Know What You Don't Know

“Know what you don’t know” is a common saying that I have used throughout my career, with trainees in medicine. It seems to be the best piece of advice that I have been given and the most important teaching point that I’ve passed along to others. However, I have only just begun to realize how important the phrase is in all areas of life and not just in medicine.

Why is “know what you don’t know” such an important teaching point for everyone? Without understanding the limitation of your knowledge base, you will never know the right questions to ask to learn more. If you don’t learn more, you will not know what your knowledge gaps are and you won’t continue to explore your deficiencies. Your knowledge base will stagnate and not expand. If your knowledge base stagnates and doesn’t expand, your intellectual growth will be stunted…and you won’t even realize it!

In medicine, examples of understanding “know what you don’t know” are often reflected in clinical judgment and interactions. We see incorrect diagnoses from not recognizing subtle clinical symptoms or signs on exam, incorrect treatments being given for illnesses that are not well understood, continuing routine management strategies without evolving because “that’s how we’ve always done it”, and many more examples. The common thread is not recognizing the knowledge gaps and not asking the right questions to make corrections.

So, why are these knowledge gaps ignored or just not recognized? There may be many reasons, but ignoring or not recognizing knowledge gaps may be due to a lack of curiosity.

• If you are curious, you ask questions.
• If you ask questions, you find answers.
• If you find answers, you learn more.
• If you learn more, you learn what you don’t know.

It seems to be a cycle that positions you in the direction of investigating what you don’t know and, subsequently, gaining knowledge.

Asking questions and being curious doesn’t mean that you have to learn everything that there is to learn. That would be impossible. But, it does mean that you reach out to sources for the information. This can include educational materials or reaching out to people who know the answers and who know more about the subject in question.

In medicine, we manage or treat patients based on what we know and feel comfortable with. If we are involved with the care of a patient and we encounter something that we don’t know or feel comfortable with, we investigate by reading or researching information or consulting colleagues who can help us. We learn by this investigation and interaction. We learn what we don’t know and fill the knowledge gaps or utilize others to help us with our deficiencies. A physician with inadequate knowledge, who doesn’t know to feel uncomfortable with managing or treating a specific patient, can be quite dangerous to the health of that patient.

What I’ve seen in medicine is also applicable in all areas of life. Learning what we don’t know will protect us from making mistakes with filing our taxes, fixing our car, investing in the stock market, helping our kids with their homework, and any number of other activities that are required for daily living. “Know what you don’t know” is one of those life lessons that I’ve learned by being taught and by teaching others. As I’ve matured over time, learned more, and tried to stay curious, I have realized how much I don’t know and how much more I still need to learn.

What is something that you recently learned that made you realize what you don’t know?