Taking risks to improve safety? Workplace learning in anesthesia

Purpose Previous results show that the anesthetists’ activity during the planning phase is aimed at neither identifying risks nor pinpointing the adverse events likely to occur; rather, it is to devise “manageable situations” that are adapted to their own competences. The present paper focuses on the issue of understanding how, in practice, these “manageable situations” are constructed. In particular it wonders if a link between the seniority of anesthetists and the way they design these “manageable situations” may be established. Design/methodology/approach The paper sought to answer these questions through a qualitative study conducted in partnership with anesthetists. The method, combining interviews and case-based simulation, required that 20 anesthetists “thought aloud”. Findings Results show that the anesthetists sometimes selected a solution that they themselves and experts viewed as riskier. Why? And who selects a riskier solution? The answer is about workplace learning and the continuous development of experience-based competences. “Manageable situations” appear to be planned situations so as to propose solutions adapted not only to present competences but also for future competences to be developed. In that sense, they are part of a developmental process at work. Originality/value These findings have implications for practice and they open pathways for further research studies. They call for rethinking the link between experience and workplace learning.