Business writers are remarkable for their neologisms- what the hell is “organic flow of information”!
Jargon aside, this blurb was interesting to start a chain of process of thoughts on better collaboration on tumour boards. We generate so many ideas during the discussion that it could be ploughed back for decision making trees. However, in the absence of proper documentation, we lose the process, and information gleaned off; especially from the unusual cases.
It’s true that knowledge passed from person to person can morph as it diffuses. However, you can protect against the most egregious or dangerous distortions in two ways. First, content must be reviewed by the experts before the undocumented know-how is considered gospel and paid forward in training or translated into wikis, repositories, or checklists or becomes the subject of any challenge or campfire. Second, because the knowledge cascade is structured, visible and transparent, it is thus more trustworthy than a more informal, unmonitored, organic flow of information. In cascades set up as part of formal knowledge transfer programs, nextperts’ responsibility for educating others can be acknowledged and assessed through progress reports to management that detail the targeted learners, the techniques used, and progress within the cascade.
As part of the medical education, these informal wikis, for example, can serve as digital repositories.
I’d illustrate this with an example- We had stumbled on a very unusual presentation on FDG-PET CT where it wasn’t possible to determine the primary. It required several rounds of back and forth discussion because everyone agreed that subjecting the patient to multiple or repeated biopsies wasn’t in their interest.
In the absence of a system to record the “raw, unprocessed” thoughts, the knowledge is irretrievably lost to the participants and trainees. Hospitals need to invest in a mechanism for digital repositories that can help to improve processes in the future. It is a human-curated effort (and not an algorithmic approach) that would enhance its value. If and when it passes through multiple peer reviews (formal and informal), it would form a permanent template for trainees to base their opinions or workaround for challenging oncological presentations by referring this repository as a template.