Build the Problem

Get the Behavior

I was recently in a class teaching students how to do blood sweeps to look for hidden injuries—particularly bullet wounds—on patients. This involves using your hands to rake across different parts of the person’s body. Because many bullet wounds are small, it is important to keep all your fingers together—imagine the difference between sweeping with a flat paddle versus a clawed hand. If your fingers spread apart, like the talons of a bird, it's easy to miss small wounds. But with fingers pressed firmly together, your hand becomes a single, smooth surface that is much more likely to detect subtle injuries. When the students started doing the sweeps they did this, but very quickly they started letting their fingers get separated, and when we did scenarios later, they only did the sweeps with their fingers separated (like a claw). As I mentioned before, this is important because this could cause the responder to miss a critical injury and this could result in the death of the patient.

I have seen this in numerous other training environments with a variety of different skills that were being taught. The instructor shows a way to do something, the students initially copy it, but over time they end up doing something else.

Why does this happen? I don’t think students are simply ignoring the instructor or being lazy. I think the problem is that the training is notionalized. We are teaching students to do something that matters for real-world performance, but the training environment lacks the factors that make that action meaningful or necessary in the field.

I know that is a bit of a word salad, so let me give you an example. Back to the blood sweeps. As I mentioned, these are important because patients can have injuries that you and they are not aware of and these injuries can kill them. So we teach students to do blood sweeps with their fingers together so that they can search the patient’s body and not miss anything. However, this process is usually notionalized in training. That is there is nothing to actually find during the sweep. So students just go through the motions. Because there is no feedback, they don’t know that there is a problem with what they are doing (other than an instructor telling them that they are doing it wrong). In fact, it makes all the sense in the world for them to cut corners in the training environment. There is nothing to find and using spread fingers (the claw) allows them to do the sweeps faster. In other words using the claw in training is more efficient than keeping your fingers together. In the language of EcoD, doing the claw is actually a deeper attractor than keeping your fingers together. So naturally, a lot of trainees will do it.

So what do we do about it? The solution is straight forward. Stop notionalizing. Put something in the training environment that will reinforce the behavior you want to see. In the case of blood sweeps, this means that you must have something for the student to find during the sweep. While you can buy fancy moulage pieces which look like actual bullet wounds, you can also do something simple like sticking a small washer or dime somewhere under the patient’s clothes for the student to find. This gives the student feedback about whether they are doing a good job or not. Find the washer—Success! Miss it—Failure! When you go to scenarios you can add consequences for success or failure. Find the washer and take appropriate action—the patient lives. Miss it—the patient dies.

The same basic idea applies to any area of training. Want students to look in the hard corner first when doing room entries? Put a bad guy in the hard corner. Want students to provide cover for their partner (instead of visually tracking their partner’s movement) during bounding overwatch practice? Have a threat appear in the area that the student is supposed to be covering.

Now, I am going to touch on Ecological Dynamics (EcoD) to explain why notionalizing generally does not work (You saw this coming, didn’t you?). If we go back to the Perception Action Loop (PAL) post that went up not long ago, we can use this as a starting point. In that piece, I argue that if you change the perceptual cues, you change the action. That is a big part of what is happening here. You are giving the student an action that you want them to perform, but the perceptual cues that let them know if they are being successful and shape the action are absent. So the students will tend to do whatever is easiest in the training environment.

Adding something to find during the sweep changes the whole task. The intention of performing the blood sweep without something to find is to look like you are doing a good job. This changes what your attention is focused on and the information that you pick up. When your intention is to find a wound, your attention is focused on that and the information you get will be different, so what you do will be different.

I have seen this happen time and time again. When we teach students to do bounding overwatch (where one student moves from a position of cover to another while the other student covers potential threat areas), you commonly see the students looking at each other and taking bad positions that do not allow them to provide cover to their partner. They’re trying to make it look good, not cover their partner. So they watch their partner to see when they are in cover and can start moving themselves. The whole world changes when someone with a gun suddenly appears in the area that they are supposed to be covering and begins shooting or simulating shooting at their partner. They start choosing cover positions that allow them to see the areas they need to cover and they watch threat areas instead of their partner.

Now that I’ve made this problem salient to you, you will see it everywhere. Fortunately, it is fairly straight forward to modify most training so that it isn’t notionalized. Change the constraints, and the behavior follows. Change the game, and the players play differently. Want better performance? Build better problems. That’s why how you build training matters. No matter what you do, at the very least —

STOP NOTIONALIZING!