Surgeons, Singletons and Coaching in a PLC

In a recent New Yorker article, noted surgeon and author Atul Gawande makes an interesting observation: Professional athletes – who are already at the top of their game – almost ALWAYS hire a coach to guide their continued growth yet successful professionals in fields like medicine and education somehow believe that “being coached” is beneath them.

This dichotomy stood out starkly to Gawande after squeezing in a tennis lesson with a 20-something tennis pro who helped him to improve his already impressive serve – Gawande was once a highly ranked high school tennis star in Ohio – in just one lesson.

He writes:

“Not long afterward, I watched Rafael Nadal play a tournament match on the Tennis Channel.

The camera flashed to his coach, and the obvious struck me as interesting: even Rafael Nadal has a coach. Nearly every élite tennis player in the world does. Professional athletes use coaches to make sure they are as good as they can be.

But doctors don’t.

I’d paid to have a kid just out of college look at my serve. So why did I find it inconceivable to pay someone to come into my operating room and coach me on my surgical technique?”

(p. 2)

Determined to experiment with his theory that coaching carries potential for professionals working beyond the courts, Gawande contacted Robert Osteen – a general surgeon that Gawande had admired and trained under during his residency – and asked him if he’d be willing to serve as a surgical coach.

Osteen agreed and began observing Gawande’s practices in the operating room over the next several months.

From the first procedure – a routine thyroidectomy that Gawande had performed thousands of times – Osteen’s observations proved to be invaluable.

He picked up on seemingly minor things – the way Gawande held his elbows during the procedure, the negative impact that patient draping curtains were having on aides and assistants, the positioning of surgical lights – that Gawande could work on immediately.

As Gawande explains:

“That one twenty-minute discussion gave me more to consider and work on than I’d had in the past five years.

It had been strange and more than a little awkward having to explain to the surgical team why Osteen was spending the morning with us…

Yet the stranger thing, it occurred to me, was that no senior colleague had come to observe me in the eight years since I’d established my surgical practice.

Like most work, medical practice is largely unseen by anyone who might raise one’s sights. I’d had no outside ears and eyes.”

(p. 7)

The principals of PLCs can learn real lessons from Gawande’s coaching experience.

Here’s three:

Finding coaches for every faculty member – including singletons – is essential for continued improvement.

Perhaps the most important lesson in Gawande’s coaching experiment is that every professional – experienced teachers included – can benefit from the guidance and advice offered by talented peers who observe their practice.

That is a lesson that resonates with the principals of professional learning communities, doesn’t it? After all, we’ve embraced the notion that collective reflection around practice can change educators.

The challenge, however, is ensuring that EVERY teacher – including singletons and teachers working in small schools – has access to a capable reflection partner.

While finding logical intellectual pairings for singletons and teachers in small schools can be difficult, it’s not impossible.

New digital tools and spaces can make giving and receiving feedback around instruction possible for every teacher.  Physical boundaries are no longer an insurmountable barrier for creative schools and teachers who are willing to explore the potential in electronic teaming.


Coaches don’t automatically HAVE to have experience in the field where they are coaching in order to be valuable.

One of the most interesting twists in Gawande’s story is that he wasn’t initially sure that Osteen – a general surgeon who spent the bulk of his career removing cancerous tumors – would be able to offer any kind of meaningful support simply because he was a specialist in endocrine surgery.

What he learned, however, is that there are a TON of skills – body positioning, tool management, patient monitoring, pre-surgical planning – that transfer across surgical disciplines.

While Osteen may not be able to offer specific advice about thyroidectomies – the first surgery he observed Gawande conducting – his input on the skills that DO translate across disciplines has helped Gawande to reduce his surgical complication rates.

For those leading small schools or trying to support singleton teachers, this lesson is perhaps the most important, isn’t it?

Just like the skills that cross surgical disciplines, there are PLENTY of skills that cross educational disciplines – and interdisciplinary teams of teachers focused on these skills can result in productive learning for teachers, too.

Why can’t art teachers join together with language arts teachers to study persuasion or giving and receiving feedback?

Students in both fields must master the skills of influence and critique, right?

Why can’t social studies and language arts teachers join together to study nonfiction reading strategies?

Students in both fields must master the skills necessary to tackle challenging texts, right?

Why can’t teachers in ANY domain join together to study 21st Century skills like problem solving, information management, and collaborative dialogue?

EVERY student must master these skills if they are going to succeed in tomorrow’s workforce.

The point is a simple one: The content of our curricula isn’t the only factor that teams of teachers can study together.

Meaningful learning can occur when educators with disparate professional expertise focus on shared skills that cross disciplines.


Non-instructional staff can and should be involved in improving the performance of a PLC.

Perhaps the most troublesome part of Gawande’s coaching experience, argues medical specialist Virgina Tyack, is that he never mentions any efforts to learn from the nonsurgical personnel that are a part of every procedure.

“Gawande, like all surgeons,” she writes, “operates with other members of a surgical team, and his piece doesn’t explore the shared experience of his team members, all of whom are vitally aware of the progress of a surgery.

“I once worked in a lowly position in an operating room. I was never consulted about how any aspect of a procedure, however minor, might be improved, until the hospital was faced with a malpractice lawsuit” (Tyack, 2011).

Professional learning communities make the same mistake, don’t they?

Instead of working to incorporate the voices and experiences of non-instructional staffers – secretaries, janitors, teachers’ assistants parents, community leaders – we tend to fall into comfortable patterns where important choices are informed by teachers only.

The fact of the matter is that we inadvertently hobble ourselves when we overlook the experiences and expertise of the people in our professional learning communities that are working beyond the classroom.


In the end, Gawande’s argument that coaching matters for professionals regardless of their level of expertise is fundamentally sound.

He writes:

“Élite performers, researchers say, must engage in “deliberate practice”—sustained, mindful efforts to develop the full range of abilities that success requires.

You have to work at what you’re not good at.

In theory, people can do this themselves. But most people do not know where to start or how to proceed.

Expertise, as the formula goes, requires going from unconscious incompetence to conscious incompetence to conscious competence and finally to unconscious competence.

The coach provides the outside eyes and ears, and makes you aware of where you’re falling short.

(p. 5)

Our challenge as leaders of professional learning communities, then, is to make sure that EVERY teacher – regardless of their field or the size of our schools – have coaches to learn from.

Whether we embrace electronic tools to pair teachers of similar content areas together or choose to encourage teachers of interdisciplinary teams to focus on the kinds of broader skills that transcend content, we have to make sure that peer coaching plays a role in the professional growth of our entire faculties.

We also need to ensure that we work to maximize the contributions and to take advantage of the expertise of our non-instructional personnel. Overlooking their contributions is nothing less than shortsighted.


Related Radical Reads:

Twitter for Singletons in a PLC

Electronic Teaming for Singletons in a PLC

Organizing Learning Teams in a PLC

6 thoughts on “Surgeons, Singletons and Coaching in a PLC

  1. Tree surgeons in London

    I see coaching as an almost must if you wish to keep up with the evolution of an industry, I see to many experts in fields who refuse to retrain or even except advise from other people because they feel that they now it all, Well maybe that was true 50 years ago but now a days things move so fast you have to constantly continue in further studies.

  2. Naomi Epstein

    I also read this excellent article (b.t.w – the same author’s excellent article on process checklists is also relevant for education).
    Regarding your point that the coach doesn’t have teach the same subject matter that you do: in my experience it is incredibly hard to get teachers from different disciples to discuss teaching strategies.Interesting enough, I find that language teachers are the ones who search most for collobarition and form PLNs.
    Great post! Thank you!

  3. TeachMoore

    What a wonderful set of analogies! I’m still working to make PLC a reality in my community college setting, but this piece will help me nudge my colleagues (many of whom think such coaching and learning communities are for PK-12 only, hence “beneath” them)to see the power of such collaborations.
    I know there are some higher ed learning communities (think the preferred term is faculty learning communities). If you or anybody else knows of some please put me in touch with them.

  4. Matt Townsley

    Thanks for pushing me on the idea of peer coaching and singletons, Bill. I have to admit that for a while I was stuck in a rut when thinking about singletons and collaborative teaming at the secondary level in a small-to-medium sized school in the midwest. As much as I’ve enjoyed reading and thinking about your previous singleton suggestions (and learning from your #atplc colleagues at the PLC Institute), implementing the ideas still seems like a far off dreams at times. Sure, digital teams between schools are a great idea, but when our calendars and schedules aren’t always in sync, it can still leave teachers feeling like their time isn’t as well spent.
    Now, I have a broader lens when thinking about peer coaching. As always, thanks for your connections and candid writing.

  5. dborkovitz

    I teach math to future elementary teachers…. had a music teacher observe me once. She said a) No reason to pass out manipulatives myself, students could go get them and put them away and b) I shouldn’t let them get away w/not projecting voices better. Big payoff for one class worth of coaching years ago…
    Nice post, thanks.

Comments are closed.