Hi, it’s Gerard O’Dea here, director of training for Dynamis. And today I’m with you on part two of our series on Breakaway Skills and Performance with you. If you remember, the last part that we discussed was around the research that had been taking place around breakaway training for healthcare and how staff in healthcare and social care settings have been trying to put that into place. And that there were some really quite variable results of the successful implementation of breakaway skills that had been learned in classrooms and in training sessions. So in this session today, I want to talk to you about why that might be happening and perhaps start looking at some of the reasons why we think it might be happening. So the first question we’re going to ask you is whether or not the program that is being taught around breakaway training for healthcare is actually designed to fail under pressure?
So one of our templates that we use at Dynamis is a series of 10 questions that will test a program for its viability under real life stress conditions. And that’s something that we do to make sure that any program that we are teaching has a viability under the high stress and the pressure and the collisions that happen during real life violent confrontations. Sometimes programs are designed based on a traditional view or a view that if it’s written in the manual, it must be okay. And time and time again of course, both ourselves in training situations, and I think the research also bears through that learners find that the actual design of the program is failing long before the personal factors come into play.
Secondly then, is the breakaway training for healthcare actually the cause of failure here? So I suppose the best example of that is where you have staff being asked to learn a whole series of breakaway procedures, but they’re being asked to do that in just a couple of hours of training. Over the years, we’ve been asked to do incredibly short blocks on physical skills, and sometimes the training commissioners have a belief that we can teach people many, many skills in a very short space of time. And we try to educate people that the uptake of these physical skills for protection, it takes time and it takes repetition. Sometimes if a breakaway training for healthcare training program and it’s delivery is in too short a timeframe, then there’s no way really that the average person is going to be able to retain those skills.
Sometimes a compounding that is that the techniques themselves have been adopted modified or just plain made up to fit a set of criteria, which means that the techniques are not really viable so that they’re not robust, and they will not stand up to the real life pressure of a motivated attacker who’s committed to hurting a member of staff. The techniques sometimes that have been created in a vacuum perhaps with all good intentions, they’ve been created to be non-aversive or to be non-harmful. But by designing them in that way, it actually makes the techniques themselves less functional and therefore less robust under pressure. It means they’re going to fail sometimes, or maybe a lot of the time when they’re put to the test in real confrontations.
We could then ask, of course, is it staff failure? Is it the fact that the athletic ability, the general physical condition of staff is such that really when you teach a breakaway training for healthcare technique or ask them to take on board a skill, perhaps their physical attributes themselves would limit them from being able to use that skill. And a second major component of that is their emotional and psychological makeup, their wiring. So the average care staff or healthcare member, or the team, they’re not involved in that profession because they want to go and hurt people. So the actual ability to make a decision to use physical force on somebody which might really result in discomfort or harm or pain, that actually creates quite a significant barrier to the uptake of these breakaway skills perhaps. And certainly in some individuals that we’ve met, this provides quite a strong barrier to the assimilation of breakaway training for healthcare.
So just in those four different areas alone, you can see already that there could be any number of reasons or combination of reasons why breakaway skills are a very difficult topic to teach in a way that will guarantee high performance under pressure. Now for a long time, it’s been understood what the effects of stress are in terms of physical skill performance. And this [inaudible 00:05:29] starts in curve from, very early in the last century, 1908, this inverted U hypothesis that has been really quite well used to describe the effects of stress both in a positive way and then in a negative way on the performance of an individual is a useful initial and very critical bedrock for us to start looking at how we should teach breakaway skills. So simply it says that when you are relaxed and calm and experiencing positive stress, then your performance level at any given reasonably complex task will increase.
That is gross!
Anxiety sometimes facilitates good performance, however, prolonged and/or very extreme levels of anxiety will create tension and eventually panic in an individual where upon their performance of any given procedure, task, or method will significantly decrease and become dysfunctional. And this is a really important thing for us to remember is that survival stress can make the simplest of things in terms of procedures, especially if they’re complex procedures. Survival stress can make the simplest of things difficult to perform breakaway training for healthcare at a high level.
Moving on, then we can see that survival stress can have a specific impact actually on how a human being can move. So typically it’s recognized that we have three sets of motor skills that we use. So that’s fine motor skills, complex motor skills, and gross motor skills. The fine motor skills are movements where we use smaller muscles in a more coordinated way. So something like putting a key in a lock, signing your name with a pen. These are fine motor skills where we have to use smaller movements. And those smaller muscle groups are very fine type of detailed skills that we have. Then we have complex motor skills which are defined as combinational coordination type movements where you have perhaps the fingers gripping a ball and then the arm and body swinging to throw the ball or maybe even to catch one where you’ve got combinations of different movements that are sequenced in such a way that you get a complex set of articulations so that skill can be performed.
Finally, then we have gross motor skills. Now those are the much bigger and more dramatic movements that larger muscle groups would use to facilitate the skill of in question. Gross motor skills are things like jumping, shoving, pulling, and generally bashing and crashing around in a not very fine or delicate way. What survival stress does is of course, it increases the heart rate because the body’s adrenaline systems will be kicking in and flooding the blood system with various survival hormones. One of the results of that is that heart rate increases and sometimes when the stressor is quite large and overwhelming, the heart rate will quite drastically increase right the way up into the 200 beats per minute kind of range. Fine motor skills cut out at a relatively low level of stress…and then the complex motor skills start to drop off.
But across the whole piece here, you can see that the gross motor skills are available to the person to use, and they remain functional regardless of the heart rate increases. So we have to take that on board and look at it as one of the key ideas that’s going to help us to teach people skills that will be robust enough to still be active and still be available to them even though they might be experiencing survival stress. And this is born out in the research in a number of different ways, and research that’s been around for a long time. In 1976, Weinberg and Hunt were talking about how if a task requires fine motor control or it contains important decision making components, then we need a low level of arousal to achieve maximum performance of it. So they’re saying there that if you’re in a high level of arousal in a situation such as being attacked by another human being, then you shouldn’t really be trying to do fine motor control or trying to make important decisions at that time such as which hand to use or something that’s relatively complex like that. So they’re saying at high levels of arousal you need something that’s not fine motor skill.
People revert to instinct
Secondly, then we can look at the other Weinberg quote on the screen, which is to say that individuals when they’re under high stress will revert to their instinctive modes of behavior. Now we’re going to come back to that in part three of this series, and I’m going to describe to you some of the scientific research about what is an instinctive motor behavior for self protection. So looking at survival stress, that could be a really easy way for us to describe what’s happening when staff are forgetting or omitting or not able to produce breakaway skills that they have been taught in the classroom setting during breakaway training for healthcare. Survival stress says, because of the way the body is wired up for survival, certain skills just switch off, they just won’t be available. And that’s really a key thing for us to remember.
Now I’m going to go ahead and talk about stimulus response here. So we’re going to go through some very key sport science about reaction times and stimulus identification in someone like that so that I can talk about how maybe the staff are missing the stimuli. So the basics of motor performance here are encompassed in this stimulus response model which has been around for an awful long time. In essence, it says that your reaction time in any given situation to produce a skill will be made up of three different phases. First phase is when your body mind system has to identify the stimulus. It has to pattern match to figure out what exactly is happening. It then goes into phase two, which is to choose the appropriate response to that particular stimulus. And as we may see, the more responses you’re programmed in, the longer it may take your body mind system to actually select one from the range.
Once the appropriate response has been chosen, then your body mind system has to actually get into action to deploy that response. And all three of those phases when you put them together, we call that your reaction time. Obviously when we look at physical protection, self protection systems, we want systems that will have the smallest reaction time possible. So let’s just start in talking about identifying the stimulus. What exactly is the stimulus we want our staff to recognize in order for them to perform a breakaway skill effectively? And the fact is, when we look at the various studies that are out there, the overwhelming majority of them show that healthcare staff in these kinds of situations are attacked by kinetic assaults. What I mean by that is that they’re being hit, struck, or punched, and at times they’re being kicked, but mostly they’re being slapped or punched in these situations. This has huge implications for breakaway training for healthcare.
The wrist fixation
So in all the studies, the same result was born out that roughly half of the time, sometimes more than half of the time, staff were being hit or punched. Now the incredible thing for me to discover when I went around and asked various training bodies about that, is we found that even though this is quite a well established idea and a fact that hitting and slapping and kicking and punching are the main ways that people are attacked, we still find that an overwhelming majority of breakaway skills packages focus on wrist grabs, clothing grabs, arm grabs, and so on. And personally, I think that’s a throwback to some traditional martial arts models of training which maybe we won’t get into with you just now, we may revisit that in the future, but certainly here’s the thing, if we’re not teaching the staff how to identify the correct stimulus, the one they’re most likely to face in reality, then their stimulus identification is going to be poor.
That will definitely negatively affect their choosing of the appropriate response to that. And then when they deploy a response, the quality of it won’t be so great. So if we just look back at the stimulus response model, we may be failing staff if we’re not addressing the correct stimuli. So that’s a really key idea, and I’ll return to it in part three of my talk. But I want to thank you for your time today. It’s been really useful to be able to get these ideas out into the public domain. And I hope that you’ll come back and look at part three of this talk when we get that ready for you in just a few days’ time. Thanks again.
Dynamis Training is a leading provider of advice and effective in-person training courses in personal safety, self-protection and breakaway skills which are easily learned and which can be retained well over time. Because of our unique coaching methodology and the time and thought we have devoted to what YOUR staff need to know to be able to disengage effectively from a violent assault, this breakaway training is likely to be the most beneficial type of such training your staff could undergo.
Whether its officer safety, breakaway skills or deescalation you are looking for, Dynamis has a course which can be tailored for your specific environment, the context of your team’s encounters and the risks you need to address.
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