It’s Time to Share Our Failures

(Illustration by iStock/Maria Vonotna)

Especially in low- and middle-income countries, there are limited resources to address a variety of public health priorities. For this reason, it’s crucial that health professionals around the world share not only their successes with but also their failures. For a variety of reasons, global health professionals are less likely to share their failures—especially with peer organizations or with donors—than their successes, but we need to get comfortable with it, if for no other reason than simply pragmatic necessity: being honest and open with failures can help us pivot more quickly when things aren’t working and potentially avoid larger (and costlier!) failures down the road.

Sharing our failures and mistakes in global health and learning from them can enhance problem-solving, encourage innovation by fostering a culture that supports taking calculated risks, and improve quality by analyzing workflows and identifying areas where errors occur. Indeed, a study exploring the dynamics of failure in three very different areas—science, entrepreneurship, and terrorism—found that the individuals who failed in these areas and then went on to eventually succeed were precisely those who could identify what worked and what didn’t and adjust for what didn’t work well in subsequent attempts. That kind of learning can only happen through open and honest reflection.

Failure-sharing session held at the International Conference on Family Planning (ICFP) in Bangkok, Thailand, in November 2022.

For example, a donor at a recent “learning-through-failure” event told the story of one of her earliest investments in the digital health space: using a digital platform seemed like the most cost-efficient and sustainable approach to gather data from young people on the quality of services they were receiving, but audio surveys, interactive-voice response, and text messaging all failed (for a variety of reasons, from privacy concerns and lack of trust to low health literacy and language barriers). Through a series of honest conversations about these failures throughout implementation, the donor and implementing partner ultimately decided to abandon the digital platform and use a more traditional paper-and-pen option to complete the study.

What is failure?

Since 2022, we’ve been hosting cross-organizational events under the USAID-funded Knowledge SUCCESS project, to encourage global health professionals in sub-Saharan Africa, Asia, and the U.S. to share their failures with each other. When we first started this work, we thought a lot about what we meant by failure. We knew for sure we didn’t want people to just share stories of “humble bragging”—stories that were couched as failures while the actual intention was to draw attention to something the storyteller was proud of. We also didn’t want to host a traditional “fail fest,” which typically operates like a comedy show with the best storytellers presenting failures with funny twists. We wanted to get more people talking about failures—not just the funny storytellers—and help facilitate a dialogue with their colleagues, so that both the person sharing the failure and the people hearing about the failure can learn from the experience.

After consulting with an expert from the NGO Fail Forward who advised that it’s more important to get people talking about whatever failure they are comfortable sharing than being particular about specific types of failure, we decided to take a broad approach to our definition. We define failures in global health as: any situation where the results do not meet expectations. This very broad definition therefore encompasses a range of failures, anything from incorrectly executed tasks to undesired performance outcomes and from “unavoidable” to “intelligent” failures. We believe we can learn from any failure and that what’s important is to share what works and what doesn’t work in global health so that what was once unpredictable can become predictable and, therefore, avoidable in the future.

Are global health professionals sharing their failures?

In a survey we conducted to better understand the dynamics of sharing failure in the global health community, we found that global health professionals do recognize (at least in theory) the importance of sharing failures with each other: Of the 302 program managers, technical advisors, researchers, and other global health professionals around the world who responded, 96 percent said they think it’s important for global health professionals to share their failures with each other. Respondents explained, “There are many missed opportunities for learning if we only share what works and do not share the full spectrum of program experiences and learning.” Some respondents thought we could learn more from failures than successes, with one respondent explaining, “even with successes, there were probably some failures along the way that helped the eventual success.” They also thought it was important to share failures to set appropriate expectations that failure is a part of life. One respondent explained that “the facade we see is always only the success, the good part, and this is not helping those of us that are coming up and struggling in some aspect. When we hear that those we are looking up to had some time in the past made mistakes or failed, it boast [provides a boost to] us that we will do better with experience and time.”

However, when we asked respondents if they had shared a failure in the past six months with different categories of people—a colleague within their organization, a colleague from a different organization, and their donor—we found a progressively diminishing percentage of respondents who said they had, from 72 percent to 41 percent to 23 percent, respectively. These results track with other research showing that people systematically undershare failures.

What prevents health workforce members from sharing their failures?

In our survey of global health professionals, among those who said they did not share a failure in the past six months, many said they “did not experience a failure” during this time period, which may point to a lack of recognition of failure and valuable information contained therein. Some said they “didn’t have an opportunity to share the failure” while others said there was a “lack of trust or not wanting people to think less of them.” Other reasons, although less commonly reported, included “not thinking the failure had lessons” that others could learn from and “not having time” to share the failure.

In a donor-driven context, many people reported that sharing failures with donors may lead to a risk of losing resources. To overcome this, people may use different terminology when sharing with a donor. As one respondent said: “These failures have been shared as challenges faced during implementation and not necessarily as professional failures. The word failures carries too heavy penalties, but addressing them as challenges is much more acceptable.”

Our survey findings align with results of psychological research that point to three main factors that may prevent people from sharing their failures: at an individual and interpersonal level, people may have emotional and cognitive barriers to sharing failures, while, in a broader contextual frame, organizational or environmental barriers may prevent sharing of failures.

Failures may lead to negative emotions such as sadness or guilt. In an attempt to cope with, or minimize these emotions and feel good about themselves, people may use avoidant strategies such as refusing to think about the failure or paying attention to them. This is similar to the “ostrich” effect shown by investors who “bury their head in the sand” and check their portfolio less frequently when markets are flat or falling. People may also have self-esteem concerns about sharing failures as this is negative information about the self. A way to overcome these concerns may be to frame failures differently. In previous behavioral research that we conducted, we found that using gain framing, or words that convey failure as an opportunity for growth, such as “learning from failures,” has the potential to motivate people to share their failures.

People may also not share failures because of cognitive barriers. They may not believe that failures contain any valuable information. Learning from failures is not as direct as learning from success, where one merely has to replicate the process. Learning from failure means attending to the information, understanding the connection between the failure and a successful response, and knowing how to share the failure to promote learning.

Furthermore, sharing of failures may be inhibited by organizational design characteristics. Organizations may not give enough time or autonomy to workers to reflect on failures. Organizational culture may not prioritize psychological safety, the perception that it is safe to take interpersonal and professional risks in the workplace. Failures of knowledge can be hard to recognize if the team is not diverse enough or members do not have an opportunity to rotate outside teams and be exposed to new information that can help them analyze failures. However, organizational structures can promote sharing of failures as well. One respondent to our survey offered, for example, that “We often work in consortiums and partnerships, so our failures can be shared.”

How can we improve?

Between 2022 and 2023, we hosted a series of four virtual events focused on improving through failure in collaboration with other partners, and we plan to continue hosting additional events over time. When designing the events, we built in elements to address the three key types of barriers discussed above: emotional, cognitive, and organizational.

To address negative emotions associated with failures and self-esteem concerns, we aimed to reframe failures as an opportunity to learn from others, which is reinforced in the title of our sessions, called “Learning from Failures.” To address cognitive barriers, we aimed to reduce the effort to share failures. Participants were encouraged to share any kind of professional failure—we left the definition very broad. We tried to reduce the cognitive effort in storytelling by asking them to tell their story in two minutes and focus on facts, not on crafting the best or funniest story. We provided participants with a ready-made set of “curious questions”—carefully crafted questions that promote learning, like “What makes this experience important to share?” and “How has your understanding of the situation changed since it happened?” Curious questions are an approach created by Fail Forward to help both the listener and the person sharing their failure avoid blaming and instead better understand the failure, learn from it, and incorporate that learning into future work. Finally, to increase fluency with this format, we had individuals model telling the story and responding with curious questions at the onset of the event before having participants break out in their own groups and share.

To address organizational barriers, we also designed the events to foster psychological safety and a supportive environment. Participants shared their failure stories not in a large public group but in much smaller groups of 3-5 people. There was a general level of trust and camaraderie because participants all worked in the same area of global health—family planning and reproductive health (FP/RH) programs. At the same time, the groups were set up in a way that individual participants most likely did not know each other, so some level of anonymity was preserved. We were clear that there was to be no recording of discussions or documenting and distributing specific stories shared. Participants also knew that it was Knowledge SUCCESS, a knowledge management program for FP/RH, that was organizing the program, and not donors, so it was a neutral host. Furthermore, we provide participants an after-action review template to more regularly discuss with their teams what works and what doesn’t work. In addition to these virtual events, we also hosted a physical event at the 2022 International Conference on Family Planning, where four senior professionals representing donor agencies, the World Health Organization, and an NGO shared their professional failure experiences. The speakers, intentionally selected because they are prominent professionals in their field, served as an example to endorse and encourage the behavior.

Knowledge SUCCESS’s “Learning From Failure” sessions addressed barriers to sharing in the following ways:

1. Minimize stigma: Sessions are as much about learning from others’ failures as they are about participants sharing their own failures.
2. Reduce effort to share and learn from failures: Participants focus on a short (two-minute) story and don’t need to worry about crafting the funniest or best story, use “curious questions” to facilitate learning and asking questions, and view demonstrations of the storytelling and curious questions approach to increase fluency.
3. Promote cultures of psychological safety and learning: Participants share failures in small groups rather than a large general group. Discussions are not recorded and the specific failures shared are not documented or distributed more widely. Participants work on similar global health programs and so share some camaraderie but typically come from different organizations and countries, creating a certain level of distance or even anonymity.

Many of the failure stories shared by the participants across the four sessions had common themes, including involving stakeholders in the right level of depth, being aware of what other partners are doing before starting a project, and understanding specific contextual issues that the intended audience may face. (In keeping with the ground rules agreed on in each session, we cannot share any of the specific failure stories.)

The sessions were generally well-received by participants who shared their appreciation for this type of event, the safety that it provided, and the camaraderie in knowing that other individuals and programs had experienced failures and challenges. In a post-session survey from one of the events, 86 percent of respondents agreed or strongly agreed that the session motivated them to be more open to sharing their failures with colleagues and that it had given them a useful approach to sharing their failures. They thought that sharing in small groups was the most useful aspect, followed by the curious questions. One participant noted that it was like a support group that they didn’t know they needed, and another said that it made them feel better knowing that other programs have had challenges and failures as well. The large majority of the participants said the session made them feel “reflective”. However, a significant portion (21 percent) said they felt “embarrassed” which suggests we still have some work to do before failures can be shared openly. One participant shared that they had mixed feelings: while it felt like a support group because they could relate to each other’s experiences, it was also painful to remember the experience. Overall, 77 percent of respondents said they had learned from the failures that had been shared during the session, with many indicating appreciation for both the reflection and learning afforded to the storyteller from the curious questions as well as the learning that came from hearing others tell their stories.

What are some steps we can take now?

We propose five recommendations for projects, organizations, and the global health field more broadly to mitigate the emotional, cognitive, and organizational barriers that stand in the way of sharing and learning from failures:

1. Increase the number of forums for sharing: Our experience and our survey of global health professionals show that there is a clear need to provide a psychologically safe forum to encourage failure sharing. Increasing opportunities to practice the behavior would also make it easier over time for people to share their failures as they learn how to do so in safe forums that are specifically designed for failure-sharing.
   
2. Pay attention to the framing: As much as global health professionals recognize the importance of sharing failures, it’s still hard for people to deal with failure: they may feel embarrassed or find it a painful experience, as our respondents played back to us. While some may argue that we need to be direct and call a failure a failure, we think it’s more important to get people to share their experiences. Gain framing, coupling failure with learning, and framing failure sessions as “advice sessions,” as well as reminding people of their expertise in the field, may be helpful approaches in getting people to “let go of their ego” and be comfortable to share failures.
3. Experiment with different groupings: From our experience, it was clear that participants had different ideas of what was high risk or not and what they considered “private” or “public.” Experimenting with different kinds of audience groupings (such as mid- vs. early career) would be useful to see if that encourages psychological safety. Another grouping could be around shared project goals—there was high engagement in our session when people were part of the same project. But even professionals working on the same project may see themselves as competing for donor resources if they are affiliated with different organizations. Further, such groupings may reduce heterogeneity and an outsider perspective, which could be valuable to recognizing and learning from failures.
4. Make it easy for people to share: Encouraging participants to reflect on past experiences pre-session may be useful to help them come prepared to share a failure. Organizers can experiment with simple templates to share failure stories or encourage people to share their stories in whatever way they’re comfortable with. Keeping stories short in our case was important to encourage participants, even those who did not feel like they could tell good stories or who were fluent in the language, to engage in the activity. Experimenting with anonymity may encourage sharing, particularly among early-career individuals or those who feel their job security is at risk.
5. Get in the habit of sharing what works and what doesn’t. We work in complex environments, which means we probably don’t find ourselves in a zero-sum game very often. Instead, we likely experience both successes and failures within our projects and initiatives. Incorporating opportunities for continuous learning and reflection throughout implementation can help teams learn from both successes and failures and improve performance accordingly. After-action and mid-mortem reviews—with focus on learning, not blaming—are simple yet powerful tools that help support a continuous learning culture, improve communication and feedback within teams, and foster skills and trust needed to discuss both the positive and negative.

Global health faces big challenges, like climate change, mental health crises, and emerging infectious diseases. Solving these problems requires coordination, collaboration, and innovation—and honest conversations. We can’t afford to only share success stories and hide our failures. While sharing failures may be a new behavior for many global health professionals, it’s critical that we encourage it by providing a range of forums—within and across projects and organizations, countries and regions—that foster trust and learning in order to advance our approaches and improve and save people’s lives.

Read more stories by Ruwaida Salem, Neela A. Saldanha, Anne Ballard Sara, Elizabeth Tully & Tara M. Sullivan.