This is the 24th WILTW

The inspiration for my learning this week came from a tweet and a road sign..

I have been thinking a lot about gut feeling and gestalt (we had a consultant CPD session on it this week).

@broomedocs @EMManchester I describe gut feeling as making a decision that goes against the available clinical information…

— Damian Roland (@Damian_Roland) October 29, 2014

I thoroughly recommend you watch Prof. Carley’s talk on risk factors. I had this partly in mind while driving on the motorway to see some friends. We were advised to slow down due to an ‘obstruction’ in the road.

Clearly the traffic slowed, although to be honest not all to the required speed limit. We waited for the ‘obstruction’ to appear while passing through three further signs, a reduction to 50 and another two miles. There was still no obstruction. You could see slowly people deciding there was no obstruction and speeding up again.

Variable speed limit signs are a funny beast. They are no different than any other traffic sign on the road in terms of the penalty for disregarding them.  However their deployment is usually in conjunction with prophylactic traffic calming measures. Therefore when travelling on a motorway you often see the sign to slow down but no sign of the associated queue. Although the slowing down prevents the queue getting worse (or even happening at all) there is a perceptual deficit created in not seeing the end result of an inaction (i.e a large traffic jam).  I’m sure people would be honest in admitting they don’t always slow immediately to the required speed. This is risky behaviour as you are technically taking a chance with your own licence and potentially other peoples lives. However the learnt experience is that the final outcome is never bad so a rather negative attitude is employed.

What other signs or advice do you feel the outcome is worth taking a chance over? I think most people would follow the sign below:

So what about this?

So while the management of a sick patient may be a million miles away from a motor way traffic sign it got me thinking about how often we dismiss an obvious clinical warning sign as we think, “We know best…?”

What have you learnt this week? #WILTW