The quality of higher education is of great importance especially in medical education. Improving educational approaches, planning, and evaluation will improve students learning, which in turn, will lead to health promotion (1). Knowledge about the teaching process, cognitive and social theories of learning, as well as the perception of how to apply these theories in classrooms, is called pedagogical knowledge (2). This knowledge contributes to improving the quality of learning by professors. Therefore, it can be admitted that professors are intrinsically knowledge worker (3, 4), they produce and use knowledge and information to teach the students. As pedagogical knowledge workers, professors can share their experiences with other peers. However, professors are in isolation in classroom, faculty, and their group, which prevents of the development of knowledge (5). The results of a narrative study showed that in universities, in terms of professionalism and non-professionalism, content knowledge (CK) is usually considered, and most professors teach in the form of experiment and error with information gained from observing their own professors. Studies have shown that professors have described one of the most important ways to improve the knowledge of medical educators by sharing and organizing these educational experiences (6). This collection of processes a person uses to collect, organize, store, search, retrieve, and share knowledge in his daily activities is known as personal knowledge management (7).
Liebowitz and Wilcox (1997) emphasize the importance of knowledge management system in lifelong learning (8). According to Zhao (2010), knowledge management, by improving the professional development of instructors, seeks to make the knowledge available in their minds obvious (9). Knowledge management can help improve the quality of teaching by acquiring and sharing knowledge in teaching and learning (10). There are numerous studies in knowledge management of teachers such as the studies by Wang et al. (2018), Qiao et al. (2013), Wang and xu (2012), ZHAO and XIAO (2009), Yang (2008), Liu (11-15); however, it seems the term pedagogical knowledge management was first proposed by Akhterov et al. (2010). These researchers consider knowledge management as a system that provides the opportunity to use existing knowledge to decide on the strategic development of an educational process (16). In another study by the same researcher in 2013, the term “pedagogical knowledge management” was mentioned to analyze the structure of the knowledge management information system for professors of the technical school (17). Pedagogical knowledge management is managing pedagogical knowledge in all areas of the educational process, such as evaluation, teaching, learning experiences, classroom management, and etc. which provides the basis for effective teaching quality. However, a review of studies has shown that in practice and theory, pedagogical knowledge management in medical sciences has not been addressed. Clarifying the application of this concept can provide the basis for its use in practice. Therefore, we decided to extract and explain the various applications of pedagogical knowledge management in medical education by referring to different texts.
This research is carried out with qualitative research synthesis method and aims to achieving integrated knowledge in the field of pedagogical knowledge management. Synthesis research is a type of research which results in integrated knowledge; a knowledge that brings together diverse and scattered studies that can relate to the needs of the field of action. In order to achieve a knowledge that can solve current problems and issues that require planning or adoption of practical decisions, the integrated study evaluates and combines ongoing and finished studies (18). To study the history of research and to collect data tailored to the purpose of the research, library resources, theses, research projects and articles of Google Scholar, Science Direct, SID, Springer, IEEE, and Eric have been used. Searching for articles was done based on the keywords of Pedagogical Management, Pedagogical Knowledge, Pedagogical Pedagogy, Knowledge Management and Medical Education, Professional Development Medical Education and also with their Persian equivalent in Google Scholar and SID. In all databases, the article’s title was searched without time limit until 2018. All original researches or reviews published in Persian or English were included in the study. Articles related to the subject were selected and after reviewing, articles that met the inclusion criteria and their full text was available, entered the process of quality review through the QUESTS benchmark. Based on this criterion, each article was evaluated based on six criteria: Quality, Utility, Extent, Strength, Target, and Field, and indices A, B and C were given to each of them and it was decided to include the results based on them. Articles with A and B indices were studied. The inclusion criteria are the suitability of the title of studies with the goals of the present study, the language of the research (Persian and English) and ranking as A and B from the QUESTS criterion and credibility of the journal, and the repetition of the research title and resources with low credibility such as conference articles and books and index C articles are considered as a criterion as the exclusion criteria based on the QUESTS criterion. Analysis of the findings has been done through thematic analysis method. Thematic analysis is a method for recognizing, analyzing and reporting the patterns in the qualitative data. This method is a process for analyzing textual data and converts scattered and varied data into rich and detailed data (19). Therefore, in this study, the general themes of scientific articles have been reported and analyzed.
In the initial search, 3227 articles, books and theses were obtained with respect to the title. After removing duplicates and reviewing the articles, 381 (Figure 1) were introduced into the quality review process for QUESTS benchmarking. In total, after reviewing full texts, 66 articles were used to write the content of this research.
Figure 1. Selection, Refinement, and Organization of the articles
A review of these studies showed that no study has ever been conducted in the field of pedagogical knowledge management in medical sciences. However, by studying knowledge management in education, its wide used in medical education can be deducted, which is discussed later on.
Application of pedagogical knowledge management
1) The application of knowledge management in the lesson study process
The most important path to improve educational standards is to improve the quality of teaching in the classroom; and one of the strategies in this area is to conduct lesson study (20). Lesson Study is a new approach to the development of teachers' knowledge and the quality of education, which has been first developed for primary school teachers in Japan. In higher education, this model can also lead to the development of professors and ultimately improve the quality of education. In the process of lesson study, faculty members will have the opportunity to collaborate and interact in planning, conducting, and evaluating the process with classroom issues, find answers and apply them in practice, and end up with a grouped assessment of each other's educational work. They practice in groups, exchange and interact with each other, learn from each other, and, in addition to teaching the theoretical foundations of teaching and learning, they learn the academic and applied skills related to the teaching-learning process, the assessment of teaching methods, self-assessment and learning activities (21). In fact, they acquire and enhance their pedagogical knowledge. Cheng and Yang (2014) and Cheng (2015) used the Nonaka and Takeuchi model of knowledge management for lesson study in teachers (22-23) and see it as a major factor in promoting pedagogical knowledge.
2) The application of knowledge management in life-long learning:
Life-long learning is the solution to many of the problems that professors face in the educational process (24) and is one of the most important issues that most countries consider it to be the most important factor in education (25). Knowledge management leads to lifelong learning in professors, because professors can continuously improve their knowledge and skills through their knowledge management (26). In knowledge management, professors learn how to gain knowledge, share and organize, and ultimately use it. Thus, in current world, where knowledge is growing and changing, they can gain the required knowledge and the way to apply it, and by providing knowledge sharing, by creating synergy, they can provide the context for their own knowledge development (25).
3) Knowledge Management as a tool for the professional development of professors:
As the most influential factors in learning students, professors need professional development. Knowledge management in education, by identifying, sharing and validating knowledge can improve their performance (27). This improvement can be done through the creation and sharing knowledge (28), i.e. the exchange of educational experiences among professors and the sharing of knowledge and professional skills that lead to learning and, as a result, their professional development in education (29). Also, by enhancing innovative abilities (30) of professors, knowledge management provides the context for their professional development. One of the uses of knowledge management in professional development is the creation of a training portfolio to enhance the ability of professors (31).
4) Application of Knowledge Management in curriculum design
If we look at the process view of implementation of the curriculum, professors will no longer be considered as presenters, who are is fully aligned with the curriculum, and do not execute the curriculum without any changes according to the instructions; however, from this perspective, the professor can also play a role in curriculum planning (32). On the other hand, in addition to major curriculum planning, curriculum planning for the classroom, which is an important component of pedagogical knowledge, requires the acquisition of multiple knowledge for the needs analysis, and analysis of the existing curriculum (33). Knowledge management in curriculum can be used in the curriculum planning process (34), curriculum designing to achieve responsive curriculum (36-35), curriculum assessment (37), and curriculum development (38).
5) Application of Knowledge Management in Evidence-Based Education
Today, insufficient use of documented knowledge has led to a gap in knowledge. The reason for this is not the lack of knowledge resources, but the inadequate use of knowledge due to the lack of a comprehensive framework for storing and updating knowledge, so practical information or knowledge is not available at the right time and place of decision (39). This application in medical sciences, in addition to influencing the teaching performance of professors, the therapeutic performance of professors is also the basis for student learning. Davis (1999) believes that the purpose of evidence-based education is to use educational research and to create objective evidence through scientific methods for applying in quality education (41-40). This function is influenced by their experiences, the outstanding performance of other professors in medical sciences, namely, treatment, is traditionally based on the experience and scientific knowledge gained from their studies and limited retraining courses, and the same is passed on to the student; while in evidence-based medicine, scientific data must be collected and transformed into comprehensive knowledge to make clinical decisions wiser and less risky. Knowledge management helps professors of medical sciences as health care providers in their individual clinical experience and their visual problem solving skills (tacit knowledge) and structured information inside and outside the organization such as evidence-based guidance, studies, and more (explicit knowledge) for clinical decisions (42) and transfer these information and skills (tacit knowledge) to students.
6) Application of knowledge management in educational design
Educational design, provides a systematic process to use educational principles in the planning of educational events (43). The knowledge management system classifies the basic knowledge base of learning goals in different dimensions of learning and at different levels; and with an emphasis on the knowledge structure, provides the most suitable educational methods that are appropriate for students in the context of learning objectives (46-44). Reverse learning, as a new educational method, can be seen as an example of educational design, in which knowledge management plays an essential role. In reverse learning, students learn online content and then respond to questions that are designed by the professor and then participate in class discussions and exercises. This model is contrast to the traditional one, in which the teacher offers lectures in the classroom, and learners perform homework at home, which is why it is referred to as the reverse class (47). In reverse education, knowledge is obtained from various sources by students (converting explicit to implicit knowledge), then exchanged in the classroom (converting implicit to explicit knowledge) that is simultaneously evaluated by the professor and other students, and thus, proper knowledge is formed in the minds of students (explicit knowledge to implicit). In fact, the reverse learning approach incorporates a complete knowledge management system (48).
7) Application of knowledge management in promotion of professional qualifications (clinical reasoning and ...)
One of the qualifications needed by professors in medical sciences’ universities is clinical reasoning; so that they can transfer it to students while using it in the health process. Knowledge management can be used as a tool for clinical reasoning in the process of transferring this knowledge (49).
Proposed Methods of Using a Knowledge Manager in Education:
Many methods can be used to apply knowledge management in education, including storytelling, creation of knowledge management platforms, knowledge management system based on Web2 theory, blogging, and wiki, as well as formation of learning communities. These methods are briefly presented.
One of the proposed methods is storytelling; storytelling by professors leads to rethinking experiences (51-50). This facilitates the self-assessment of the professors and thus the improvement of the educational quality. Storytelling also provides a platform for sharing knowledge and experiences (53-52). It can also provide the context for the transfer and creation of knowledge (54).
2. Knowledge Management Platforms
Knowledge management systems provide the context for knowledge acquisition, and make storage, organization and exchange of knowledge available (55). These systems include Web 2 (56), wikis (59-57), blogs (61-60), and social networks (62). Using these systems can lead to educational justice and appropriate education for deprived areas. These systems also provide the relationship between professors, and consequently, their synergy, in the educational process.
3. Establishing a learning community
At the Carnegie Endowment, Schulman brings together a group of professors who work on research in various areas of teaching and learning (63). He sets out a developmental pattern for these learning communities. In this development model, instead of emphasizing on subjects, emphasis has been placed on transferring the individual and social experiences of teachers into a process of group and participatory thinking (64). Therefore, knowledge management can shape this learning community in two forms, either virtual or in person, leading to the promotion of teachers’ pedagogical knowledge. Researches on pedagogical knowledge management (67-65) show that research in this field has been done in education and attention has not been paid to the management of pedagogical knowledge in higher education, especially in medical education.
The purpose of this study was to examine the application of pedagogical knowledge management in medical sciences in various texts. All articles that were retrieved were searched using QUESTS criteria, and only articles with good quality were used in this study, which means that there is a certainty about the results of these studies. The findings of this study, based on the analysis of the researches conducted, indicate that pedagogical knowledge management in medical sciences can be used in various fields of medical education from the professional development of professors, curriculum, lesson study, life-long learning, evidence-based education, and evidence-based medicine. The most important methods of using pedagogical knowledge management can be the creation of learning communities, the design of learning experiences, and storytelling. As the results indicate, knowledge management leads to the professional development of professors (27-29), and since the professional development of professors, make the improvement of the quality of education possible (30-29), knowledge management will be essential in the educational process. In fact, knowledge management can contribute greatly to professional development, and by establishing a conscious path of production and creation of knowledge, knowledge storage, knowledge sharing and application, it organizes the professor’s experience as a pedagogical knowledge and enables professors to convert knowledge and experiences into products, services, and processes that can be used by other professors (68).
The results of this study showed the application of knowledge management in lesson study. Coenders and Verhoef (2018) introduce lesson study as a methodology for the development of experienced and inexperienced professors (69). Through lesson study, knowledge management process is applied, meaning that knowledge is acquainted, exchanged, evaluated, and applied. In fact, lesson study provides a framework for rethinking and developing the teacher's practice that leads to the creation of new and critical knowledge (70).
Life-long learning was also a result of the application of knowledge management in education (71). Pauleen et al. (2009) believe that knowledge management in people enhances the ability to absorb knowledge, using technology skillfully, retrieve knowledge, share knowledge and gain knowledge from others, which lead to information literacy in individuals and make it a life-long learner (72). In addition, one of the characteristics of life-long learning is the use of knowledge, which is one of the fundamental components of knowledge management (73) and Marzo et al. (2016) believe that the use of knowledge will create a self-directed learning context that will influence the development of lifelong learning.
The results of this study showed the application of knowledge management in educational design (47-43). Due to the explosion of knowledge and the consequent change in the knowledge and skills required by students, as a result of the need for new methods and knowledge in the field of medical education, the use of knowledge management in educational design of education provides a platform for the use of modern design education.
The application of knowledge management in curriculum design was another result of this study (33-32). Knowledge management will provide the knowledge needed to design a curriculum. Of course, there are challenges in applying knowledge management in curriculum designing, which has been emphasized by research in this regard. The first challenge is that there are no standards for applying knowledge management in the curriculum; and second, the curriculum specialists and the curriculum accomplishers who are professors of universities are not well trained in knowledge management, and there are some deficiencies (63,75).
The findings of this study also showed that knowledge management is used in evidence-based education. Masters et al. (2018) argued that the effectiveness of education without the use of evidence would not be feasible because the professor should use evidence to decide on all stages of education, including choosing the appropriate strategy, monitoring and learning progress; it is necessary to search for, evaluate and apply knowledge, or to manage them in the sense of its pedagogical knowledge (76). What needs to be considered in this regard is that the practice of professors, both traditionally and evidence-based, is transmitted to the students and shapes the professional practice of the students in the future.
Another finding of this study is the use of knowledge management in the development of professional qualifications, such as the ability of clinical reasoning (49) to be based on decision-making (77), scientific ability (78), which ultimately constitutes the main goal of the educational system in medical sciences which is reducing mistakes which are due to inaccurate knowledge and ultimately improving community’s health (79).
The results of this study showed the application of pedagogical knowledge management in the comprehensive development of professors and the development of innovative individuals responsible for applying the best evidence in teaching and design and educational planning. According to the goal of medical education which is improving the quality of health care in the community, the use of knowledge management in the process of medical education will be important. One of the limitations of the present research was the lack of access of the researcher to the full text of the articles that were able to be included in the study.
Ethical issues (Including plagiarism, informed consent, misconduct, data fabrication and/or falsification, double publication and/or submission, redundancy, etc.) have been completely observed by the authors.
This article is part of the second chapter of the doctoral thesis with the code number 1431210. We are grateful to all those who helped us with this research.
This article is part of the PhD thesis with the code number 1431210 wich was funded by University of Birjand, Iran.
Conflict of Interest: The authors declare that they have no competing interests.