“Care that is patient-centered and includes the positive attributes of bedside manner has been shown to improve recovery from illness, revealing a link between provider behavior and effective disease management.”
This passage was written by Linda Finch, a registered nurse and associate professor at the University of Memphis, in her paper on the effects of bedside manner in healthcare. Not surprisingly, it has a significant influence.
The way we communicate with one another can provide real benefits. But it works both ways: Style of communication can also mask or disfigure the substance of what we are trying to say. In other words, the content of what we say matters, but it matters equally how we say it.
Bedside manner is just as important in aviation. We pilots interact with everyone from air traffic controllers to mechanics to flight instructors. Their “bedside manner” has far-reaching implications on our safety of flight. At face value, a simple conversation or interaction may not seem to hold that kind of weight, but you’d be wrong to assume that. In fact, it’s the most insidious kind of safety issue because we don’t know the mistake is being made. Someone’s bedside manner may lead us to trust when we shouldn’t. It can create an atmosphere where one is hesitant to respond appropriately, ultimately leading a pilot down the wrong path.
Bedside manner as a term conjures the image of a doctor tending to a patient, but all types of professions are deeply affected by style of communication. I just returned from directing a TV show in Los Angeles. On my first day, we shot in a crowded hotel lobby. One of the crewmembers did not know I was the director and snapped at me when I asked him about a camera mount on the crane he was operating. Not wanting more of the same, I communicated in a very different manner with him the next time we spoke: I was brief, bordering on incomplete in my direction. As a result, my instructions were misunderstood, the shot wasted. Frustrated, I called, “Cut,” pulled him aside and properly introduced myself. We started over and had a great working relationship for the duration of the shoot. His biting initial reaction, however, changed the way I normally communicate—and not for the better.
A good bedside manner doesn’t necessarily imply niceties. With an established relationship, clarity and frankness can be enough. Bob Ripley, my mechanic down in Georgia, is the single most succinct human being that I know. The man makes Class B ATC transmissions seem verbose. Before I call Bob, I have all my ducks in a row. I know exactly what I’m going to ask him, and I have all the pertinent information at the ready in case there are follow-up queries. I am prepared for the brevity—I’ve come to admire it. As an A&P mechanic, Bob’s excellence in his work is far more important than any hand-holding I might desire through the maintenance process. I don’t need him to change his manner for me. Instead, I change my approach and expectations, safe in the knowledge that his work is the finest done on my airplane.
I have interacted with other mechanics that made me feel warm and fuzzy but whose work left something to be desired. I may have felt heard when we spoke, but the work was subpar and required additional visits to rectify. I’d rather pay up front. I am OK with a more austere bedside manner in a mechanic whose work is untarnished. Expertise supersedes nurturance. When you pull your airplane inside Bob’s hangar, he immediately conducts a compression test. No “Hi, Ben. How’s things?” It’s just cowls open and ratchets flying because the man likes a warm compression reading. You can talk later.
I come from a world where niceties are very important. I talk to actors carefully. They need a particular tone from me to do their best work. They need assurance. Bob needs nothing from me. He works on my airplane, and I sleep soundly at night. Vitally, I fly soundly at night knowing that he spent more time on my airplane’s well-being than my own. This is a fair trade-off.
The effects of bedside manner change dramatically when you get into flight instruction. Here, the goal is quite different. While every engine is essentially built up in roughly the same way, every pilot requires a different approach. Things get interesting when the part being built up is you. My mother is a therapist. She ran a private practice for many years, in that time treating hundreds of patients. She said that when choosing a mental health practitioner you really need to make sure it’s the right fit. If you have a broken wrist, there’s the orthopedic surgeon everyone agrees is the best, bedside manner be damned. Finding a shrink is more akin to dating. The most qualified person may not be the best match for you. In aviation, CFIs are closer to therapists than orthopedists. Yes, they all must convey the same material and knowledge, but how and if that occurs varies wildly between instructors.
Bedside manner is crucial in these interactions because it influences how the student learns. A student who is made to feel stupid for asking a question will think twice before asking another. He may let something slide that he does not fully grasp to avoid the discomfort of being judged. Somewhere down the line that deficiency will reveal itself to the student—hopefully not on a solo flight.
Read More by Ben Younger: Leading Edge
Neil Korman trained me for my private pilot certificate in 2012 and, later, for my instrument rating. He gave me all the right tools. He taught me to be cautious but confident, showed me how to fly approaches with a partial panel, and made me listen to the plane. Initially, I didn’t think I could make my turns to base and final without an airspeed indicator. He convinced me otherwise. He imparted on me good decision-making skills. The single exception where I ignored his instruction was in the spring of 2018, departing Telluride, Colorado, where I was caught out by low-level wind shear. Thankfully, the stick-and-rudder skills he ingrained in me early on ended up saving my life. Throughout our time together, Neil gave me just the right balance of encouragement and criticism. Above all, he let me make mistakes: the kind that etch themselves into your brain in a way no amount of instruction ever could. He never let me get close to hurting either of us, but he did let me touch the stove once or twice.
Neil was able to teach me all this because of the way our personalities intersected. He has a paternal quality to him; I lost my father when I was young. As a student, I was hungry to learn and also eager to please a father figure. Getting accolades from someone you admire is, in itself, a motivation—and that’s fine, as long as you’re learning and not just basking in praise. I was acutely aware of this dynamic and careful to keep an eye on it, but it was ultimately useful in my education. More recent, with additional experience under my belt, I returned for recurrent training, and we would sometimes butt heads. Accolades are no longer the carrot on the stick they once were. I am more impatient and want to dictate the pace of my instruction. I felt some of the details he was getting hung up on were not as important as he did. I am a different (read: difficult) student. Our dynamic shifted.
The way we react to others is often historical and therefore hard to detect. This requires caution. Why do we trust this instructor? Hopefully it’s based on objective criteria. But it could be something else. Do we misinterpret silence for intelligence? Confidence as know-how? Verbosity as mastery? It’s different for everyone, but no one is immune. We are drawn to certain personality types, and it sometimes has no correlation to merit. That comfort we feel can be misplaced and end up costing us. A friend told me about an instructor he trusted so much, had become so familiar with, that during a recent lesson in hard IMC, he simply gave up and handed the controls over to this CFI when he felt just the initial signs of being overwhelmed. He could have turned on the autopilot and reorganized, but he did not. He had become so trusting that he knew there were no real stakes—his teacher would be able to get him out of anything. At this point, you stop learning.
I have a new CFI who I will be training with when I pick up my Bonanza next week in Colorado. Eric Eviston specializes in teaching in Bonanzas, so he is well-suited to explaining the ins and outs of my airplane. We had one lesson this past fall before I brought N1750W in for her winter-long restoration. I am eager to begin training again once I—very carefully—fly her home to KMSV in Monticello, New York.
It will be interesting to see how Eric and I interact. What do I need from an instructor at this point? Expertise, certainly. But what kind of teaching style will I respond to? I’m not sure. I’m a very different pilot than I was just a year ago. I certainly have a lot to learn. What I do know is that a CFI or mechanic or movie director’s bedside manner will influence how and how well that happens.
