Atul Gawande On Performance And Coaching

by Thomas Brett

In his recent New Yorker article “Personal Best” (October 3 2011), physician and writer Atul Gawande explores the question of whether or not professionals–such as say, doctors or teachers–might benefit from having personal coaches watch them as they work and then provide performance critiques.  For most of us, once we finish school and get out into the working world, our days of having teachers are over.  And once we’re working, some of us (most of us?) are never again closely observed in the workplace.  In those professions where a reliably high level of performance is paramount–like professional sports or acting–getting regular guidance is key.  If, then, professional athletes and actors have coaches, what about the rest of us?  Without coaching, how will we know we’re really performing to the best of our ability?

Gawande is a surgeon in Boston and the author of the books Complications (2002), Better (2007), and The Checklist Manifesto (2009).  One of the things that makes his writing compelling is how it examines the mechanics of performance–specifically how we do things in the heat of action as well as the decision-making processes that guide us.  In Gawande’s medical world, even microscopic improvements in technique or decision-making can save lives.

Gawande describes how he had hit a plateau after eight years of working as a surgeon and so decides to ask one of his former surgery teachers (now retired and writing books on navel mapmaking!) to observe him in surgery–in other words, to coach him.  The teacher agrees and watches one of Gawande’s routine procedures while taking copious notes.  Afterwards, the two doctors chat about what was done and what was observed.  Interestingly, Gawande’s coach observed, among other things, some small details having to do with the author’s body positioning at the operating table.  Long story short, Gawande feels that he learned more from a single observing-coaching-feedback session than he had in years of working on his own.

In the course of the article, Gawande also accompanies some academic coaches who visit a middle school math teacher in Virginia who wishes to improve her already impressive teaching acumen.  And Gawande talks with some famous musicians too, like violinist Itzhak Perlman and vocalist Renée Fleming, both of whom still use coaches to help refine their work.  For many years, Fleming has taken weekly lessons anytime she has an important upcoming performance, and for Perlman, it’s his wife (also a violinist) who provides him with another set of ears and tells him what his playing sounds like.

From Gawande’s article we get a sense of coaching as an advanced kind of teaching that works by tweaking a new self-awareness in us, the observed.  Coaches see and hear things that we can’t because we’re either too busy caught up in the flow of our performance or else we’re too numbed by the repetition of something we’ve done a million times before.  Coaching, says Gawande, can lead us to make discoveries about how we do what we do, make productive changes based on these discoveries, and thus become better at our profession.