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Friday, February 3, 2012

New Knowledge and MLQ.

If there is a core essence to research in academia it is the production of “new knowledge”, an idea that is by design both tangible and sufficiently vague.  Pieced together from a variety of sources, knowledge is about the appreciation of concepts and relationships that link the objects within a body or area of interest.  Knowledge may be derived from information or data, but it extends beyond both.  Knowledge extends beyond facts.  It embraces integration and understanding.

Research is the method by which new knowledge is created.  Research and knowledge build from foundations created by previous research and established knowledge, resulting in new concepts, new ideas, and new relationships resulting in  (ergo) new knowledge. 

Knowledge production in its traditional concept has been characterized as having its place in academia, focused primarily within specific disciplines.  It is said to be autonomous, that is it should be able to stand alone, but at the same time is dependent upon “peer review” for its quality control.  A more modern approach, described as Mode 2 new production of knowledge (NPK) turns most of that on its head and recognizes the knowledge production is much broader in its reach and embrace and capture. Mode 2 NPK speaks much more to the issues of ethics, and society and transdisciplinary impact.  Importantly it goes beyond traditional peer review as the sole criteria of quality and looks to broader political and economic and social and cultural impacts.  This is not so much a deterioration from “good science” but a recognition that “good science” need not be exclusively tied to the beliefs and practices of tradition and peers.

I bring this to mind because at the moment I am pushing very hard to raise the concept in my institution about the value, importance, and indeed criticality that Quality adds to laboratory medicine.  We need to recognize Medical Laboratory Quality (MLQ) as a discipline worthy of research and development of new knowledge.  At the same time I am preparing to be a part of an examination committee for a candidate’s thesis defence of her work being submitted for a PhD which addresses some extremely important concepts in laboratory quality.  I suspect that once the work is finalized and published and widely distributed, her work has the potential to result in new societal ideas and change for the better.

Given the caution that my institution is showing in moving forward on a proposal to recognize the importance and opportunities in new knowledge production, it would be easy to interpret this with frustration.  Perhaps.  But this is revolutionary change that I am proposing. 

MLQ as a focus of academic pursuit is the essence of Mode 2 NPK.  It crosses the traditional boundaries within and outside the pathology laboratory.  It goes beyond traditional medical practice.  It addresses economy, society and cultural issues.  Its peer group includes medical leaders and government and business and (perhaps especially) consumer and patient advocates.  This is not intended to denigrate traditional study that leads to improved concepts and novel diagnostics.  It is about recognizing that it is time to broaden our scope.

MLQ is a new and innovative (indeed foreign) to traditional medical academic faculties.  Quality has routinely been the responsibility of (interpret that as “relegated to”) the administrative managers.  It is not the stuff that folks with MDs and PhDs would want to tinker; it is not real science.  That is not to say that there are not leaders in the world of medical laboratory quality and its first cousin, patient safety (Dick Zarbo comes to mind), but while the discipline is growing and its advocates increasing, it has been a slow process.  The peer community is small, which may be one of the reasons that I get the opportunities that I do. 

So at this point I can not yet identify the university and department that has taken the progressive step to embrace MLQ nor can I identify the candidate.  That will come.  But I can and do hand to both kudos for taking an important indeed transformative step forward.   

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