From my last post, Sharing implicit knowledge by writing, reading and reflecting, I got a comment regarding how to help turn implicit knowledge into explicit from Deirdre who works with these issues at hospitals where students learn by walking next to an experienced doctor. The following text is all taken from her blogpost:
Before the student arrives
- Pick two or three things you do very well and break these procedures/techniques down into steps that the student needs to know in order to replicate what you do.
- Create two or three illness scripts for the most common issues students will see in your clinic.
- List 5-10 attitudes that you think exemplify great physicians and think about how you are going to role model those attitudes while students are in your clinic. Pick some that relate to patients, some that relate to staff, some to other areas of you life.
While the student is in your care
- Encourage the student to ask questions about why you made the decisions you made.
- Pick one or two difficult cases a week and walk the student through how you made the diagnostic decisions; even if it seems obvious to you that A=F, it may not be as obvious to the student. Avoid asking students to read your mind.
- Share your illness scripts with students before asking them to create their own.
- Guard the appropriateness of your behaviour to patients and staff even when the day is trying.
- Talk to students about working with patients whose values, behaviours, and illnesses can create issues for the physician. Try and reflect the guidelines of the profession even if they aren’t your own (save those discussions for colleagues).
- Demonstrate and encourage Deliberate Practice by giving students multiple opportunities to apply what you are teaching them with patients.
What does this mean?
I work in a technical construction industry where we have sales/service representatives that learn by taking the first calls together with a more experienced sales/service rep. The idea is of course that the rookie should pick up on the experienced methods and therefore make money quicker than if he/she started from scratch – did it all by him/herself the first couple of months. This works already but the thing is – could it work better? Using the model shown above and changing “illness” to “machine breakdown”, “physician” to “service rep”, “clinic” to “Sales and Service Unit” etc., I believe this model would greatly increase the output of amount of implicit knowledge shared.
In most cases implicit knowledge CAN be shared but it requires a lot of reflection from both “transmitter” and “receiver” (don’t like those descriptions but I’ll go with it for now). The transmitter most reflect on what he/she has been doing wrong and, more importantly, right through the years before it can be shared. The receiver must of course reflect upon it to make it his/her own.
Also worth noting from the article is the concept of “illness scripts” or “illness patterns” used to describe common issues. That’s a great concept that formalizes explicit knowledge into a job aid or a performance support tool if kept in a easy-to-reach binder or similar.
Thank you Deidre for the tip!