stupid ideas and dead people

You may remember my obsession with the Cochrane Collection Collaboration. I've been pursuing this on the actKM list with all the ferocity of a man trying avoid a major deadline around a difficult client report. Anyway, we got into a big discussion of measurement and causality and stuff - but the vibe I got from a few people was "this is just too hard, we will never produce anything as rigorous as medical science". They may well be right. Knowledge managers are not doctors.

But if you compare the Cochrane Collection with The Old Operating Theatre in London then some perspective comes into play. I was at the Operating Theatre a few months ago (there's nifty picture of me getting my leg cut off that I've go somewhere) and, although they'd tidied it up a bit, you could imagine what a dirty, dingy, deathly place it must have been. If you got a broken limb then you were probably dead. And if you weren't dead then you were certainly due an amputation.

How has medical science advanced? Simple: stupid ideas and dead people. There have been lots of stupid ideas in the history of medicine. Often not completely wrong but not right either. And these stupid ideas meant lots of dead people. And at various points in history, medics have decided (whether for reasons of humanism or greed or pride or whatever) that working out which ideas are the least stupid will mean less dead people. This is not a linear narrative of progress. This is messy. There were (and are) mistakes, blind alleys, and maddening gaps.

One of the most interesting things for me are the articles in the Cochrane Review that say "there is insufficient evidence to come to clear conclusion on this". That speaks of an ambition to eventually find out what works and to improve health.

In my own discipline, we need that ambition. Lots of catastrophes have a knowledge dimension (or more frequently an ignorance dimension). But to be honest, most of my work is about the alleviation of small problems that make working lives miserable and organisations less effective than they could be.

We need to be more reflective and critical of our own practice. We need to find ways of sharing our failures as well as our successes. And we must not loose the focus on results. Most of all, we need to understand that our first efforts in this will be partial, messy, crude. We don't get to start in a gleaming, hi-tech surgical lab. We are rummaging around in the darkness and grime of garret. Tough - that's where you start.

We may not have as many dead people but I'm sure we can make up for that with stupid ideas.

bad science and getting better

Ben Goldacre writes for the UK's Guardian newspaper and also puts out the Bad Science blog. His mission is to attack poor uses of science - esp. in the medical field where he was trained. New Age therapist, Big Pharma PR, dodgy neuroscientists, credulous journalists and dishonest labs get mercilessly ripped. BG seems to rather enjoy doing this.

It's via BG that I discovered the Cochrane Collection Collaboration. It's an organisation that systematically reviews the medical literature for evidence that particular treatments work (or don't).

For the past year or so, Patrick's presentations and blog posts have explored the development of health science as discipline in comparison with knowledge management. It's something I've been pondering recently too. In part because I've been reflecting on the divisions between academics and practitioners in the KM world - which encompassed a discussion on actKM (many thanks to the participants). Patrick articulates it well:

"There is no great merit in and of itself that a practitioner "gets into" academia, or an academic engages in practice successfully, or that gifted individuals manage to get invited to both tea parties. The merit is in whether practice gets better. KM is fundamentally a practice - theory is its servant. And the practice needs to show beneficial outcomes affecting real people in real organisations in real economies and societies."

How do we get better?

km theory vs case studies

Final follow-up to this post below. Most case studies are useless. I remember being at a major KM conference and a friend asking me: "What's wrong with me? Why aren't my KM projects as smooth and flawless as these presentations?" It reminds me a bit of the argument about unrealistic portrayals of female bodies making ordinary women depressed. If everyone looks like a Hollywood starlet then I must be ugly and useless.

The thing is most case studies as written up in articles or presented at events leave out the really useful stuff. Where did you screw up and why? What were the unexpected events?

However 'real' case studies (warts n all) are very powerful indeed. I love The Mistake Bank. I think that knowledge managers are slowly, painfully building up this base of experience - but we could do a whole lot better - as Patrick has often stated.

The role of theory here is, for me, not fully decided. Dave, Patrick, Shawn, Gary Klein and others, have all done a brilliant job of bringing in research from complexity theory, cognitive science and narratology to bear on real-world problems. More KM practice needs to be built on research. However theory by itself is not enough. It needs to be constantly tested against brute reality.

What I am arguing for here may be impossible: A transparency around KM practice that requires a strong theoretical base, a willingness to experiment and a drive to learn from the work of others.