One of the best things about my military career has been the variety of assignments that I have experienced. When I retired from the Army I started a small consulting business utilizing my training in leadership, team and personality training experience and built upon my final assignment as the Chief of Leadership Training for the Army Reserve’s Readiness Training Command. Unfortunately it did not take off well and in a short time I was looking for an actually paying job. Fortunately with a Sunday morning phone call the day before I would have accepted a full-time job an old Army buddy asked me if I was interested in flying again. A couple of months later I started flying helicopters again although this time it was for a hospital instead of the Army and I was able to put to use flying skills I had learned in the Army that I did not think I would ever use again. Now, over 6 years later I am bringing skills from both of these divergent lives together in something called Crew Resource Management (CRM) or Air Medical Resource Management (AMRM) training.
CRM and AMRM are both fancy names for team communications skills. This is nothing new and has been around for quite some time. What I believe is different is my approach to it. You see for the past six years I have continued my quest to gain experience and knowledge in the areas that I pulled together originally to do business as a consultant; communications, team dynamics, conflict resolution, interaction styles, group decision-making and the like. I have attended workshops and certification courses, earned a master’s degree in Education, and become certified in a diverse collection of personality assessment tools. Assessment tools that look at a person’s core values and behaviors, cognitive/decision-making processes, emotional intelligence, conflict/interaction modes, need for inclusion or control, and more. More important than an assessment though is the ability to bring an understanding of how to apply the theories behind these assessments without worrying about the results.
While I personally like talking and discussing CRM/AMRM, I have always felt that the HEMS industry in general are focusing on the wrong part of CRM/AMRM while many individuals see AMRM as just another mandated class turned into a yearly requirement. What we are in fact trying to deal with is the difficult task of combining several individual personalities into one crew without giving them the knowledge( or even talking about it in a meaningful way) of how to do this. The problem I see here is a lack of training and understanding in how much individual personality types affect a crew decision.
Advisory Circular 00-64 is the FAA’s Recommendation to the HEMS industry of what should be talked about in AMRM. While not an overly large document, they spell out what topics should be addressed without mandating how to actually go about it. But within the 18 page (approximately 6000 word) circular, is just one sentence and a smattering of inferences that talk about personality types. The very next paragraph has all of two sentences on group dynamics, which should be addressed as much as individual personality types. The topics of these two paragraphs influence almost every other topic of discussion in the circular. So that you do not need to go look it up here are the two paragraphs or three sentences. (Go here to see the actual AC 00-64)
Understanding of Basic Personality Types. The type of personality defines “what” is important to an individual and significantly influences the way one makes a decision.
Understanding of Group Dynamics. The “group” may have its own way of making decisions. The group should be aware that perhaps their “informal” structure does in fact work in a formal organization.
My contention is simple here; I believe that these two paragraphs should be the focal point of a meaningful AMRM/CRM program and not just an “Oh, by the way…” This program is not about an annual “check the block” requirement that has to be met. This program is not about how to fly, how to drive, how to administer to a patient, or how to be a communication specialist or a mechanic. This program is not about pilots, ambulance drivers, medics, nurses, doctors, mechanics, comspecs, or administrators. This program is about people. About individual personalities that HAVE to come together as a group and deal with their varied and unique personalities in a meaningful way so the group dynamics on the crew can be such that they complete each and every patient transport, reposition, static display and demonstration safely.
This past fall I decided that I was going to stop standing on the sideline and became an AMRM instructor for the company I fly for. More importantly this coming fall at the 2014 Air Medical Transportation Conference in Nashville TN, I have been selected to give two presentations on incorporating personality type and group dynamics as the focal point and not an afterthought of a meaningful AMRM/CRM training program. The first one will be a six-hour pre-conference workshop incorporating a personality assessment and looking at how personalities affect the crew dynamics. The second will be a one hour education session and discuss how personalities affect team building in this industry. I recognize that this is a very new approach to an industry wide training program and a lot of education needs to be done yet. While I may not know where or how this will look 5 years from now, I do know that individual lives are at stake and it is those individual personalities that will either make a safe team or fail in that attempt depending on how they approach team dynamics. I also know that we can no longer afford to have everyone learn about how they might best fit into a team through trial and error.
We as an industry cannot expect everyone to learn and treat the topic of AMRM the same way, although that is the goal. It was one thing when we mainly concerned ourselves with one profession. Pilots in general tend to be similar in personality or have figured out how to deal with training and certifications as just the way it is. AMRM encompasses a whole new group of professionals that do not normally deal directly with the requirements of flight and yet they have been made an active and meaningful part of the crew. Medical crew members have learned to speak a different language and have very different backgrounds and experiences from professional pilots. Likewise when actually performing the tasks they are hired to do, they often have very little time to focus on the flying business.
Thankfully, using a simple model of personality as a bridge between the various groups of professionals involved allows for a common language that can easily be learned. The one thing we all have in common in the air medical industry is that we are all different. As an aviation unit operations officer for the US Army I was once told that I had a personality conflict with an individual that I absolutely had to work with daily, and that I should get over it. So instead of ignoring this or writing it off as something for you to get over, I am proposing that we stop ignoring the individual personalities that are present in any team or crew. Stop telling your teams that there is no “I” in team – The “I” is every individual team member. What we should be teaching them is how we can turn a group of “I’s” into a cohesive team that they can proudly refer to as “we”. Especially when they get done with a flight or transport, and in their post transport debrief can claim that “WE made a great decision tonight”.