Name: 為什麼技能瓶頸無法避免？以及如何突破它們 | Atul Gawande 帶你飛越極限！ (Why skill plateaus are inevitable – and how to push past them | Atul Gawande for Big Think+)
Uploaded: 2025-11-12T18:09:29.000Z
Duration: 8 min 19 s

I am a surgeon, a public health leader and researcher, and a writer.

我是一位外科醫生、公共衛生領導者、研究員，也是一位作家。

I'm the author of four New York Times bestsellers, Complications, Better, the Checklist Manifesto and Being Mortal.

我寫了四本紐約時報暢銷書：Complications、Better、Checklist Manifesto 和 Being Mortal。

One of the things that's interesting to me is how different professions approach people, improving their skills over time.

有一件事讓我覺得很有趣，那就是不同的職業是如何對待人們，以及如何隨著時間提升他們的技能。

The common approach in a field like medicine is what I call the pedagogical approach.

在醫學領域常見的方法，我稱之為教學式方法。

You're going to get your 10,000 hours of practice in internship and residency, in some apprenticeship or training in one way or the other, and

你會在實習、住院醫師訓練，或是某種學徒制或培訓中，累積你那一萬小時的練習，

then you're going to be set loose on the world.

然後你就會被放出去闖蕩世界。

And part of being a professional is the expectation that you will improve yourself, that you own responsibility now for the fact that the technology will change, the skills will change, and

而身為一個專業人士的一部分，就是期望你會自我提升，你現在要為技術會改變、技能會改變的事實負責，

you will go about the task of getting to better performance yourself.

然後你會自己去努力達成更好的表現。

And then there are fields that take an entirely different view of this.

而有些領域對這件事的看法就完全不同了。

And Roger Federer, number one player in the world, had a coach.

而世界排名第一的 Roger Federer，他是有教練的。

hardly the only one where the very top people in the profession at every step of the way, not only did they have someone they hired and paid for to give them advice, but

這絕不是唯一的例子，在每個階段，這個職業裡最頂尖的人，他們不只找了付錢請來給建議的人，

they would observe them, pull apart where they've fallen short, and

還會觀察他們，剖析他們哪裡做得不好，

help them get to improvement on the assumption that you cannot improve yourself.

並在假設你無法自我提升的前提下，幫助他們做得更好。

I had been assiduously tracking my surgical complications and other measures of how I was doing as a surgeon.

我一直勤奮地追蹤我的手術併發症以及其他衡量我身為外科醫生表現的指標。

And I'd seen year on year, steady improvements.

而且我年復一年地看到穩定的進步。

And at about 10 to 12 years into practice, I found that I'd flattened out.

大約執業了十到十二年後，我發現我的表現停滯了。

I'd reached a mid career point where I wasn't getting that much better.

我進入了職業生涯中期，進步空間不大。

It struck me that I might consider getting a coach.

我想到或許可以考慮找個教練。

Here I was, midlife in my tennis game as well.

我當時的網球生涯也處於中年。

And I thought nothing of paying some college kid coming off of a tennis team 200 bucks an hour.

我覺得付給剛從網球隊退役的大學生每小時兩百塊美元，這沒什麼大不了。

But still, it was expensive to pick up my game, and

但還是很貴，要提升我的球技，

they regularly found ways that I could do better.

他們經常找到方法讓我做得更好。

And I thought, why don't we do this in medicine?

我心想，為什麼我們不在醫界也這樣做呢？

There are lots of other fields where it's the case.

I happened to have a chance to interview Itzhak Perlman, the greatest violinist of his generation.

我剛好有機會採訪了伊扎克·帕爾曼，他那一代最偉大的小提琴家。

And I asked him, why don't violinists have coaches?

我問他，為什麼小提琴家沒有教練？

And he said, I don't know, but I always had one.

他說，我不知道，但我一直都有一個。

Yes, he had married a professional violinist who'd graduated from Juilliard, where they were in school together.

是的，他娶了一位茱莉亞音樂學院畢業的職業小提琴家，他們當時是同學。

she gave up her career in being a violinist to sit in the audience and give him feedback after every performance.

她放棄了她身為小提琴家的職業，坐在觀眾席上，在每次表演後給他回饋。

And that was, he said, critical to how he became the violinist that he is.

他說，這對他成為現在的小提琴家至關重要。

That ability to have someone providing an external set of data on your reality is such an important part of changing your mindset.

他說，能夠有人提供關於你真實情況的外部數據，是改變心態非常重要的一部分。

I asked one of my former professors to come to the operating room and observe me.

我請我的一位前教授到手術室觀察我。

It was doing one of the operations that I had done a couple thousand of these thyroid cancer procedures in the past.

當時我正在進行一項手術，這是我過去做的數千例甲狀腺癌手術之一。

I was kind of feeling pretty high on myself.

He'd been sitting in the corner taking some notes when the surgeon, the patient had been woken up and left the room.

這位教授一直坐在角落做筆記，直到外科醫生、病人都醒來並離開房間。

He had 20 minutes of things to tell me about.

Did you notice that the light that was shining in the patient's wound had drifted off course and you were only getting indirect light?

你有注意到照進病人傷口的燈光偏離了方向，你只得到間接光嗎？

Did you notice that the anesthesiologist was struggling with the blood pressure for about 10 minutes during the operation and wasn't telling you about that?

你有注意到麻醉師在手術中花了大概 10 分鐘處理血壓問題，但沒有告訴你嗎？

I notice your elbow goes up in the air, and

if you move your feet a little to the left, that allow you to keep it down at your side so you're always in full control.

然後你稍微往左邊移動你的腳，這樣你就可以讓它保持在身體側邊，讓你隨時都能完全掌控。

And I was able to improve the outcome based on ongoing feedback.

而且我能夠根據持續的回饋來改善結果。

I had them come in once a month, and we produced lower complication rates, better outcomes, and

我讓他們每個月來一次，我們達到了更低的併發症率、更好的結果，而且

我又重新學習了，這是我非常喜歡的。

And then we could set new goals, like, how could I be a better teacher and coach to my students?

然後我們就可以設定新的目標，像是，我該如何成為一個更好的老師和教練給我的學生？

像是，我內心那個愛微觀管理的自己。

If there was bleeding and they did not control the bleeding immediately, I would reach in and do it for myself.

如果有出血而且他們沒有馬上止血，我就會伸手自己來。

And I needed to let them struggle a little bit.

而且我需要讓他們稍微掙扎一下。

And so he taught me to count to 30 in your head before you intervene.

所以他教我，在介入之前，先在心裡數到30。

我覺得我從來沒有真正數到30過。

But getting to the point that I would let them struggle and learn along the way was part of also improving how I was as a professor of surgery.

但能夠讓他們掙扎並在過程中學習，這也是提升我作為外科教授的教學方式的一部分。

The purpose of a coach is to not be the one to set the goals for a surgeon, but

教練的目的不是為外科醫生設定目標，而是

instead to say, here are the kinds of goals we can work our way through.

而是說，我們可以一起努力達成哪些目標。

What would you like to accomplish over the next three months that gives you a shared basis for saying, we now agree on what I'M going to observe and help you with I have an executive coach as well you know he's asked me to record my meetings so that he can and get permission for him to listen to a recording of the meetings so that he could give me feedback.

在接下來的三個月裡，你希望達成什麼目標，這樣我們就有共同的基礎來說明，我們現在同意我要觀察並協助你什麼？我也有一個高階教練，你知道他要求我錄下我的會議，這樣他就可以，並取得他的許可，讓他聽錄音的會議，以便他給我回饋。

Did you know you spent more than 70% of the time doing the talking in this meeting?

你知道你在這次會議中超過 70% 的時間都在說話嗎？

So what's your goal on how much talking you want to be doing next time?

那麼你下次目標想說話的比例是多少？

Can you start the meeting with questions instead of statements?

你能不能用提問開始會議，而不是陳述？

Can you make sure you set clear action steps at the end of your meeting and that's the difference between a teacher and a coach.

你能不能確保在會議結束時設定清楚的行動步驟，這就是老師和教練的差別。

A teacher is going to make deposits of knowledge or skill but not necessarily see your performance in an ongoing way over time Circling back and helping you walk through the process of change and improvement is the role of the coach to watch the full class become a member@bigthink.com membership.

老師會傳授知識或技能，但不一定會持續關注你的表現，而教練的角色則是回頭協助你走過改變和進步的過程，讓整個班級都成為會員。