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I recently picked up a copy of Atul Gawande’s The Checklist Manifesto: How to Get Things Right after New York University’s Kristen Smith recommended it in The Chronicle of Higher Education. I’ve been thinking about it ever since.
Although the book doesn’t dig into education, it is remarkably relevant to the dynamics that govern higher education, particularly around quality-assurance efforts related to online teaching and program development.
Gawande uses stories from high-pressure fields, including his own experience as a surgeon, to focus attention on what he characterizes as a pressing human dilemma: ineptitude. It’s not that humans don’t know things, Gawande argues; it’s that we know too much. So much, in fact, that many of us now work in environments that have become unmanageably complex. Overwhelmed by this complexity, we are more likely to make what tennis aficionados call unforced errors -- simple mistakes of carelessness or oversight.
Gawande has two solutions to the problem of ineptitude. One is, of course, the checklist. Throughout the book, he details the transformative effects of checklists in fields as varied as intensive care and structural engineering. Most of his discussion focuses on a safe surgery checklist that he and his team developed in partnership with the World Health Organization -- a checklist designed to minimize the incidence of surgical mistakes and complications. Clinical trials proved the safe surgery checklist to be astoundingly effective. Hospitals that adopted the checklist experienced huge declines in major complications, surgery deaths and infection rates.
Almost from the first page, I could see the book’s relevance to the development and delivery of online courses, programs and support services. Serving fully online students well requires an incredible amount of work both inside and beyond the classroom. Putting up online programs involves working across academic and operational domains and juggling the different rhythms and structures that govern them.
Teaching online requires faculty members to flex different pedagogical muscles and navigate a landscape crowded with technology options. As any person who has done this work knows, getting to the first day of an online class is indeed a complex process.
Like the safe surgery checklist, online course and program development checklists can improve online students’ chances of success. Tools like the Quality Matters Rubric and the Online Learning Consortium's Quality Scorecards draw on a robust scholarly literature on online teaching and learning to help us manage the process of designing effective online courses and programs. But the adoption of such checklists pushes against some of higher education’s cultural norms.
Despite its proven effectiveness, Gawande’s safe surgery checklist campaign repeatedly encountered resistance, in large part because it challenged one of medicine’s core cultural beliefs: “that in situations of high risk and complexity what you want is a kind of expert audacity.” Many surgeons dismissed the checklist as interference and balked at how the checklist redistributed some authority to nurses. “This is my patient,” surgeons exclaimed. “This is my operating room. And the way I carry out an operation is my business and my responsibility.”
Like the surgeons Gawande encountered, many faculty resist the notion that they might benefit from a checklist of best practices for online design and teaching, particularly one developed and administered in tandem with nonteaching professionals. From a faculty member’s perspective, teaching involves their students and their classrooms. They voice their resistance in familiar refrains: “Teaching is a very personal endeavor,” “My students are unique,” “I have academic freedom,” et cetera, et cetera.
The student populations we serve, like the patient populations entering hospitals, are more diverse than ever and bring with them a miscellany of experience and needs. Educating and caring for them, particularly in environments mediated by technology, has made teaching significantly more complex. As they do in operating rooms, checklists can help promote quality of care for our online students and prevent simple oversights that can compound into serious problems over time.
Harried faculty members often forget to do very basic things in online courses -- things like greet their students, use their students’ names or even make themselves visible to students. Such oversights have real consequences for students and can end up sucking up faculty members’ time and negatively impacting institutional retention rates.
Gawande’s analysis reveals the lie behind the notion of expert audacity or what many call the myth of the lone genius. Working as a team is Gawande’s second solution to managing complexity. Modern surgical practice is absolutely a team effort, requiring not only rock-star surgeons, but top-flight scrub nurses, ace anesthesiologists and crack circulating nurses to all work from a shared set of expectations and standards.
Like nurses and hospital administrators, nonfaculty educational professionals play an important role in elevating the quality of care we deliver to online students. Working together to adopt or co-develop checklists, an instructional team that includes instructional designers, educational technologists, online education administrators, advisers and faculty can nail down basic things -- things we know improve online students’ chances of success.
Rather than enforcing instructional rigidity and standardization or reducing faculty to mindless automatons, checklists and a team approach can help save time and empower us to channel our cognitive energy toward those creative judgments that make student service provision, program development and online teaching so much more than a series of steps.
In the end, Gawande sought to counter cultural resistance to his checklist by asking surgical staff a simple question: If they were the patient lying on the operating table, would they want their surgical team to use the checklist protocol? The results weren’t surprising; 93 percent responded that they would.
How might we answer a similar question if we were students about to enroll in an online program?