We all need experts for things we can’t do ourselves. And we are all on a path to becoming expert ourselves, whatever our areas of interest. But what does it mean to be expert? In his new book Expert: Understanding the Path to Mastery (Viking Penguin, 2020), Roger Kneebone explores these challenges. You can buy the book from Waterstones here. This lecture summarises Roger’s insights from his own experience as a clinician, his decades-long collaborations with extraordinary experts, and his Gresham Lecture series Performing Medicine, Performing Surgery.
Knife violence is one of the biggest challenges facing our society. Simulation offers a way to involve young people in exploring the consequences of carrying a knife and responding when incidents occur. Realistic physical simulation invites participants to co-design scenarios that show the effects of a stab wound. Building on over ten years of research, the lecture shows how healthcare and criminal justice professionals can work with young people to develop ‘reciprocal illumination’ for everyone who takes part.
Clinical practice depends on the acquisition and analysis of evidence - detailed information from each patient’s clinical history, laboratory tests, imaging scans and biopsies. Yet data on its own is not enough, and must always be interpreted in the context of each unique person. Similarly in forensic science, analytical data must be interpreted to make sense of a crime. This lecture discusses evidence and interpretation with a leading Professor of Crime and Forensic Sciences from UCL, Ruth Morgan.
Trauma surgery, combat flying and polar exploration require professionals to work in risky conditions where error can lead to catastrophe. One key skill is recognising when a situation is getting out of control and finding a ‘place of safety’; another is to learn from mistakes without allowing self-confidence to be destroyed. This lecture explores how high-risk professionals can share insights relevant to medicine, helping clinicians to develop essential skills.
With Phil Bayman (combat pilot) and Dougal Goodman (polar explorer).
Clinical practice is often seen as the acquisition and application of scientific knowledge to diagnose and treat diseases. Yet every patient is different. This lecture draws on a ten-year collaboration with a Savile Row tailor to explore ‘bespoke’ as a metaphor for clinical practice. Using this approach, the knowledge and skill of a practitioner must intersect with the needs of the patient to create a unique solution for each problem.
With Joshua Byrne (bespoke tailor).
Medical care often frames patients as the passive ‘recipients’ of expert professional knowledge and skill. This lecture explores what comes into view if we reframe clinical treatment as hospitality, and patients as guests. Drawing on collaborations with leading restaurants and their chefs, I explore parallels between the worlds of fine dining and medical care. In a hospital, as in a restaurant, what happens out of sight (in the operating theatre or the kitchen) must be matched by sensitive care at the bedside, in the clinic or at the table.
Scientific knowledge is advancing at dizzying speed and each day brings new breakthroughs in medical understanding. Unprecedented advances are opening possibilities that only a decade ago would have seemed like science fiction. Yet a deep anxiety pervades our society, raising questions about the wisdom and motives of experts and the implications of new technology. This lecture uses examples from cutting-edge science and medicine to explore the ethical questions which advances in robotics, personalised medicine, transplantation and artificial intelligence pose for doctors, patients and society.
Few patients like to think of their physicians or surgeons as improvisers. Yet clinical care is a human art where there will always be uncertainty. Though doctors spend years learning facts and gaining skills, each patient is unique and every situation holds surprises. Jazz musicians also spend years in training - practising scales, learning harmony, mastering technique. Such musicians celebrate their ability to improvise, to respond to one another in the moment in front of an audience. This lecture asks what clinicians can learn from the world of jazz - and vice versa.
This lecture examines how minimal access (‘keyhole’) surgery has revolutionised medicine in just a few decades. By re-assembling teams of long-retired surgical pioneers from the 1980s and inviting them to re-enact early procedures using realistic simulation it will document the ups and downs of an extraordinary decade. Using video footage and interviews, Professor Kneebone will show how surgeons, radiologists, nurses and instrument manufacturers developed completely new ways of working. Their successes, their failures and their challenges continue to resonate today.
Touch is central to the performance of medicine. Traditionally, doctors depended on touch to diagnose illness. Revolutions in imaging technology, machine learning and artificial intelligence seem to reduce the need for physical examination. Yet touch is not only about gathering information but is how we express compassion and care. This lecture considers how ‘gnostic’ touch (identifying disease) and ‘pathic’ touch (conveying care) are becoming separated by technological developments, and asks what we can do to ensure that touch remains central in connecting doctors and patients.
People often think that surgery is about the skill of a single surgeon. In fact operations depend on teamwork, with nurses, surgeons, anaesthetists and technicians all playing vital roles as they work together. Experts outside medicine need similar skills and have much to teach clinicians. This lecture introduces Rachel Warr, a leading puppeteer and dramaturg. After Rachel demonstrates how she and her colleagues bring puppets to life, we will discuss how her expertise in dexterity, team-working and preparation for performance can shed light on the world of surgery.
The consultation is the focal point of medicine. A clinician and a patient, held together in a relationship of care, collaborate in identifying that patient's needs and finding a solution. Scientific knowledge and clinical skill only make sense in the context of that interaction. Each consultation is unique, a close-up live performance with a very small audience.After describing key elements of the consultation, an expert in a different kind of close-up live performance will be introduced - Will Houstoun, a leading magician. After watching Will perform, similarities and differences will be explored through conversation.
Medicine demands factual knowledge, physical skill and the ability to work with patients and colleagues. Most of the time clinicians learn from other clinicians, studying hard within a frame that discourages exploration outside medicine. Focusing on the performance of medicine challenges this frame by connecting with actors, musicians, craftsmen, dancers and other experts. This lecture explores the idea of frames, using illustrations to ask what benefits may result from thinking widely and challenging longstanding assumptions.