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Invited Commentary
November 25, 2013

Known Unknowns and Unknown Unknowns at the Point of Care

Author Affiliations
  • 1Department of Medicine, University of California, San Francisco
  • 2Medical Service, San Francisco Veterans Affairs Medical Center, San Francisco, California
JAMA Intern Med. 2013;173(21):1959-1961. doi:10.1001/jamainternmed.2013.7494

Lifelong learning (LLL) in medicine is at once a value, a set of skills, and a social pact. It is part of our professional identity, a core competency of the modern clinician, and an inviolable obligation to our patients. Despite its alignment with professional ideals, LLL remains a voluntary and self-motivated pursuit with no direct extrinsic rewards, which raises questions about what can be done to enhance its value and facilitate its widespread enactment.

Clinicians consistently report that patient problems from their own practices are their greatest motivators for learning, yet most of their questions go unanswered.1 Health systems have an opportunity to capitalize on this motivation and unmet need by optimizing point-of-care learning (POCL), where questions triggered by patient care activities are answered in real time. All physicians know, however, that this is easier said than done.

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