What they didn’t teach in medical school Part 3: Knowledge (or Information) Management

One of the things they don’t tell you at medical school is that one of your major jobs will be managing information or knowledge management. All though training the implication is that you have to know a lot of stuff to be a good doctor. Well that is true but in reality only a few of us know (or think they know) everything – I’m definitely not one of them. Teaching others now it is hard to communicate the message that you need to be exposed to everything but not know everything. This problem is compounded by the fact that we are dealing with a google-generation. Medical students google stuff on their smartphones in the middle of my tutorials – fortunately for me and unfortunately for them they still often don’t get the answers. There is an emerging myth that you don’t need to know stuff if you can look it up – this isn’t very time efficient and of course you need to know what you are looking for and be able to interpret it.

As I see it there are 4 categories of information.

(1) Stuff you need to know without looking up – or thinking fast information. Examples are doses of medications prescribed on a daily basis.
(2) Stuff you need to know about and need to be able to access easily through a personal filing system or through readily accessible websites or conventional sources. An example might be a chemotherapy protocol that you know about but don’t use everyday and you need a reference or webpage to check the details of the protocol.
(3) Stuff you think you might need to save for a rainy day. You think you might need it but probably not on a routine basis.
(4) Stuff you need to should know exists but isn’t important enough to file personally and can be obtained by searching online via literature databases such as Medline or Pubmed, or via google. An example might be information you look up only when you give a talk e.g. the latest stats on a particular problem. This category arguably includes everything else you don’t even know you need yet.

When I first started oncology training I had a filing cabinet full of photocopied journal articles filed according to topic. I also started using the reference management software Endnote. I still use this but mostly if preparing manuscripts or references for a publication.

The technology changed a lot in the last decade. For a while there were a lot of USB drives. Now favourite references can be stored in the cloud using managers such as Connotea (which is about to be phased out) and CIteuLike. One isn’t always online and so computer-based platforms such as Papers (from mekentosj.com) are useful for storing and searching pdf files (bye bye filing cabinet).

These days my favourite piece of software, Evernote, is cloud-based and syncs across multiple devices including my laptop, iPad and iPhone. The beauty of Evernote is the ability to send yourself any piece of information – not just journal articles – either by cutting and pasting, web clipping, taking photos, by emailing, scanning (I use a Canon P-150 portable scanner which scans straight into Evernote), writing using an Echo smarten, or simply by making typed notes. The notes can be organised into specific notebooks or other buckets and can be tagged using your own tags to allow complete them to be searched and sorted. Everything in my category 2 & 3 goes into Evernote.

There is other software that can be used including your email client. Some people use Dropbox but personally I find Evernote the best for merging knowledge and time management related activities – which so often overlap.

The most important thing is to have a system that works for you. Using the system will help you sort out what you need to know and what you need to know how to find.

Med School needs to teach this stuff – in fact all schools do.

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