Case Study: Sharing The Learning Task

( Source: Evans, 2002)

Jim McMorran is a GP based in Coventry. He qualified as a doctor in the mid-1990s from Oxford Medical School. During his time as a medical student Jim and six fellow students (one of whom was his brother) established a routine of writing up and sharing their clinical notes with each other. As Jim and his fellow students also had a strong interest in Information Technology they looked for ways in which they could apply their IT expertise and at the same time make the task of building their clinical knowledge easier.

Together Jim and his fellow students designed and developed a relationship database system. The content of this initial database was based on their lecture notes, as well as information located from references suggested during lectures. But what evolved was the beginnings of a shared knowledge resource.

As the database grew it became a sought-after reference point for other medical students. Initially, access to other medical students was provided locally through the Cairns Library in the Oxford Clinical School. Wider access was later made possible through a rudimentary version of the database, published by Butterworth-Heinemann in the mid-1990s. It was this version that was awarded the prestigious John Perry Prize, by the Primary Care Specialist Group of the British Computer Society.

Now qualified doctors, this initial rudimentary database has been further developed into a product known as GPnotebook (see www.gpnotebook.co.uk), which other professionals working within the primary healthcare profession can access via the internet. GPnotebook provides a source of concise practical clinical information, with an easy to use rapid indexing system, in the style of a pocket book. The content of GPnotebook is aimed at UK primary healthcare physicians. However, as it is also recognised as being a useful resource for other healthcare professionals, it is now included as a resource on the National Electronic Library of Health.

The database has been designed to allow rapid access to information specific to a user’s query without the user having to trawl through a vast list of references. For practitioners, GPnotebook acts as an aide-memoire to different clinical conditions, i.e. the symptoms, underlying causes and sources of treatment. In addition to providing a clinical reference, GPnotebook acts as a useful tool for clinical governance and continuing professional development.

Maintaining the GPnotebook system enables Jim and his former fellow students (who now work either as GPs, specialist registrars, or in clinical research) to work in a collaborative way to keep their professional knowledge up-to-date. Each member of the team takes responsibility for reading and summarising a set number of medical journals each month. These summaries are then added into the GPnotebook system and cross-referenced with existing information.

What this group of clinicians have demonstrated is how partnership/collaborative working has enhanced their own professional development, as well as making their jobs much easier as they now have easier and faster access to the most up-to-date clinical information when treating patients.

While the benefits of this collaborative approach to knowledgebuilding are clear, it does have its downside. Each member of the group invests a considerable amount of their own time on this activity. Collectively they spend around 40 hours a week, either in the evenings or at weekends, reading journals, summarising and updating the database; a time commitment which has had to be negotiated with their families.

Trust has been paramount to the continuing success of this knowledge-building activity. Reading and summarising professional articles is a skill in its own right, a skill that each of the group members has had to develop. However as Jim and his colleagues have known each other for several years now they have learnt to respect each other’s professional judgement. Now that the system is becoming more widely utilised the information published in GPnotebook is peer-reviewed and cross-referenced (thus making it evidence-based). These changes were felt important to ensure the credibility of the information source.

Reflecting on their experience of developing GPnotebook Jim and his fellow clinicians feel that keeping the GPnotebook system up-to-date has become a backdrop to their lives. The personal learning has been enormous ‘ We have all learnt a lot about medicine, but more than that we have learnt to work as a team. We have had fascinating insights into the world of online commerce and the business of publishing. But without doubt the most satisfying part of the work is that we can now share the fruits of our labour with thousands of people around the world.’

Suspend Judgement On Ideas Until Tried And Tested

One of the things that can put individuals off sharing their ideas with others is the put-downs that they can get from others, particularly from people who have been with the organisation longer than they have. What needs to be addressed is the ‘not invented here’ mantra. The Chaparral Steel Company has gone one further than this. They have introduced an operational slogan of ‘not re-invented here’, acknowledging that creativity is a process of synthesis – the building on of ideas (Leonard-Barton).

An important message for both individuals and organisations is to accept that knowledge reuse is just as important as knowledge creation. We cannot all be great inventors or pioneers, however, we are all capable of learning from the practice of others. Eric Abrahamson (2001), a leading change management guru, argues that organisations that are experiencing continuous change need to adopt the behaviour of rewarding ‘shameless borrowing’.

The Spanish have a phrase which is relevant to the knowledge era and that is ‘Well stolen is half done’. Equally we need to follow a rule of thumb of ‘Pinch with pride, but give credit where credit is due’, otherwise you may find that you become excluded from knowledge circles.

Blow Your Own Trumpet Once In A While

This is something that in this country we are not always that good at. While conducting this research there have been several people who have told me that they feel uncomfortable using the term ‘best practice’, as it implies that they are experts in a particular practice. However, it is important that individuals shout about what they know, or have learnt, and what they are interested in learning more about.

Many organisations now have systems available where individuals can post their successes (e.g. skills databases, internal newsletters, personal web pages). If your organisation has a ‘Yellow Pages’ database make sure that your details are kept uptodate. Get in the habit of reviewing your achievements and development goals after each project and/or assignment and updating your details. If there is an opportunity to have a home page on your organisation’s intranet then take it. Often this can create the space to say more about yourself than the information held within a ‘Yellow Pages’ system.

Develop Your Knowledge-Building Capabilities

Participating in a knowledge-community requires some key competencies to be developed. These include research/ investigative skills, questioning skills, listening skills, experimental or ‘what if?’ type thinking, observation and critical reflection, as well as networking.

Communications Theory suggests that a network’s potential benefits grow exponentially as the number of nodes (i.e. contacts) build and expand.

But as Wayne Baker points out we need to be trustworthy in our knowledge-building interactions ‘Repeated interaction encourages cooperation. If you sponge information and never give, your sources will dry up. But give and you shall receive. This does not mean that you should become an inveterate gossip. Be a tactful, judicious supplier of information and a trustworthy, responsible user of information’ (Baker, 1996:213).

The ability to build social connections is also important for successful career management within the knowledge economy. The more people we connect with the more opportunities we are likely to uncover. In addition it can help to expand our sphere of influence.

Building and keeping knowledge up-to-date, as we saw earlier in the GPnotebook case study, is something that all individuals need to plan into their daily life routines.

Help Colleagues To Develop Their ‘Know How’

Several organisations are beginning to specify the knowledgecreating behaviours that they want to see present in day-to-day practice. The KPMG case study in Chapter 6 shows how the organisation is building a coaching culture, based on an assumption that all employees are expected to apply and share their knowledge. Knowledge-building behaviours, linked to the firm’s values, form part of the firm’s assessment practices.

In DERA, the level of contribution that an individual makes, i.e. by sharing their ‘know how’ with others, is reflected in the organisation’s performance management system (Evans, 2000).