We are delighted to welcome back Dr Andrew Petrosoniak, who we first interviewed on episode 22, when we explored the role of coaches in medicine. In this episode we will take a deep dive into decision making. Human are estimated to make approximately 35,000 decisions a day. Very few of us have received formal instruction in how to make decisions particularly when under pressure, but like many things, decision making is a skill that can be learnt and trained. Andrew is an expert in human factors and has studied and thought about the elements that go into critical decision making, and he will present 8 tools we can all use to help us make better decisions.

Dr Petrosoniak is an emergency physician and trauma team leader at St. Michael’s Hospital, and an Assistant Professor in the Department of Medicine at the University of Toronto. Dr. Petrosoniak’s academic work focuses on using simulation to help design clinical infrastructure and improve patient safety. His other area of research involves understanding how rare, life-saving procedures can be best taught and practiced using simulation.

In 2020 Andrew co-founded Advanced Performance HealthCare Design - a company focused on using simulation, behavioural psychology and clinical expertise to enhance high performance teams in healthcare.

https://advancedperformance.ca/

Andrew is an invited speaker both nationally and internationally, and so we are honored that he has agreed to talk to us a second time!

8 Decision Making Tools:

1. Reduce decisions whenever possible.
2. Sign-post decisions.
3. Deliberately consider alternative options.
4. Assign probabilities to decisions.
5. Use one-line summaries, and simplify where possible.
6. Use a pre-mortem.
7. Debrief decisions.
8. Learn from decisions.

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Richard De Crespigny is an expert in leadership, decision-making, and human performance under pressure. He is best known as the Captain of Qantas Flight 32, the Airbus A380 that suffered a catastrophic engine failure shortly after takeoff from Singapore on November 4th, 2010—an event that has since become one of the most studied and finest examples of effective CRM in aviation history. He has over 45 years of experience in aviation and his book, QF32, is a powerful exploration of leadership, teamwork, communication, and calm thinking when the stakes could not be higher.

What makes the story of QF32 extraordinary isn’t just what went wrong—but how a team came together, how decisions were made in uncertainty, and how human factors, not heroics, made the difference to effect a safe and successful outcome.

In this conversation, we go beyond the headlines to explore what QF32 teaches us about crew resource management, cognitive load, emotional regulation, communication and leadership when suddenly faced with potential catastrophe.

Richard's books:

1. QF32
2. Fly! The Elements of Resilience

Richard's website: https://qf32.aero/

Richard's podcast, FLY: https://podcasts.apple.com/us/podcast/qf32-the-inside-story-from-the-flight-deck/id1832400848?i=1000723751309

(Episode photograph supplied by Richard De Crespigny used with permission)

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Dr Jorian Kippax is an emergency medicine specialist based in Tasmania, Australia — but his work spans mountaintops, disaster zones, and deep wilderness. He’s a Retrieval Consultant with Ambulance Tasmania’s Critical Care and Retrieval Service, and a Trauma Specialist at the Royal Hobart Hospital. He’s also a veteran of international disaster response, having led medical teams in the aftermath of Typhoon Haiyan and earthquakes in Myanmar as part of Australia’s elite AUSMAT deployment force.

In November 2024 he was involved in a 22-hour rescue deep in Tasmania’s Franklin River wilderness. He performed a life-saving underwater field amputation to free a trapped rafter using only the gear that could be delivered by helicopter. That act of skilled courage earned him Lithuania’s Life Saving Cross and the 2026 Australian of the Year for Tasmania.

In today's episode, Dr Kippax shares a firsthand account of the rescue, and we explore the underlying human factors skills used by him and the large team of specialists that day.

To watch the ABC News Documentary: You Tube: https://youtu.be/nMa-Lqxfzqk?si=3or2-2ZjAh6oziyi

https://australianoftheyear.org.au/recipients/dr-jorian-kippax

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