Getting Better


Do you want to become better at something worthwhile? For most of us, the desire to be the best we can is intrinsic.

The latest in my very sporadic series of books relevant to veterinary medicine and its teaching addresses just that issue. ‘Better. A surgeon’s notes on performance’ is written by Atul Gawande, a US surgeon and staff writer for the New Yorker magazine.

Gawande believes that three core requirements underpin success in any task that involves risk and responsibility:

Diligence– attention to detail which enable errors to be avoided and the logistics of huge projects to be tackled,

Doing right – navigating the potential minefield of ethical decision making

Ingenuity – Gawande defines as this as reflection on failure and constant searching for new solutions.

For each of these essential elements he provides three examples of different ways in which these principles have been applied.

Although I certainly found the main part of the book interesting and inspiring, it was the afterword which stuck with me. Gawande outlines the following 5 suggestions for himself and his students to make a positive difference in their work.

  1. Ask an unscripted question. In the veterinary education context this could be asked of a student, an owner or a member of staff you don’t know well. The question should be unrelated to the job at hand but aims to provide a human connection. Listen to the reply and remember what you learn. Before ever having heard of Atul Gawande, I used to do this as an intern when having groups of students introduce themselves to me on clinical rotations. This has reminded me that some of the answers were memorable and valuable. It’s inspired me to rekindle the habit.
  1. Don’t complain. All vets have very difficult clients, frustrating cases and long days. Gawande’s words describe a situation common amongst vets – ‘Whenever doctors gather…the natural pull of conversational gravity is towards the litany of woes all around us. But resist it. It’s boring, it doesn’t solve anything and it will get you down.’ I know I’m guilty of this one, both in a veterinary and personal context so I’m trying to start more positive conversations.
  1. Count something. I love this one. Gawande’s reasoning is that we should all be scientists in the world and count something that interests us. It could be outcomes of clinical cases, or, as I have decided to do next year, student marks for particular types of questions. Gawande believes that if you count something you find interesting, you will learn something interesting. I’ll report back on the results of my counting.
  1. Write something. Gawande encourages everyone to write something, whether a few paragraphs or a full scientific textbook. He notes that science is built from many snippets of information, that writing makes you step back from the daily tasks and that by making your writing available to others, you show willingness to contribute to a larger world. I heartily concur with this sentiment. Blogging makes me reflect on my learning and organise my thoughts to a much greater depth than merely reading does.
  1. Change. Gawande encourages thoughtful early adoption of new ideas to solve current problems rather than taking the apparently safer course of doing what everyone else is doing. He points out that the choices are imperfect at best and that a new solution to a problem may turn out to be a brilliant idea. Following his own advice, he advocates counting and writing about the results of new ideas to help judge their merit.



About rebekahmcbrown

I am a veterinarian with a special interest in instructional design and developing eLearning in the veterinary and medical areas. I write teaching materials for both face-to-face and online learning as well as writing and editing articles.
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One Response to Getting Better

  1. Anne says:

    Great post! I love it and had forgotten about this section…he is spot on at every level.

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