Checklists: Valuable for Exam Taking as in Life

In The Checklist Manifesto: How to Get Things Right, Dr. Atul Gawande demonstrates the power and importance of checklists for our increasingly complicated twenty-first century lives.  As the set of issues that professionals face become more complex and specialized, professionals routinely fail to follow protocol, not because they don’t care but because they simply cannot manage the bewildering array of responsibilities before them in a reasoned way.

Consider the routine administration of central lines into ICU patients. As critical care specialist at Johns Hopkins Dr. Peter Pronovost discovered, adhering to checklists can prevent an enormous number of central line infections, saving lives and money.  To avoid infections, doctors are supposed to (1) wash their hands with soap, (2) clean the patient’s skin with chlorhexidine antiseptic, (3) put sterile drapes over the entire patient, (4) wear a mask, hat, sterile gown, and gloves, and (5) put a sterile dressing over the insertion site once the line is in.  Although these steps seem easy enough, Dr. Pronovost discovered, in a controlled study, that in more than a third of patients, doctors skipped at least one.  After requiring doctors to follow a checklist checked by nursing staff, the ten-day line-infection rate dropped from 11 percent to zero.  Over a fifteen-month period, only two line infections occurred.  There, the checklist prevented 43 infections and eight deaths while saving two million dollars.

The Checklist Manifesto explores a variety of fields where checklists have helped professionals navigate complex times, from aviation to structural engineering.  Law, and law student life, seems no exception.  Some tests give students three or four hours to analyze a variety of fact-intensive hypothetical problems.  It’s often a lot to tackle, whacking through complicated fact patterns, identifying various legal issues, ignoring red herrings, and working through policy and theory that your professor has emphasized.   In this crazy environment, checklists can be incredibly helpful.  They can help ensure that students don’t “miss” issues/elements/policy concerns.  To be sure, checklists can’t analyze the problems for you — that skill is often what differentiates solid exams from stellar ones.  But it can help get you started in a most productive way.

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