I have been reading the extraordinary and compelling Checklist Manifesto (vacation reading for anyone, despite the somewhat anaesthetic title) in which surgeon Atul Gawande described how a specific intervention reduced surgical death rates in trial hospitals around the world by up to 47%. The most striking thing about the intervention is that it is not a medical one – it’s a procedural one; a deceptively simple checklist containing several mandatory pre- and post-operative checks such as has the identify of the patient been positively confirmed? and are the ventilator machines working? and do we have the radiology images we need? Gawande argues, on the basis of extensive evidence, that the striking gains made are as much to do with the creation of a purposeful and committed team as they are to do with the specific medical gains; that for most surgical errors, someone on the surgical team knew the answer, but were not always called upon, listened to, or sometimes were not even aware of a problem.
Of course surgery is an immensely complex field, but the book also examines in detail how builders erect skyscrapers; in this case again, the problem is not generally one of expertise, but one of coordination between architects, structural engineers, electrical engineers, arpenters, acoustic specialists and so on. The surprising central theme here is once again the existence of a master checklist (and also a fact that we take for granted – for all their stunning scale and complexity, modern buildings do not fall down). In this case the list has a very different feel to the surgical one; it asks things like “Have the mechanical engineers, concrete specialists and architects signed off on the final plans for the foundations?”.
But despite the differences between the surgeons’ and builders’ checklists what is common is the fact they ensure communication between experts, and ensure that specialists (individuals in the case of surgery, teams in the case of buildings) are talking about what they are doing and ensuring coherence.
Naturally, I am wondering about possible implications for us as teachers, parents and as an institution. I have wrestled with my initial disdain for checklists as somehow reducing one’s professional standing; surely something as creative and complex as teaching cannot be reduced to a checklist? Is there a danger that something is lost that way? The evidence from the surgeons’ case seems to be that the checklists don’t tie the surgeons down, but in fact free them up to be as creative as they can be, assured that the basics have been covered. And in any case, if checklists help us do a better job than the professional thing to do is to embrace them. But still, can they help us in education? Building buildings and operating on bodies are both incredibly complicated tasks – but essentially they are both about physical situations; education has the added dimension of trying to mould minds and shape values. But there are similarities of complexity and perhaps the issue of coordination is the same. Schools probably have an advantage over these other examples as the teams are relatively stable, and we are certainly putting a great deal of effort into ensuring we have robust internal communication and a strong sense of teamwork; this applies to individual students, to curriculum planning and to dozens of other matters.
One essential part of teamwork is ensuring good communication between school and home, and I was, therefore, most grateful to those parents who came to the Principal’s Forum last week; I was able to speak to all the issues raised by parents beforehand and explain our thinking in some complex areas. Next year we will be putting more time into these consultative mechanisms, and as well as Principal’s and Head of Grade coffee morning, we will be having a Friday/Saturday Meet the Mentor and Year Ahead for Your Child style event, and also Grade Level Representatives for each year. I am sure that increasing what is already a good level of open communication will only enhance our effectiveness as we strive to offer the best possible education of our students, your children, and that has to be at the top of all our checklists.
