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Decoding a diagnostic riddle, wrapped in a medical mystery, inside an enigma - Part 2

Updated: May 17, 2021

By Meredith Carr

Imagine you were asked to diagnose a patient whose medical condition has, thus far, completely baffled their treating medical practitioners. Producing a definitive diagnosis would not only advance the medical community’s understanding of highly complex and indeed rare medical conditions, it would greatly improve the patient’s medical care and provide meaningful answers for them and their family.

This near impossible task is the reality facing a team of expert medical and health practitioners from a range of specialities when they meet once a month to decode a diagnostic riddle, wrapped in the medical mystery of a selected patient. This much needed and progressive approach to diagnosing complex and long standing medical conditions, is known as the Undiagnosed Diseases Program, and is a part of the International Undiagnosed Diseases Network. Since the first Undiagnosed Diseases Program expert panel meeting was held in Western Australia in March 2016, the diagnostic rate of patients going through the Western Australian program has nearly doubled to 55%, when compared to the previous approach. [1]

So what is it about these monthly meetings that has led to an increased diagnostic rate and provided patients and their families with valuable answers? Like the challenge facing the multidisciplinary expert panel meetings, CAT has enabled my team at the Centre for Transformative Work Design to decode a team interaction riddle, wrapped in a…let’s just say CAT provides a platform to capture the problem-solving processes that occur during these monthly meetings.

CAT enabled us to develop our own coding scheme and identify the specific time points at which important knowledge was shared – and by whom – within each expert panel meeting. In effect, CAT made possible our near impossible task of tracking and measuring complex communication patterns while unobtrusively observing the ‘live’ expert panel meetings.

Using data from CAT, our research is revealing that the answer may lie in the type of knowledge-sharing undertaken by the expert team members [2][3]. In fact, the expert panel meetings operate on a delicate balancing act of team members exploiting and exploring their clinical knowledge with each other.

So what does that mean? Well, knowledge exploitation occurs when a person, in this case an expert panel member, shares information they consider factual with other members. This means that the meeting members are communicating knowledge they already possess, like facts about the patient’s medical history and previous test results, as well as descriptions of medical conditions.

In contrast, knowledge exploration occurs when a person, ‘thinks out loud’ and shares information that they are still considering or offers information they believe might provide insight into the problem [4][5]. In terms of the expert panel meetings, members’ employ knowledge exploration when they share ideas about potential diagnoses and suggest possible diagnostic testing options.

So, it seems that experts considering all possibilities including novel and innovative ideas, in light of a patient’s medical history and their collective knowledge of medical conditions could hold the key to decoding a diagnostic riddle, wrapped in a medical mystery, inside an enigma. And the key to decoding how experts problem solve near impossible diagnostic riddles…well that’s not a mystery, it’s using CAT.

Check out this short video where Meredith talks about her experience of using CAT in her work with the Undiagnosed Diseases Program:

Still not sure if you could use CAT in your work? Stay tuned for the next post in this series, where we will give other examples of how CAT can be used, including videos from our very own ‘CAT lovers!’

For further detail on the functionality and history of CAT, and how to access it, click here.

For the original Curtin University media release on CAT, click here.

[1] Baynam, G., Pachter, N., McKenzie, F., Townshend, S., Slee, J., Kiraly-Borri, C., ... & Verhoef, H. (2016). The rare and undiagnosed diseases diagnostic service–application of massively parallel sequencing in a state-wide clinical service. Orphanet Journal of Rare Diseases, 11(1), 77.

[2] Klonek, F. E., Meinecke, A. L., Hay, G., & Parker, S. K. (2020). Capturing team dynamics in the wild: The communication analysis tool. Small Group Research, 51(3), 303-341.

[3] Kostopoulos, K. C., & Bozionelos, N. (2011). Team exploratory and exploitative learning: Psychological safety, task conflict, and team performance. Group & Organization Management, 36, 385–415.

[4] Uitdewilligen, S., & Waller, M. J. (2018). Information sharing and decision-making in multidisciplinary crisis management teams. Journal of Organizational Behavior, 39, 731–748.

[5] March, J. G. (1991). Exploration and exploitation in organizational learning. Organization Science, 2, 71–87.

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