Escaping the Bell Curve

Happy New Year!

I hope you’re all feeling fully rested and recovered and ready for the rigours of the Spring Term. I’m getting back into the swing of things, following an unusually useful and productive training day on Monday, learning about the wonderful Firefly VLE.  No, honest, no irony intended, Firefly is really amazingly brilliant. You’ll wonder how you ever managed without.

Anyway, this week’s burble was inspired by a book that Santa left in my stocking – Better by Atul Gawande. If you’ve not read anything by this chap, you really should. He’s a North American surgeon by trade, but he is also an eloquent and profound writer on medical matters and gave a superb set of Reith lectures this year on The Future of Medicine which are well worth a listen.

In his first book, Complications, he reflects on various aspects of medicine, exploring the practical and ethical issues thrown up by specific case studies. His compassion for his patients shines through, from the man who is morbidly obese and undergoing a stomach stapling operation, to the young girl facing amputation as a result of necrotising fasciitis I recommend it to all my prospective medical students. He’s wise, philosophical, reflective and humane – and he writes brilliantly.

Better is themed around the challenge of improving performance in medicine, in his own words, how “we must advance, we must refine, we must improve.” So, for example, there’s a fascinating chapter on hand washing to reduce risk of infection in hospitals. It’s not a controversial issue -everyone knows how, when and why they should wash their hands, but hardly anybody strictly follows the protocol. Why? There’s also an extraordinary and humbling chapter on what it’s like to work on the front-line of polio eradication in India, and yet another on the doctors who agree to assist at executions in the US. He also writes on the Bell Curve, the statistical reality that most doctors are average. He writes, “What is troubling is not just being average but settling for it. Everyone knows that average-ness is, for most of us, our fate. And in certain matters – looks, money, tennis – we would do well to accept this. But in your surgeon, your police department, your local high school? (my italics). When the stakes are our lives and the lives of our children, we want no one to settle for average.”

He draws on this with his final chapter based on a lecture he gives his medical students, suggesting 5  ways in which they might make a difference, how they could become a “positive deviant”, as they strive to push their performance to the right of the Bell Curve and escape “average-ness”. I think his suggestions also have purchase for the teaching profession which, you might argue, has much in common with medicine. See what you think – some of them I find very affirming, but I’ve made at least one New Year Resolution based on the following!

Ask an unscripted question

For Gawande, this is about engaging with patients on something other than their immediate concern, and with colleagues on something other than the immediate professional need. It helps him feel less like a cog in a machine.  For teachers, it might indicate the importance of going off piste with a class, to tell them a little bit about yourself, to show that you’re interested in them, that you’re not just an automaton designed to deliver a biology specification.

Don’t complain

“To be sure, a doctor has plenty to carp about: predawn pages, pointless paperwork, computer system crashes…. Wherever doctors gather, the natural pull of conversational gravity is towards the litany of woes all around us.”

Yep, guilty as charged. Substitute “teachers” for “doctors” in that paragraph, and “Michael Gove” for “predawn pages” and I don’t think anyone who has ever worked in a school would disagree. And it’s so easy to do. He goes on…

“But resist it. It’s boring, it doesn’t solve anything, and it will get you down.”

I think he’s right – especially about the not solving anything. And about it getting you down. And it being really, really boring. So, I am resolved! I will concentrate on the aspects of the job I find enjoyable and worthwhile and I will endeavour not to complain.

Write something

“I do not mean this to be an intimidating suggestion. It makes no difference whether you write five paragraphs for a blog, a paper for a professional journal, or a poem for a reading group. Just write.”

OK, so I’m ahead of the game on this one, as are many of you. But see how Gawande articulates why writing can have such a positive impact.

“by offering your reflections to an audience, even a small one, you make yourself part of  a larger world.  Put a few thoughts on a topic in just a newsletter, and you find yourself wondering nervously: will people notice it? What will they think? Did I say something dumb? An audience is a community. The published word is a declaration of membership in that community and also of a willingness to contribute something meaningful to it.”

Yes, exactly. I now realise that that’s why I started this blog – I just hadn’t fully thought through my motivation, never mind expressed it so eloquently. I like the sense that I’m contributing ideas that may get used in other schools, in other countries, with other students. I welcome the ideas and dialogue and feedback that follow. So I just write.

Measure something.

This might be more difficult for teachers – I personally think there’s far too much measuring in teaching, especially of children, and I loathe the corporate culture of target setting and key performance indicators that has infiltrated the profession. But perhaps it depends what you measure and what you’re interested in finding out. I like to look at how many A-level students subsequently choose to study Biology/Natural Sciences at university – that’s a real indicator of how inspired they are. Or you might want to rise to Ben Goldacre’s challenge and contribute to research on a national level.


“Look for the opportunity to change. I am not saying you should embrace every new trend that comes along. But be willing to recognise the inadequacies in what you do and to seek out solutions. So find something new to try, something to change.”

I think that this is a real risk for teachers, that we deliver the same lesson year after year – by doing so, we disengage from the subject and from our students. We stop reflecting on how well it’s working, if at all, and we become stale. There are lots of good reasons for this – time is in desperately short supply, inspiration is hard to come by when you’re stressed and exhausted, and you’re in a hurry to finish the specification before the exam.

But, deep down, we know when a lesson isn’t quite right, when we’re just painting by numbers. And I think we have a responsibility to our students to continually reflect on and assess what we do. So try something new! Re-plan one old lesson a week. Trial a new investigation. Take a different approach. Flip a practical. Your students will appreciate it, even if it doesn’t quite work. And you will learn something useful and insightful about your teaching. See also

Back to more specifically Biological Burblings next week.


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