The Beginner's Mind Applied to Software Testing

Something has been bothering me for some time now as I conduct software testing training classes on a wide variety of topics - ISTQB certification, test management, test automation, and many others.

But it's not only in that venue I see the issue. I also see it in conferences where people attend, sit through presentations - some good and some not so good - and leave with comments like "I didn't learn anything new." Really?

I remember way back in the day when I chaired QAI's International Testing Conference (1995 - 2000) reading comments like those and asking "How could this be?" I knew we had people presenting techniques that were innovations at the time. One specific example was how to create test cases from use cases. At the time, it was a new and hot idea.

So this nagging feeling has been rolling around in my mind for weeks now. Then, this past week I had the need to learn more about something not related to testing at all. One article I found told of the author's similar quest. All of his previous attempts to solve the problem ended up looking similar, so he started over - again - except this time with a mindset in which he knew nothing about the subject. Then, he went on to describe the idea of the "Beginner's Mind." Then, it all clicked for me.

When I studied and practiced martial arts for about ten years, my fellow students and I learned that if we trusted in our belt color, or how many years we had been learning, we would get our butts kicked. In the martial arts, beginners and experts train in the same class and nobody complains. The experts mentor the beginners and they also perfect the minor flaws in their techniques. The real danger was when we thought we already knew what the teacher was teaching.

Now...back to testing training...

I respect that someone may have 30 years experience in software testing. However, those 30 years may be limited by working for one company or a few companies. Also, the person may only have worked in a single industry. Even if the experience is as wide as possible, you still don't have 100% knowledge of anything.

The best innovators I know in software testing are those that can take very basic ideas and combine them, or find a new twist on them and innovate a new (and better) way of doing something. But you can't do that if you think you already know it all.

In the ISTQB courses, I always tell my students, "You are going to need to 'un-learn' some things and not rely solely on your experience, as great as that might be." That's because the ISTQB has some specific ways it defines things. If you miss those nuances because you are thinking "Been there, done that," you may very well miss questions on the exam. I've seen it happen too many times. I've seen people with 30+ years of experience fail the exam even after taking a class!

So the next time you are at a conference, reading a book, attending a class, etc. and you start to get bored, adopt the beginner's mind. Look at the material, listen to the speaker and ask beginner questions, like "Why is this technique better that another one?", "Why can't you do ..... instead?", or "What would happen if I combined technique X with technique Y."

Adopt the beginner's mind and you might just find a whole new world of innovation and improvement waiting for you!

Dallas Ebola Patient Sent Home Because of Defect in Software Used by Many Hospitals

Here at Rice Consulting, we have been making the message to heathcare providers for over two years now, that the greatest risk they face is in the integration and testing of workflows to make sure electronic health records are correctly made available to everyone involved in the healthcare delivery process - all the way from patients to nurses, doctors and insurance companies. It is a complex domain and too many heathcare organizations see EHR as just a technical issue that the software vendor will address and test. However, that is not the case as demonstrated by this story.

From the Homeland Security News Wire today, October 6:

"Before Thomas Eric Duncan was placed in isolation for Ebola at Dallas’ Texas Health Presbyterian Hospitalon 28 September, he sought care for fever and abdominal pain three days earlier, but was sent home. During his initial visit to the hospital, Duncan told a nurse that he had recently traveled to West Africa — a sign that should have led hospital staff to test Duncan for Ebola. Instead, Duncan’s travel record was not shared with doctors who examined him later that day. This was the result of a flaw in the way the physician and nursing portions of our electronic health records (EHR). EHR software, used by many hospitals, contains separate workflows for doctors and nurses."

"Before Thomas Eric Duncan was placed in isolation for Ebola at Dallas’ Texas Health Presbyterian Hospital on 28 September, he sought care for fever and abdominal pain three days earlier, but was sent home. During his initial visit to the hospital, Duncan told a nurse that he had recently traveled to West Africa — a sign that should have led hospital staff to test Duncan for Ebola. Instead, Duncan’s travel record was not shared with doctors who examined him later that day.

'Protocols were followed by both the physician and the nurses. However, we have identified a flaw in the way the physician and nursing portions of our electronic health records (EHR) interacted in this specific case,” the hospital wrote in a statement explaining how it managed to release Duncan following his initial visit.

According to NextGov, EHR software used by many hospitals contains separate workflows for doctors and nurses. Patients’ travel history is visible to nurses, but such information 'would not automatically appear in the physician’s standard workflow.' As a result, a doctor treating Duncan would have no reason to suspect Duncan’s illness was related to Ebola.

Roughly 50 percent of U.S. physicians now use EHRs since the Department of Health and Human Services (HHS) began offering incentives for the adoption of digital records. In 2012, former HHS chief Kathleen Sebelius said EHRs 'will lead to more coordination of patient care, reduced medical errors, elimination of duplicate screenings and tests and greater patient engagement in their own care.' Many healthcare security professionals, however, have pointed out that some EHR systems contain loopholes and security gaps that prevent data sharing among healthcare workers.

The New York Times recently reported that several major EHR systems are built to make data sharing between competing EHR systems difficult. Additionally, a 2013 RAND Corporationstudy for the American Medical Association found that doctors felt 'current EHR technology interferes with face-to-face discussions with patients; requires physicians to spend too much time performing clerical work; and degrades the accuracy of medical records by encouraging template-generated doctors’ notes.'

Today, Dallas’s Texas Health Presbyterian Hospital has made patients’ travel history available to both doctors and nurses. It has also modified its EHR system to highlight Ebola-endemic regions in Africa. 'We have made this change to increase the visibility and documentation of the travel question in order to alert all providers. We feel that this change will improve the early identification of patients who may be at risk for communicable diseases, including Ebola,' the hospital noted."