Improvement through Reflection

“There is always room at the top for the best”

I have heard this several times over my years. Most recently it was on a TEDx talk. Bill Crawford is a retired Navy Stealth bomber pilot. That is cool enough to justify listening to him talk about almost anything.

Go – watch his TEDx presentation. I will wait. Its on YouTube. Actually; I won’t wait, I’ll go grab a bourbon or a coffee, its that time of day when either of these are acceptable.

You back now? Good. Not bad, eh?

Also now that you’ve watched it you know why I am writing about his presentation on our page where we generally talk about teaching and medicine. Let me get into it.

We often say around here that hope is a terrible plan. Which is why I love that the Air force has “Plan” as the first phase of an event. Then there is “Execute” this is often where the fun stuff happens. Then the fun is over and we are relieved that it went so well, or are very glad that it is over. AND we so often do not take the time to “Debrief”

The topic I want to discuss today is the application of this model to our profession. Whether you are a medical provider, a medical teacher, or a non-medical teacher – I fully believe that this method can have a great influence on your performance.

Lets get started!


The Plan – in his presentation Bill talks about how the missions were planned and that the planning was approximately 39% of the time compared to the 58% of the time he spent Executing the mission. I like that this is well represented, but I feel like in the education world the ratio is off a bit. Generally, we say that for an hour of presentation you should anticipate spending 2-3 hours preparing. If we are applying this to medical care, then the ratio becomes more accurate. This isn’t meant to be a conversation about planning and preparing. I will leave that topic to this statement: failure to prepare is preparing to fail. More on this later.

The Execution – this is what you do. Do it and do it well. I am not prepared for the breadth of conversation that would entail if we tackled this topic at this time. What I will say is this – be good at what you do. But do not spend so much time in the execution phase that you forget to address the other phases.

The Debrief – this is where winners are made.  And I can say that because I am not one of those. I did not ever spend any time effectively debriefing formally any of the presentations I gave. Occasionally I would reflect (often in horror) on some of the presentations I gave. The closest I came to legitimate debrief of my former presentations was when I started using good audio equipment and I recorded a few hours of a day long presentation I was giving. I didn’t make it through 30 minutes of my own audio recording. I learned a lot that day. We can do better. We need to do better. Here is how.


Use a system. Keep it simple. Use it often.

When you have completed a mission/presentation/operation/call-for-service – whatever it is you do – you need to ask yourself a few questions. Write them down. If you don’t write it down – its not worth doing.

  1. Reflect on your pre-execution planning or preparing. Ask yourself: how well prepared was I?
  2. During the execution phase: what happened? Keep it simple, just the facts – you want to reconstruct the events objectively
  3. What went right? These are your wins. You need to reflect on these. We often do not spend anytime with our wins and just completely overlook them. These are the things you need to make sure you do again – so it is very important to make sure you spend some time writing down the things that went well.
  4. What went wrong? Simply list them out. Do not dwell on them.
  5. WHY did the things go wrong? This is where we do a root cause analysis of the things that we felt didn’t go well. What was it that caused us to feel like we had gaps? Were we not prepared? Did we get questions we were not ready for?
  6. Do I need to follow-up? If there were questions during the presentation you didn’t know the answer to – do you owe someone an answer? Do we need to thank someone for the opportunity to give our presentation? Do we need to thank someone for the advice or support they gave us? Do we need to apologize for/or clarify something we said that was un-clear? Is there anything left un-done regarding this presentation?


There are 6 questions – you can write them on the inside or your calendar or notebook in your own words so that you can use them to reflect on your performances. I wrote them out as if it was a presentation – but it is easy to extrapolate from there to cover the other aspects of life where this could apply.


I wanted to share the above TEDx talk and also share some of the thoughts I have related to it since I saw it. I hope this helps you all to be a better provider/presenter/whatever you are.


Be well. Stay safe


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