Memory: The Enemy of Learning

forgetfulI have written about the memory-based model before but I had several coincidental experiences last week that warranted I readdress this and package it slightly differently as my own thinking evolves on this matter.

In healthcare, there has been a powerful movement to get away from “Memory-Based Care” to what some call “Knowledge-Driven Care.” What does this mean? In memory-based care the caregiver decides the course of treatment on the spot, at the examination or during the consult, based solely on their training and effective memory. This has been the modus operandi for clinicians throughout the world for centuries. There is a problem though. 

A study published over 10 years ago in the Institute of Management showed that there are over 100,000 deaths in the US (conservatively) that occur due to medical errors. These errors are not committed by bad clinicians — these errors are committed because at the time that the treatment was prescribed in the examination room, there was not enough data to alert the clinician of any issues.

For example, the doctor knows that given a certain set of symptoms, the appropriate prescription is 20mg of Drug X.  The doctor prescribes it, unaware of perhaps other drugs the patient may be taking that might produce adverse reactions. The doctor — at that moment — may also be unaware that there was a recent study showing that the dosage of that drug to a profile of this patient had certain side effects previously unknown. Clearly there is a lot of information and data points that a clinician has to store, recollect, and retrieve from memory all at the right time and all in a matter of seconds. As a consequence, this approach contributes to the #3 cause of death in the US.

The fact is that with as much data as we have flying at us in this new millenium (emails, calls, apts, text messaging, etc.), our memory is simply not the best place to store and retrieve valuable information, especially in healthcare where the consequences can be fatal. The shift to “knowledge-driven care” provides best practices, patient profiles, etc. to clinicians at the point of care so that the unintentional poor decisions are minimized or eliminated entirely. In other words, complementing the memory with knowledge at the point of care is the secret recipe.

Now, how is this relevant to those of us not in healthcare but in management or leadership roles? Though the consequences of our bad decisions are not fatal, dramatic, or immediate, we too are relying on our past memories and experiences to make daily decisions. In the workplace, we often make decisions where consequences show up way down the line, sometimes in someone else’s business processes and departments, and when the poor decisions are ratted out, we often raise our hands and say “Well, I did not have all the right data.”

Working professionals, especially managers and leaders need to also avoid relying solely on memory. Instead, we should be complementing our memories with knowledge at the time when decisions are being made. With easy access to technology, this has never been more doable and relatively easy to systemize across organizations. Organizations that provide this knowledge at the point-of-need for their managers and leaders will clearly avoid more mistakes than those that don’t.  And for those of us in the consulting, training & development, coaching world think about this; if what we teach our clients is predicated on them remembering what we teach them, then we are falling far short of empowering our clients.


4 responses to “Memory: The Enemy of Learning

  1. Interesting article. I would like to understand more of the details behind the following statement: “complementing the memory with knowledge at the point of care is the secret recipe.” What is your vision? Computer tablets which compile and rank the best course of action? Or maybe a more organic solution?

    Thanks again for sharing!

  2. Pingback: Memory: The Enemy of Learning Part II — New Evidence « Professional Development

  3. Pingback: Memory: The Enemy of High Performance « Professional Development

  4. Pingback: Memory: The Enemy of High Performance | HRM Today

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