Long before Curt Olson et al. published what I have called the landmark “serendipity in healthcare improvement” paper (“Knowledge systems, health care teams, and clinical practice: a study of successful change,” PDF download), I was interested in how clinicians address what they don’t know they don’t know and how change happens in healthcare when teams know only one way to get things done. This is, in many ways, a classic tale of understanding innovation: There are times when people or facts are available to us, but we do not see the value in the connection; then at some point in the future, the value become tangible and the people or facts provide us a new understanding, a new vision, or a new strategy for changing our behaviors or practices.

It seems that many professionals are content to restrict their networking and skills acquisition efforts to within the profession—after all, 95 times out of 100 it is easier to see the return on effort of this engagement. But if we think for a moment about what we are actually learning from our over-reliance on learning from “people like me,” we might find that we are spending most of our time echoing each other or making small and gradual refinement to existing models—in other words, supporting the same old, same old.

So what has worked for me?

I have committed to social networking and new social learning technologies as a way of building channels to new ideas, while solving problems I know I face each day. My investment of time and energy in social networks (i.e., #HCSM, #meded, LinkedIn’s CME group) is very specifically engineered to help me stay aware of the problems, conversations, and best practices relevant to my professional development. But I am cautious not to get caught up in a filter bubble or echo chamber, so I look to other communities and engage in other discussions too. For example, the informatics communities are constantly evolving how information is aggregated and flows, and this may be relevant to me, so I have built channels that allow me to stay abreast of their problems, conversations, and best practices too.

Likewise, the broader educational communities (K-12, higher ed) are constantly evolving the way classroom education and mentorships are integrated into learning and made more personalized, so I have built channels that allow me to stay abreast of their efforts as well.

If the last few years have taught me anything, it is that real learning (the game-changing learning that shifts one’s view of the world) and real innovation (of the disruptive, transformational variety) is driven by connections to the edges of my social graph, to the people who are similar to me in some ways, but who have experiences and resources far different from mine. Perhaps this is a new 80/20 model where efforts need to be split between engaging with the core of the profession versus the edge of the profession; and perhaps that ratio becomes 60/40 as you move through your career. But whatever that ratio may be, if you do not take the time cultivate and engage with the edges of your social jcrop previewgraph, you can bet that your unknown unknowns will (perhaps comfortably) remain unknown.

Brian S. McGowan, PhD, has dedicated the past 12 years to medical education as a faculty member, mentor, accredited provider, and commercial supporter. The opinions expressed are McGowan’s and do not represent the views of past, current, or future employers. Follow him on Twitter: @BrianSMcGowan.

More of Brian's Columns:

Deconstructing Your Social Network

Point of Care Social Learning for Healthcare Providers

Solving Problems with Social Technologies