It’s Time to Follow the Doctor’s Orders: The Work of Atul Gawande

March 30th, 2012

Category: Policy and Practice

As a graduate student, my education practicum professor highly recommended Atul Gawande’s work, highlighting its relevance to the reforms currently underway, particularly through Race to the Top. While initially skeptical, it was quickly apparent that my professor was on to something – and it looks like the education world is starting to see the value in his work, too.

For starters, as a former teacher, I understand the complexity of teaching and the inherent difficulties built into a profession where you are trying to motivate and teach 20+ kids inside a classroom; therefore, it’s heartening to see someone in what society deems a highly-respected profession point out similarities between the current work environments of surgeons and educators – and what they can both do to enhance their skills.

First, Mr. Gawande eloquently writes about how he utilized coaching to improve his craft as a surgeon, which is atypical in the current field. In the article, he highlights the benefits of having a seasoned set of eyes observe his actions and subsequently recognize his successes and identify areas of improvement. He also expands upon education, and I think he perfectly captures the current climate among educators when he writes:

“Researchers from the University of Virginia found that many teachers see no need for coaching. Others hate the idea of being observed in the classroom, or fear that using a coach makes them look incompetent, or are convinced, despite assurances, that the coaches are reporting their evaluations to the principal. And some are skeptical that the school’s particular coaches would be of any use.”

Upon reflection, these feelings are both expected and warranted. How can an experienced teacher, with years of classroom experience, suddenly become comfortable with frequent observations and feedback sessions when all they’ve known before was the token 10 minute observation from his/her principal? Or, how can a teacher reconcile the fact that s/he might be deemed highly-effective one year and then, upon receiving a more rigorous evaluation, be told that they need improvement? This disconnect is at the heart of many different reform efforts, including teacher evaluation, meant to change not just the practice, but the culture of teaching to one that is not afraid of being critiqued but rather seeks it. I imagine when the history book is written on Delaware’s education reform efforts decades from now, one thing that will be apparent is the culture shift among educators as they comfortably admit their imperfections and recognize the need to grow professionally.

Second, Mr. Gawande gave the commencement speech at Harvard Medical School where his overarching theme was that we train doctors to be cowboys, but people need pit crews. He states that the current discontent felt by many within the medical field, “are symptoms of a deeper condition – which is the reality that medicine’s complexity has exceeded our individual capabilities as doctors.” Reading that quote, the parallels to education are clear. In the past, teachers were given the keys to their classrooms along with the autonomy to deliver instruction as they see fit – as evidenced by such films as Dead Poets Society or Stand and Deliver. In our industrialized education system, this structure made sense – we weren’t trying to prepare all kids for college and/or careers. However, as the reality of the 21st century global economy dawns on us, it becomes apparent that our current system is ill-equipped to prepare our students to compete – to no fault of anyone. In order to transition towards a system that delivers high-quality education at scale, Delaware educators are taking similar steps to their colleagues in medicine. First, they are getting acclimated to the practice of using data to understand performance and develop solutions as part of the data coach initiative. As highlighted in Mr. Gawande’s article, this requires an acceptance of some level of standardization of practice, which is no doubt new to the field. Second, we are trying to coordinate these efforts among teams so that we can utilize the collective knowledge of our peers to solve these complex issues. The state implemented professional learning communities throughout all our schools not to cause heartache for those making class schedules; rather, they took the step in order to ensure teachers weren’t cowboys, but, rather pit crews constantly diagnosing all students and moving forward with the necessary remedy.

What do you think? What are some of the challenges/pitfalls/opportunities as we make this difficult transition towards a system that ensures all students have access to what Mr. Gawande calls, “the struggle to assure universal delivery of our know-how?”

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Brett Turner



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