By: Dan Pesut and Felix Ankel (@felixankel)
You are a postgraduate dean leading multiple successful clinical education programs. The programs are attracting the best and brightest learners who are doing well on in-training examinations and standardized patient assessments. The program directors have mastered program accreditation and are winning national awards.
Outside of medicine and medical education, you are seeing signs that a revolution in the knowledge economy is occurring that suggests that the day of the human knowledge “expert” are numbered. You surmise that augmented intelligence (AI) and electronic medical record (EMR) predictive analytics will soon inform the majority of clinical decisions. You also hear that new graduates, although knowledgeable in their field, often struggle with balancing the amount of information involved in clinical decision making while effectively partnering with patients, family members, the health care team, and the community in managing the complexity of knowledge.
How do you move from information management to knowledge management and a wisdom culture? How do prepare learners and educators for the future? What type of learning must be activated? What performance focus will be most important? How will you think about this with a future thinking mind set?
Data, information, knowledge, wisdom
The traditional Data, Information, Knowledge and Wisdom pyramid (DIKW), while valuable, lacks actionable strategies to help people develop the mind set and strategies to achieve a wisdom culture. Knowledge management sage Verna Allee (1997, 2002, 2012) suggests the need to consider a couple of other dimensions to realize the journey from information to wisdom.
These levels of consideration are embedded in her Knowledge Complexity Archetype (1997) and include modes of learning, action and performance considerations, and sense of time. Knowledge without communal learning and meaning making is not that valuable. Communal learning requires attention to context, relationships and trends. From this perspective, it is possible to detect relationships between components as well as comprehending roles and relationships between and among people. Such sense and meaning making supports the development of a philosophy that brings coherence to the understanding of dynamic relationships and appreciation of the influence of non-linear processes, discernment of patterns that connect. Such a philosophy requires recognition of the embeddedness and interdependence of systems.
Tips for moving from knowledge to wisdom
Allee (1997) describes what is needed to be successful at knowledge management. First, one needs a north star. A north star represents the purpose, sense of identity, and core principles that guide an organization. Knowledge self-organizes around organizational purpose. Without a north star for knowledge, it’s impossible to focus on what is needed. Second, one needs an organizational compass, which consists of guiding principles and strategy. Successful strategies for the knowledge management require people create and expand common languages around their work. Knowledge is embodied in people. It is impossible to talk about knowledge without addressing the way people work together, learn together, and grow in knowledge individually and collectively. So, the third ingredient is the right crew. Companies that are serious about knowledge foster an environment and culture that support continuous learning. Next, maps and guides support ways to build knowledge across multiple performance levels. Maps and guides support the creation, acquisition, sharing, and renewal of knowledge. In addition, organizations need sound vessels. There must be vessels or vehicles to support knowledge exploration. They include technology support (information systems, databases, communication technologies, Web technologies, equipment (groupware, whiteboards, videoconferencing equipment, tools (job aids, knowledge maps, and computer-based performance support), physical structures (learning centers, libraries, meeting rooms, and executive strategy rooms). Finally, attention to feedback and measurement is crucial to success and continuous improvement.
Consider evaluating the following aspects of the clinical learning environment as you prepare to transition from a focus on knowledge to a focus on wisdom:
- North Star
- Organizational compass
- Maps and guides
- Sound vessels
- Feedback and measurement
- Allee, V. (1997). 12 principles of knowledge management. Training & Development, 51(11), 71-74.
- Allee, V. (2002). The future of knowledge. Routledge.
- Allee, V. (2012). The knowledge evolution. Routledge.
- Li D, Kulasegaram K, Hodges BD. Why We Needn’t Fear the Machines: Opportunities for Medicine in a Machine Learning World. Acad Med. 2019 May;94(5):623-625
- Simpson D, Marcdante K, Souza K, Anderson A, Holmboe E. Job Roles of the 2025 Medical Educator. J Grad Med Educ. 2018 Jun;10(3): 243-246