Inattentional blindness, unintentional consequences

We are all at risk of missing the giant man in the gorilla suit every day in ED.

The Invisible Gorilla study is a classic –  watch the video.

The viewer is asked to count the number of times the people in white shirts pass the ball to each other.   At some point in the video a man in a giant gorilla suit walks slowly into the middle of the screen, beats his chest and then wanders off.  50% of people didn’t even notice him because they were so focused on counting the passes (that’s not to mention the other deliberate mistakes in the video).

Harvard researchers have now shown that even medics suffer from ‘Invisible Gorilla Syndrome’.

Although you might not think it, radiologists are just human and not superheroes who sit in a darkened room all day picking up every minor deviation from the norm.

Trafton Drew, a researcher at Harvard Medical School’s Visual Attention Lab, showed radiologists images like the one below and asked them to identify cancerous nodules…

Visual Inattention Gorilla

Click to enlarge

83% missed the gorilla waving his fist in the image.

Researchers determined by eye-tracking that radiologists spent 5.8 seconds looking at the scan with the gorilla, and out of the 20 radiologists who did not see the gorilla, 12 had looked directly at it.

So what’s the issue?  It’s called inattentional blindness – your brain is focusing on one specific issue and so all the other side issues are just phased out.

This is a problem we face every day in ED: recurrent abdo pain; drunk and disorderly; wheezy child; back pain.   The information we are given before we see the patient focuses our minds on particular areas and this can lead to us simply muting and ignoring the other potential problems.

Don’t ignore the gorilla.

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