I’m giving the Book a Week thing a go and thoroughly enjoyed my first one of the year. It was Matthew Syed’s Black Box Thinking about the theory and practice of continuous improvement and marginal gains.
The opening story is a heart-rending example that shows how little is done in medicine to systematically learn from errors — a theme Syed comes back to throughout the book. As an aside, Freakonomics Radio’s series on Bad Medicine — which I just happened to listen to the same week — makes a great companion to Black Box Thinking. If anything Stephen Dubner is a little more positive about some of the initiatives that have been put in place. Syed is in no doubt that there’s still a massive cultural problem in health systems all around the world. We still live in an era of ‘eminence’ rather than ‘evidence’ based medicine.
Syed then goes on to explore the idea of cognitive dissonance. He writes about the US justice system and how difficult prosecutors found it to admit they were wrong when DNA evidence came along and showed that they’d sent thousands of people to jail who were innocent. There’s also a section about an experiment that examined why cult members can’t admit that they’ve been duped even after the cult leader’s predictions (alien invasion, end of the world etc) doesn’t come true. There’s some evidence that people are less likely to be able to recognise that they’ve made an error if the process of being convinced was traumatic or extreme in some way. It’s how initiation ceremonies work.
Although Black Box Thinking starts with plenty of examples of how not to do it, most of the book is very positive and Syed goes on to give some company-based examples of evidence based performance improvements. I knew a bit about Dyson, Team Sky and the Mercedes F1 team but the Unilever example was new to me and pretty compelling and clear cut. I’m all in favour of using tests as often as you possibly can and regularly iterating and trying out improvements.
Overall it’s a great book — excellent story-telling and a really good explanation of up-to-date innovation theory and practice. Highly recommended.