Yields and Rabbit Holes: Medical Students’ Typologies of Sufficient Knowledge

ABSTRACT

Given the vastness of bioscientific knowledge and regular changes in evidence and protocol, how do individual clinicians make decisions about what to know and what to ignore? In this article I identify a process termed “sufficient knowledge:” the prioritizing of medical knowledge perceived as most important, while ignoring information that is not deemed essential or applicable. Drawing on 14 months of ethnographic fieldwork at an allopathic medical school in the American Midwest, I describe three typologies of sufficient knowledge that medical students devised to distinguish what to know and what to ignore or deemphasize: high yield knowledge, low yield knowledge and “rabbit holes.” I aim here to contribute to a growing topical and theoretical discussion of ignorance by social scientists, especially to generate a more balanced picture of physician training and practice beyond depictions of knowledge and expertise.

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KEYWORDS:

• Agnotology
• biomedicine
• ignorance
• medical education
• socialization

Supplementary data

Supplemental data for this article can be accessed on the publisher’s website.

Acknowledgments

My thanks are due to Jeff Knopes, Vanessa Hildebrand, Eileen Anderson-Fye, and M. Ariel Cascio for their encouragement and feedback throughout this research. I would like to thank the Case Western Reserve University Department of Bioethics and the Phi Beta Kappa Alpha of Ohio chapter for generously funding my work, and to the Case Western Reserve University Social, Behavioral, and Educational Institutional Review Board for assisting me in preparation of the research protocol. Finally, I would like to thank the faculty and students at Midwest School of Medicine, who warmly welcomed me as an observer and interviewer for the duration of my ethnographic study.

Additional information

Funding

This research was funded through grants from the Case Western Reserve University Department of Bioethics and the Alpha of Ohio Chapter of Phi Beta Kappa.

Notes on contributors

Julia Knopes

Julia Knopes is postdoctoral scholar in Bioethics and Medical Humanities at Case Western Reserve University School of Medicine. Her research examines medical students’ and physicians’ experiences of knowing, not knowing, and managing scientific information.