Saturday, April 3, 2010

How to be "Better" as a professional

I have just read "Better", by Atul Gawande. In his book, Gawande describes examples of surgeon's endeavors to improve their practice. The book is highly engaging, provoking thought with real-world examples and human compassion.

I have taken a strong interest in E-Health in recent years, and I see myself over the next decade or so seeing where my work in Quality Assurance can be applied to the Healthcare sector to reduce adverse outcomes. I can see elements of Total Quality Management and Demming applied in a clinical setting. Indeed, Gawande ponders the question "is medicine a craft or an industry?". Again a question the IT profession is asking of itself over the past couple of decades.

I thoroughly recommend this book as reading to those that are aiming to improve professional practice. Even though dealing with a domain which I have had no clinical experience, only observations from one of IT enablement, I found this book inspirational.

In Gewande's afterword, he pondered on how a surgeon may make a difference. His five propositions I believe are aspirations for any professional. Here they are :

1. Ask an unscripted question
Stepping outside of the professional script, both with the patient and colleagues. Here Gewande see the value of the human relationship to build upon the professional relationship. After nearly 13 years in business I have customers that I count as close personal friends. Professional service requires trust, and through building the relationship and empathy, we become a little bit more reliant on each other to step up when needed.

2. Don't complain
Gewande points out we all have something to complain about, but doing so doesn't actually advance us, and it depresses us and the team. Look toward the positive. Look for what we can do to prevent these problems in the future.

3. Count something
In this book, Gewande gave numerous example where measurement of individual and group practice had led to revolutionary advances. Examples he cited were Battlefield Surgeons in Iraq, Agpar scoring in Obstetrics, and comparison of Cystic Fibrosis centres across the US.

This idea I reflected upon a lot while reading this book. Indeed I am keen for us to measure our practice. This insight in most cases doesn't give me the answers, it leads me to ask more questions, but in the process I think we understand more of what is going on. Indeed I often quote Lord Kelvin, "when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory kind".

Gewande discussed how the Cystic Fibrosis Foundation is publishing the performance of individual centres, and how this may appear controversial, yet at the same time essential to get us to do better and become a "positive deviant". I reflect on how this is recently undertaken here in Australia with schools via the MySchool website.

Recently we have commenced the Software Testing Industry Benchmark, which aims to measure Software Testing practice across organisations. I think this is essential so that we understand our performance in relation to others. However we need to go further in our own company, measuring projects and individuals, not as criticism or punishment, but so that we strive to improve.

4. Write something
Gewande says this is how we contribute, and become part of a larger community. I agree. I found that contribution is a duty to give back to the community, to the profession. Whether it be a blog like this, a newsletter article, a quick presentation to colleagues at lunch, or a short idea to the staff mailing list. I found in laying down those thoughts, it also helps me to better understand what I am proposing and in the process gain greater insight.

5. Change
Here Gewande points to three adopter profiles: early adopters, late adopters and skeptics. [For more discussion of adoption profiles see also "Crossing the Chasm", by Geoffrey Moore]. He says we should seek to be early adopters, be willing to recognise the inadequacies in what you do and to seek out solutions.

The above five points I think are useful concepts for us also as Software Testing professionals to take into consideration. Certainly attributes that personally I will aspire to.

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