The Checklist Manifesto - How to get things right by Atul Gawande - Book Summary

This book has a very simple message:

• The world of the professions has become increasingly complex to the point where no one professional (be they a surgeon, a pilot, an engineer, or an investment manager) can retain sufficient working knowledge to know it all. 
• Human memory is fallible. 
• People can lull themselves into skipping steps even when they remember them. 
• Checklists seem to provide protection against such failures. 

Checklists “provide a kind of cognitive net” which “catch mental flaws inherent in us all.” (p.48) 

Gawande, a general surgeon, works out this thesis with extensive illustrative anecdotes. Gawande himself played an instrumental role in the development of the World Health Organisation Safe Surgery Checklist, which has established some basic norms around the world and has reduced the incidence of infection, complications and death during surgery. 

Drawing on the construction industry, he argues that the days of the Master Builder are long gone and that today skyscrapers are built by teams of professionals who work from daily work schedules (checklists) and who solve complex, unforeseen problems by effective communication and collective decision-making that is coordinated again through checklists. One of the key lessons that comes out of this is “When resolving complex problems, power needs to be pushed out of the centre as far as possible.” (p.75)

The origins of the checklist dates to WWII and pilots coping with the increasing complexity of planes. The aviation industry has been at the forefront of the implementation of checklists to ensure that established protocols are followed and to enable flight crews to manage the full range of possible disaster scenarios. They have identified two types of Checklist (p.123): 

1. DO-CONFIRM checklists: where team members perform their tasks from memory and experience; and then PAUSE to confirm that they have done all that they are meant to have done. A complex procedure might have a number of “pause points”. 
2. READ-DO checklists: people carry out the tasks as they check them off – like a recipe. 

Checklists = Discipline 

In conclusion, “Checklists improve outcomes with no increase in skill.” (p.168)

Squaring the Circle - The Greatest Educational Challenge

"One of the greatest challenges facing leading schools in this country is how best to prepare you, young people, for what is an increasingly competitive market place for top jobs. To some extent it was ever thus, but the difference between your generation and that of those of us who are parents is that you are competing in a truly global marketplace. You are not just competing with the best in the UK – you are competing with the best in the world. There are more A* and outstanding pupils in China than there are pupils in Britain, so if you are going to be the movers and shakers of the next generation then you will need to raise your game.

It is not so much “Berko’s Got talent” or even “Britain’s Got talent” – but it’s “The World’s Got Talent”. How will you compete? And how will your education here at Berkhamsted prepare you for that world? Britain has long since abandoned any pretence of having an economy based on making things. As Richard Sykes of Imperial College, formerly Chief Executive of Glaxo-Wellcome puts it:

 'We can’t compete against the manpower of India and China: we have to use our brains.' 

"Independent Schools like Berkhamsted have a long and distinguished history in producing world-class leaders in their various fields and they have an important role to play if UK PLC is going to remain competitive on the international stage. In the global employment market, you have a number of advantages – you are native speakers of the new global language and you have relatively cheap and easy access to some of the best universities in the world, but this is not enough – you need more – you need world-class schooling.

"The problem that we face in schools is that there is a growing dislocation between the standard school curriculum and the world of work. I believe that the exam system is the greatest obstruction to preparing young people for the world of work because it is completely out of kilter with what people actually do in the workplace. At no point in any job do people ever work alone, in silence, without technology or collaboration; and no one ever writes a handwritten essay. 

"Changes in working patterns and the increasing use of technology in business combined with subtle shift in our A-level system are making this dislocation even greater. In the past somebody who had a bit of flair could write an essay and be given an ‘A’ for it even if it was not the approach the examiner expected, because they had written it in an interesting way. But in recent years exam boards have tried to automate their marking processes and that approach has been drummed out of the system because examiners do onscreen marking with a checklist of all the key words which need to be there. The consequence is that we are coming up with a generation of people who are very accurate and don't make mistakes, but who also don't take risks. 

"So, at a forward-looking school like Berkhamsted we have to try to square the circle: we need to teach young people to pass examinations so that they can get the grades to gain places at top universities to have the start that we want them all to have in life; but we also need to nurture young people who can think for themselves, who are creative, who can solve problems, who can think out of the box, who can be an effective part of a team, who have passions and interests, who make connections, who are articulate, who are good with people, who have a sense of community and of service; and who, above all, develop the values that will enable them to make a difference in the world.

"Education is about so much more than passing examinations. It is not about cribs and shortcuts. It is about broadening the mind. It is about making connections. It is about abandoning the motorway and taking the scenic route. It is about making discoveries. It is about a deeper understanding that comes from really knowing something well. It is about kicking around ideas with like-minded people. It is about taking yourself out of your comfort zone. It is about taking risks. It is about taking time. I am not arguing this out of a romantic view of how education was in the past. I believe that these things are important for individuals and for us as a nation. Britain’s traditions in the creative arts, in science and innovation have been fed by an education system has led the world. Schools like these and our top universities have led the world by teaching young people to “think”. If all that teachers do is to teach to the exam, and if all pupils do is to learn what they need to know to pass the exam, then we are failing to educate. If we fail to educate, we will lose the Nation’s greatest asset. That is how we square the circle – that is the Berkhamsted vision for Education."

Part of my address at the Berkhamsted School Speech Day on Thursday 3rd July, 2014