If you want to succeed, double your failure rate.
Thomas Watson, Founder–IBM

John Seely Brown:New Culture of LearningJohn Seely Brown, fondly referred to as JSB and former Chief Scientist at Xerox and Director of the Palo Alto Research Center (PARC), co-authored  A New Culture of Learning: Cultivating the Imagination for a World of Constant Change. In it, JSB and Douglas Thomas discuss the need for learning in this century and beyond to be collaborative, welcoming questions, and challenging what we “know” to be answers. From the book:

…in the new culture of learning the point is to embrace what we don’t know, come up with better questions about it, and continue asking those questions in order to learn more and more, both incrementally and exponentially. The goal is for each of us to take the world in and make it part of ourselves. In doing so, it turns out, we can re-create it.

The authors also talk about the need to embrace change, “looking forward to what comes next and viewing the future as a new set of possibilities, rather than something that forces us to adjust.” We don’t have to look very far to see the world changing much more quickly around us. The technology being developed is so intuitive, kids 5- and under can easily pick up an iPad or smart phone and navigate their way through the latest version of Angry Birds. JSB and Thomas provide examples of the 70 years it took from the discovery of a color TV signal in 1929 by Bell Labs to color TVs becoming ubiquitous in American homes, versus the exponentially faster adoption of internet technology (18% of households with internet access in 1997 to 73% in 2008). The tools we use in all business sectors, especially healthcare, are now more capable of harnessing large amounts of data that can drive solutions to questions that years ago may have seemed ridiculous, too “far out”, or even crazy.

So how does this all fit in medicine and medical education? The quote that led this post–”If you want to succeed, double your failure rate,” has no place at the bedside. But now, more than ever before, healthcare has a real need to solve the problems that are burying the industry with new thinking that comes from new learning. Simulation training and redesign of curriculum are two ways to address the needs not currently being met in medical education. But it goes deeper than that–as so many have said, the culture of medicine needs to shift. Medical students and residents have not only been bullied in their training by know-it-all mentors creating a learning environment that not only kills creativity, but the spirit as well. With all the discovery yet to be made in the sciences, how could one person think they “know” all the answers–wouldn’t it be best to view what is known as a starting place, and use it as a springboard to invite other intelligent, knowledgeable people into the conversation to take that baseline knowledge further?

In my maybe not-so-humble opinion, learning should embrace the not-knowing as well as the knowing. How we accomplish that in healthcare will take a shift–not only in thinking but in long-held beliefs as well. We don’t have the luxury of waiting for those afraid of change to leave medicine, and we don’t want to continue a stilted learning process that has proven to limit options. This change needs to be embraced today, and John Seely Brown’s book is both a lifeline and a roadmap. Please take a look at his keynote at Indiana University below, or pick up the book–I barely scratched the surface of the wealth of content contained within.


  This post was first published on Educate the Young.