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response of 60 wilderness leaders to a questionnaire served as the basis for the medical
content of a generic medical examination. There were five categories of characteristics
including (Table 3):
1)
Personal characteristics
2)
Historical characteristics
3)
Medical components
4)
Physiological components
5)
Psychological characteristics
Items included in each category are listed in the appropriate column in Table 4.
Characteristics associated with category 5 above (psychological) were sprinkled
throughout the other four categories to reduce the mindset associated with answering
questions of a personal nature. The results of the survey were used to develop a relative
value of the various characteristics. For example, the highest relative value score for
predicting success on a wilderness venture was a history of success on a similar previous
venture (Table 5). The highest relative value score associated with failure on a venture
was "demonstrated problems with psychological or interpersonal relationships," clearly
psychological factors (Table 6). The experienced participant (i.e. the old "salty dog")
has proven the capacity to function in the wilderness setting with the wisdom to avoid
circumstances with potential for physical or judgmental difficulties. An examining
physician equally experienced in the wilderness (i.e. a "salty dog physician") is in an
excellent position to recognize potential problems during an interview. This is the origin
of the term "salty dog science." The least valuable predictors were derived from
physiological testing, although observation of a participant during simulation of planned
venture tasks may be helpful in predicting performance. The traditional medical
examination was of value, but the results underscore the importance of history in
completing a physician examination. This perception shifts the physician's examination
in the direction of the interview, which requires experience on the part of the physician in
the ventures being considered, the professional skills required to obtain a reliable
interview with the candidate, and the wisdom to match the participant with appropriate
activities.
