HOW DO WE LEARN TO WORK WITH INTELLIGENT MACHINES

Beane opens his talk with an anecdote about “Kristen” – a surgical resident wheeling her prostate patient into the operating theatre at 6.30am. By 8.15am, Kristen is closing the patient, having undertaken a lead role in the “nerve-sparing” part of the process under the supervision of the attending surgeon. Beane states:

"Kristen feels great. Patient’s going to be fine, and no doubt she’s a better surgeon than she was at 6:30…

"….Kristen’s learning to do her job the way that most of us do: watching an expert for a bit, getting involved in easy, safe parts of the work and progressing to riskier and harder tasks as they guide and decide she’s ready."

As Beane highlights, this kind of learning has been the main path to skill for thousands of years. 

Whether you call it apprenticeship, mentorship or on-the-job training, the methods are the same.  You watch, you learn, you try, you succeed and – in time – you teach. This cycle is present in all areas of life, and is crucial to our development.

Once upon a time, we didn’t know what the big hand and the little hand on a clock represented (arguably some of us still don’t!), but after learning from others – teachers, parents, siblings – we’re able to 1) tell the time, and 2) teach others how to.

Whilst prostate surgery is slightly more complex, the same process applies. Until, that is, the robots join in…

"It’s 6:30am again, and Kristen is wheeling another prostate patient in, but this time to the robotic OR. The attending leads attaching a four-armed, thousand-pound robot to the patient. They both rip off their scrubs, head to control consoles 10 or 15 feet away, and Kristen just watches.

"The robot allows the attending to do the whole procedure himself, so he basically does. He knows she needs practice. He wants to give her control. But he also knows she’d be slower and make more mistakes, and his patient comes first."

Beane continues:

"So, Kristen has no hope of getting anywhere near those nerves during this rotation. She’ll be lucky if she operates more than 15 minutes during a four-hour procedure. And she knows that when she slips up, he’ll tap a touch screen, and she’ll be watching again, feeling like a kid in the corner with a dunce cap."

The example may sound over-the-top, but anyone with experience of handling a new and fancy bit of tech can surely relate.

Remember when you got your first smartphone, or that shiny new laptop? The thought of handing it over to your kids to play with (or butter-fingered Ben from HR, for that matter!), would undoubtedly fill you with dread. Perhaps you had an older sibling who would grab the controller to fight The Boss in video games because you were “doing it all wrong”…

Now imagine instead of a mobile phone or a games console, you were handling a multi-million-dollar piece of robotic equipment… Oh, and somebody could literally DIE from a single mistake? After all, “power-ups” don’t exist in real life. You can’t just reset the game to continue.

One thing I find curious, however, is that Kristen is permitted to partake in the “manual” surgery but not the “robotic” one. Surely there’s more to it than worrying about preserving highly expensive equipment?

Beane states:

"I covered 18 of the top US teaching hospitals, and the story was the same. Most residents were in Kristen's shoes. They got to “see one” plenty, but the “do one” was barely available. So, they couldn’t struggle, and they weren’t learning."

AI is effectively blocking learning on the job.

Perhaps attending surgeons hold greater trust for technology than their human counterparts? Maybe it’s a question of culpability. Or do they feel they have greater scope to step in and help in a more traditional environment?

Whatever the reason, gaining experience of new tools and techniques is vital for our ongoing development and survival.  And not just in the medical field...