Atul Gawande: Want to get great at something? Get a coach
葛文德: 想要精益求精?找個教練
Surgeon and public health professor by day, writer by night, Atul Gawande explores how doctors can dramatically improve their practice using approaches as simple as a checklist – or coaching. Full bio
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who has been really interested
how good you are now,
that really matters.
in the north of India.
an extreme form of this very struggle,
用一種很極端的方式使勁掙扎,
in the face of complexity --
進步的那個樣子,
has a one-in-20 death rate for the babies,
ten times higher than they do elsewhere.
in birth for decades,
that even in this place --
and put on clean gloves,
of dilute bleach,
on the gloves from the last delivery.
手套上還有之前接生的血漬。
with difficulty breathing everywhere.
不管在哪都一樣。
to stimulate them to breathe.
刺激他們呼吸,
you give them breaths with the baby mask.
就給他們戴嬰兒氧氣罩。
mostly from textbooks,
just how dire the situation is.
his temperature by the minute.
requires a successful team of people.
skilled and coordinated;
in a place like this,
for 22 critical drugs and supplies
和醫療用品的補給員,
of the whole facility.
experienced professionals.
有經驗的專業人員。
part of thousands of deliveries.
that they face,
that really matters.
get better at what they do?
you learn, you graduate,
of managing their own improvement.
all professionals have learned by.
Juilliard violin instructor Dorothy DeLay.
傳奇教師桃樂絲.狄蕾。
of violin virtuosos:
名單熠熠生輝:
habits of thinking and of learning
in the world without her
無需她隨侍在側,
comes out of sports.
about this as a surgeon.
into my operating room,
as a very American idea.
是很美式的做法。
first American-rules football games.
當時少見的橄欖球賽。
violinist of his generation.
可說是最成功的小提琴家。
getting to write for "The New Yorker"
最棒的一件事情是
and they return my phone calls.
an almost two-hour conversation
to where he got in his career.
"Why don't violinists have coaches?"
「為什麼小提琴家不請教練?」
together from Juilliard,
as a concert violinist
a little bit mechanical.
he became, he said.
in making it on your own.
會有很多問題。
that are standing in your way
know how to fix them.
that somewhere along the way,
what had happened to me as a surgeon.
所碰到的問題。
improvement in my learning curve.
from one year to the next.
any better anymore.
as good as I'm going to get?"
of mine who had retired,
他退休了,
anything much he'd have to say
dense with notes.
had swung out of the wound
from reflected surfaces."
every once in a while.
at their sides resting comfortably.
your elbow going in the air,
或是移動一下腳步。」
or just move your feet."
fundamentally profound about this.
your external eyes and ears,
picture of your reality.
build them back up again.
drop down even further.
to have to work on things.
I would get worse before I got better.
有段時間在退步。
profoundly important.
called Ariadne Labs,
in the delivery of health care,
the World Health Organization
a team needs to go through
are ready to go home.
wasn't going to change very much,
wasn't necessarily going to be enough
that you needed to bring it alive.
at a massive scale?"
in 120 birth centers.
in India's largest state.
basically we just observed,
got visits from coaches.
of doctors and nurses like this one
and also the managers
和管理階層,
build on their strengths
they had to work on with people --
必須有的一項技巧,
fundamentally important --
比如說,嬰兒氧氣罩壞掉、
when the baby mask is broken
including the managers,
ended up coaching 400 nurses
訓練了四百位護理師、
across 160,000 births.
who did not get coaching --
of 18 basic practices
over the course of the years of study,
got four months of coaching
of the practices being delivered.
across a whole range of centers
could be a whole line of way
that could reach out in the world
at the beginning of it, though,
all of the checklist together
reductions in mortality.
that were getting there,
learn to execute on the fundamentals.
to the labor and delivery room,
how quickly all of this happens
that makes things.
measured her pulse
the heart rate of the baby.
and the fetal Doppler monitor,
and the nurse knew how to use them.
which is normal.
of the contractions picked up,
that her cervix was fully dilated.
to do her next set of checks.
she worked her way through
she needed at the bedside.
the sterile towel,
one push and that baby was out.
in that room had changed.
at the community health worker
did not seem to be alive.
with her checkpoints.
when that didn't stimulate that baby,
嬰兒沒有受刺激開始呼吸,
because you could count on electricity,
她沒有電動抽吸器,
that little girl's airways.
of being able to do that
on her mother's chest,
to grab that nurse's hand,
because of coaching.
saved because of it.
a few months later.
ABOUT THE SPEAKER
Atul Gawande - Surgeon, writer, public health innovatorSurgeon and public health professor by day, writer by night, Atul Gawande explores how doctors can dramatically improve their practice using approaches as simple as a checklist – or coaching.
Why you should listen
Atul Gawande is author of several best-selling books, including Complications: A Surgeon's Notes on an Imperfect Science, Better: A Surgeon's Notes on Performance, Being Mortal: Medicine and What Matters in the End and The Checklist Manifesto.
He is also a surgeon at Brigham and Women’s Hospital in Boston, a staff writer for The New Yorker and a professor at Harvard Medical School and the Harvard School of Public Health. He has won the Lewis Thomas Prize for Writing about Science, a MacArthur Fellowship and two National Magazine Awards. In his work in public health, he is Executive Director of Ariadne Labs, a joint center for health systems innovation and chair of Lifebox, a nonprofit organization making surgery safer globally.
In June 2018, Gawande was chosen to lead the new healthcare company set up by Amazon, JPMorgan and Berkshire Hathaway.
Photo: Aubrey Calo
Atul Gawande | Speaker | TED.com