A Teacher’s Reflection on ‘Better’ by Atul Gawande

A Teacher’s Reflection on ‘Better’ by Atul Gawande


Our staff summer reading this year is ‘Better‘ by Atul Gawande.  Seemed like an odd choice for summer read for teachers but the general premise of the book is practical for any profession:

What does it take to be good at something where failure is so easy?

I love books like this AND Sara is a pediatrician so I was excited to get a peek into that world.   Gawande broke the book up into three sections: Diligence, Doing Right, and Ingenuity.


He discussed a situation of malnutrition in Vietnam and the efforts that went into trying to fix it.  Health experts tried many things but nothing seemed to change.  One surgeon ended up finding out where the malnutrition rates were the lowest to see what they were doing right; take ideas that are working from within the community instead of imposing your own solutions.  Those ideas spread and helped drop malnutrition drastically.  I think the Heath brothers discussed this idea in their book ‘Switch.’  They called it finding the ‘hot spots’ to bring about change.

I think of how this applies to education.  To learn how to better educate, we need to find the hot spots.  Some people look to Finland, but I think that’s the equivalent of going to a tribe in Africa that’s fighting malnutrition and trying to bring those ideas back to Vietnam.  If I’m struggling in my classroom, I need to find a hot spot that’s close; someone working with the same types of students successfully.  Peer observations are rare in education.  There is student teaching which is definitely valuable, and 1st year teachers will often observe a veteran for at least a day.  This is a good start but I think personal ongoing observation and discussion of these ‘hot spots’ in education are essential to grow as an educator.  For now, YouTube and websites like Edutopia and Teaching Channel can offer a peek into some of these classrooms that work.


He spoke extensively about malpractice suits (not completely in a negative light as you would expect from a doctor). It made me think of how daunting it would be if someone wanted to sue a teacher for not doing a good enough job or making a mistake when the mistake could have been avoided.  The whole practice involves making a ton of mistakes and learning from them (the whole growth mindset thing).  I guess folks aren’t as excited about that when lives are on the line.  Of course, the argument could be made that lives are on the line when it comes to a quality education as well.  Hm.


Gawande examined the idea of the bell curve when it comes to medicine; that there are some hospitals that are exceptional, many that are average, and some that perform very poorly.  What is that top 10% doing differently than the rest, especially when many of the ‘average’ performing hospitals have people that genuinely care, are working hard, and studying the latest best practices?

One doctor who had made incredible strides in cystic fibrosis treatment served as a case study.  Gawande recognized that it was this man’s worldview that set him apart.

He believed that excellence came from seeing, on a daily basis, the difference between being 99.5 percent successful and 99.95 percent successful.  Many things human beings do are like that, of course: catching fly balls, manufacturing microchips, delivering overnight packages.  Medicine’s distinction is that lives are lost in those slim margins.

I thought of the idea of striving for 100% success in my classrooms (if we’re defining success as mastery of concepts and a positive learning experience).  Many times I’ve felt ‘oh well there will just be kids that don’t get it or just won’t like my class.’  While that may be true, settling for that vs. working towards that 100% is what will make the difference between an average teacher and an exceptional teacher.

Even doctors with great knowledge and technical skill can have mediocre results; more nebulous factors like aggressiveness and diligence and ingenuity can matter enormously.

What does it look like to be aggressive, diligent, and ingenious in the classroom?  My hope is that this blog will continue to be a document of my attempts at each of these.

I love his statement on being average:

The hardest question for anyone who takes responsibility for what he or she does is, What if I turn out to be average?

I hate the idea of being average.  I know it’s a mix of insecurity as well as a drive for excellence, but I don’t think it’s the fact of being average that really sucks, it’s the idea of just settling for it.  Seems like you’re just defeated.

Better is possible.  It does not take genius.  It takes diligence.  It takes moral clarity. And above all, it takes a willingness to try.


Gawande ended the book with five suggestions that he gives medical students on what they can do to fight the feeling of just feeling like a cog in a big machine; how one might make a worthy difference.

1.  Ask an unscripted question.

His context was bedside manner.  “Where did you grow up” or “What made you move to Boston.”  Attempt to make a connection.  I’d like to try to do this more in school with students outside of class.  I appreciate that our school culture really emphasizes building those meaningful relationships with students.  “If you ask a question, the machine begins to feel less like a machine.”

2.  Don’t complain.

It’s difficult but it doesn’t solve anything and it will get you down.  I tried an experiment last year where I tried to go 21 days without complaining.  It took several months but to this day, a little bell goes off in my head when I’m about to complain or criticize something.

3.  Count something.

One should be a scientist in this world.  Gawande counted how many times surgical patients ended up with an instrument or sponge left inside them.  The error most often occurred during emergency operations or when something unexpected happen and new supplies had to be brought in.  This led to him working on a device that could automate the tracking of instruments.  Count something that you find interesting.  I don’t know what I will count.  Perhaps the number of times a student comes to office hours and the effect it has?

4.  Write something.

Add your small observation about your world.  My hope is that this blog serve as my own reflection and hopefully add something meaningful to the educational community.

5.  Change.

Make yourself an early adopter.  Find something new to try and something to change.  See how many times you succeed and how many times you fail.  I feel being connected to the community of educators on Twitter helps me stay on the cusp of changes in education.  It’s safer to keep doing the same thing, but progress will be unlikely.  I like that I’ve been teaching the same subjects for the last few years; it allows me to modify and change things to keep making them better.


We were given three questions to reflect on as a faculty.

What teacher behaviors, beliefs, and habits work best for our students?
  • Focus on relationship building.
  • Innovation grants (desire to see new ideas)
  • Time to discuss the ‘hot spots’ of our school
What attitudes and practices unite us as a faculty?
  • Peer acknowledgements
  • Support in trying new things
  • Debrief and reflective practices
What does it mean to guide well and tell well at Khabele?
  • Guiding well takes forming a genuine connection and not settling for being average.
  • Teaching well takes doing all the stuff written above

In what ways have you worked to become better at what you do?
By Thom H Gibson

I help middle school STEM teachers create meaningful & memorable experiences for their students. Teacher, podcaster, YouTuber. Two-time teacher of the year

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