An animation introducing knowledge work

What is knowledge work? And why is it relevant to GPs? Does it mean we are like computers, meant to remember all the knowledge we ever learned, to recall it on command? Well no, we have computers for that! Knowledge workers solve the complex problems that computers can’t. Crucially, knowledge workers not only know things about their field of expertise, but are able to apply them in a social, organisational and relational context. GPs are knowledge workers – but we call it being an Expert Generalist. We have the knowledge of medical facts and apply them to our patients’ contexts which are influenced by a range of factors, to help us make sense of their illness.

Knowledge encompasses multiple dimensions and in General Practice the knowledge work we do uses multiple sources of data to explain an illness experience. We use scientific data and guidelines, but because our patients often don’t “fit” the guidelines we have to work beyond them. When we step beyond the guidelines, we combine scientific data with a patient’s perspectives and our own professional wisdom. But what is our Professional Wisdom? The professional wisdom of GPs has been described as mindlines or guidelines in the head. These mindlines aren’t just formed by facts that we recall. They encorporate a ‘tacit dimension’-traditions, learned values and judgements… knowledge that we don’t always know that we know. Mindlines can help GPs negotiate this uncertain space.

Having a community of practice where practitioners can support and learn from each other and accumulate tacit knowledge through informal means, is integral to the development of mindlines. So GPs are processing this kind of information all the time to make complex decisions. We seek to understand a problem. We consider this problem in the context of the whole person, practice or system then we explore solutions to help us make complex decisions. This is the everyday knowledge work we do as GPs. It occurs in a constant cycle of re-evaluation, from understanding a problem, to collaboratively exploring solutions, making complex decisions, reviewing the outcome and reassessing if there are ongoing concerns…

There are four key elements of knowledge work; Innovation – the discovery of knowledge Integration- embedding new knowledge into your every day work Application- using this knowledge to make every day decisions And Learning- sharing this knowledge and inspiring others. These 4 elements of knowledge work are relevant when consulting patients. However, they can also be applied throughout our extended practice roles, in leadership, policy making, teaching, quality improvement and research. Many knowledge work tasks are part of a GPs everyday role, whilst some might be classed as extended practice roles. All these tasks can carry a hidden burden of unforeseen work. Many complex tasks can’t be performed on auto-pilot. They require us to think deliberately, using our working memories. This can be exhausting.

However, building our knowledge work skills and confidence in undertaking these complex tasks can reduce the burden of the decision making in everyday practice. This can benefit our patients, whilst also helping to retain GPs in our workforce. Developing your knowledge work skills further could help you tackle issues at a patient, practice and system level, giving you more confidence to manage problems when the guidelines, existing research or even medicine don’t provide the answers. The WISDOM course aims to deliver flexible learning to help clinicians develop their expert knowledge work skills. Become tomorrow’s doctor, today.