mind, eg retire at 50, travel a great deal, have a family and be able to spend time with your children.

DO YOU HAVE ANY REGRETS?

None – I wouldn’t do anything differently!


CAPTAIN STEVEN HAWKINS

CAPT HAWKINS HOW DID YOU GET INVOLVED IN DENTISTRY?

CAPT. HAWKINS (SH): My close friend Professor Trevor Burke has an underlying interest in aviation and I have always thought that if I was to go back in my life, I would pursue a medical career. Following some lively dinner party conversations, he persuaded me to write about ‘human factors’ and the open reporting culture in aviation and how they might translate into dentistry. Some of aviation’s learning regarding human factors, reporting and creating feedback loops has transferred into the medical profession, specifically

in the area of surgery. There doesn’t seem to have been a similar transfer of knowledge or sharing of learning in the dental profession, so this was the catalyst for me to get involved.

I did some work with the GDC a year or so ago; it was looking at a rejuvenated syllabus for CPD. I felt at the time that perhaps the GDC needed to do a PR job on itself to get people to view it as other than a disciplinary organisation: it needs to be turned around so people can report their experiences and learnings, without feeling unfairly threatened by disciplinary process.

Professor Burke and I have tried to instigate a feature titled ‘I learnt about dentistry from that’, based on the articles with a similar approach found in many aviation safety publications. The concept is all about peer-to-peer sharing of lessons – both good and bad – in an open and unthreatened environment. So far, the uptake has been limited, which maybe points to the concerns that dental professionals have regarding sharing of information openly.

WHAT EXCITES YOU MOST ABOUT AVIATION?

Aviation, much like dentistry, is about people undertaking relatively difficult technical tasks, often under time pressure and coping with the management of unexpected events.

Both professions are similar, in that careers start with people undertaking intensive training programmes, which are in themselves hard to get into. After that phase of a career, both pilots and dentists are expected to perform relatively unsupervised, with a high degree of responsibility to maintain and develop their standards of performance. The challenge is: how do you make people stay engaged with personal development and share information and learning together?

When I was running training at BA, we evolved our training philosophy to include much more emphasis on ‘how’ people perform the tasks expected of them, as well as assessing ‘what’ they do. If you can develop a strong and robust set of competencies, that can be applied to the effective management of complex situations, you are much more likely to achieve consistently high standards of performance, relative to just focusing on the training of a narrow and specific set of technical skills.

HOW DO YOU UNWIND?

Right now, I am halfway through Stephen Fry’s book Mythos, prompted by the fact that I sat next to him on a recent flight from the USA and we got talking about it, amongst many other things. I do as much physical exercise as I can, struggling through gym sessions in my garage as a consequence of COVID-19 restrictions, as well as cycling.

I enjoy building and DIY, have renovated several properties and am currently in the process of looking for a plot of land to build on or major renovation project. I’m in need a new challenge!

After training, both pilots and dentists are expected to maintain and develop their standards of performance. The challenge is: how do you make people stay engaged with personal development and share information and learning together?

WHAT ADVICE WOULD YOU OFFER AN UPCOMING DENTAL STUDENT? 

Firstly, if dentists are anything like pilots, there is a risk, that has certainly been identified in aviation, that around two years after finishing initial training, they are at a significantly increased risk of making errors when dealing with challenging situations.

In aviation, there is a demonstrable increase in error and risk taking because people’s confidence can exceed their experience and skill around this time. There is a consequent need to mitigate for that within our safety culture.

A degree of self-awareness is required, with a willingness to ask advice and possibly get a sanity check as we learn from experience and our peers. Let’s face it, we can learn from people’s experience almost by osmosis. I’ve often said that a successful career in aviation is all about effective plagiarism! By the time one becomes a captain, it’s as if one has stored away in the back pocket many examples of how not to do things and also what really works well, having learnt by watching how your peers and seniors have dealt with issues.

As professionals, we are generally very good at analysing when things haven’t gone well and working out why. What we are less good at is working out why things have gone really well, so that we can then work out how to reproduce success on a regular and reliable basis (how to be consciously competent, for example). We need people to grow their strengths and not just diminish their weaknesses. Mentoring and training from experienced dentists in Alpha Omega will definitely contribute to this and open doors of opportunity.

WHAT HAS BEEN YOUR GREATEST CHALLENGE TO DATE?

While working in senior management roles British Airways it was balancing the financial pressures of a big company against the cost of maintaining and continuously improving training and safety standards. As in most professions, it’s quite difficult to articulate to an accountant (for instance), the value of investments in safety and training. The tangible benefits of high standards and the benefit of investing in them are often only appreciated in retrospect.

Often speaking with someone who isn’t necessarily an expert in your field can be useful, since they won’t assume or pre-judge what you do and how you do it, but can challenge and offer advice from an unbiased and impartial perspective.

WORST/MOST EMBARRASSING THING THAT EVER HAPPENED TO YOU?

Well, I don’t get embarrassed easily, but once a patient came in requesting an implant as he had a post crown that had fallen out. He handed it to me in my bare hand and said: ‘The reason why I want an implant is that I keep swallowing this crown!’

WHO WAS YOUR MENTOR?

In the BA senior management training programme, I had an executive training coach. She had no aviation experience but was able to ask open questions that made me stop, think and review my assumptions. Often speaking with someone who isn’t necessarily an expert in your field can be useful, since they won’t assume or pre-judge what you do and how you do it, but can challenge and offer advice from an unbiased and impartial perspective. That’s certainly made me reconsider how I do things and think outside the box, rather than stay in my comfort zone.

FUNNIEST THING THAT HAS HAPPENED TO YOU?

Well, there have been many events, but I did get struck by lightning while flying a 737 once while coming into Marseilles. Afterwards, I looked across at my poor co-pilot who was completely frozen and ashen faced. We eventually landed, all the passengers got off and then I had to accompany an engineer to inspect the top of the tail that had been damaged by the lightning, on a high lift platform.

The passengers looking out of the terminal window to see the captain of their return flight to London, then getting soaked as a thunderstorm arrived and looking fairly concerned by the lightning that was flashing, certainly seemed to cause some amusement!

There was also dealing with the ‘boisterous’ members of the Team GB ladies hockey team as I flew them back from the Rio 2016 Olympics and listening to the whole aircraft singing the national anthem as I played it over the PA from my iPad as we departed. Safe to say there have been many more…

WHAT DO YOU THINK OF DENTISTS & DENTISTRY?

The impression, as an outsider and as dental patient, is that dentistry is a profession that has a sense of infallibility, that standards and expectations are very high and that making mistakes isn’t an option.

I do think that dentistry would benefit at an individual and organisational level from more readily accepting the fact that mistakes will always be made, and that admitting to mistakes and learning from them is an essential part of achieving continued improvements in standards.

I get a sense that normal behaviour seems to be not admitting to failures. It’s viewed as a sign of weakness, whereas turning this around is actually a sign of long-term strength for the profession. To share your experience for the benefit of others is a great gift.

I also get a sense that things aren’t helped by the perception that the regulatory bodies within dentistry are more interested in their role of investigating mistakes, applying sanctions and apportioning blame, rather than creating an open atmosphere that acknowledges the benefit of open reporting and effective learning from events. I do acknowledge the fact that most dentists are self-employed, in businesses that are relatively vulnerable – especially financially. That sense of threat needs to be moderated or rationalised and the lead in this needs to come from the regulatory authorities to create positive change.

DO YOU HAVE ANY REGRETS?

When I left the RAF many years ago, I very nearly went to medical school and I’ve always wondered whether I should have done that.

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