Connections within the seemingly inevitable triad of self, social and situation

There are so many layers to my excitement about the 2022 instalment of Medical Education's State of the Science issue that I hardly know where to begin. I am filled with gratitude for the opportunity to learn from the authors, reviewers and editors whose impressive efforts culminated in this product. How you too might be intellectually stretched by their labour is where this editorial will end up. For now, let's go back to the beginning, to the issue's inspiration.

While engaging in data interpretation with Renate Kahlke, one of the far too talented colleagues with whom I have the pleasure of working, we found ourselves settling into a groove of categorising observations into personal factors, relational factors and contextual factors that seemed to contribute to the phenomenon of interest. I phrase the focus of our work generically to emphasise that what the phenomenon was does not really matter. Are not personal, relational and contextual factors always at play? We decided in the end that it was a useful framing, but it was disquieting to wonder if we had settled into a groove that was better conceived as a rut.

The triad of self, social and situation is so seemingly inevitable in the models our field uses that it can appear trite. The capacity to observe influences on our practices from more than one level, however, might reflect one of the greatest strengths we have: the varied disciplines that have come together to form a field of scholarship. In contrast, many other corners of our campuses from which those disciplines emanate deliberately constrain themselves to contemplation of one of the three categories. In many ways, I would argue, consideration of the full triad helps both to define us as a field and characterises the work we do in bringing perspectives derived from individuals' backgrounds (self) into collaborative teams with complementary expertise (social), to advance understanding in the service of application (situation).

That said, when thinking about the strengths diversity brings to our field as a whole, it is easy to overlook the reality that the individual efforts that make up our collective work often resemble distinct circles more than overlapping Venn diagrams. To some extent, that too is inevitable as no one can keep up with the entirety of the literature we produce. To wit, PubMed reveals nearly 58 000 articles published in 2020 alone when one underestimates the size of the field by searching for ‘medical education’, a sharp contrast from the barely 4000 articles that come up for 1990. Yet, it is still a source of concern when one wonders how many insights could be gained from more deliberate efforts to draw connections between work that is not commonly linked. As Kämmer and Hautz note, in this issue, there is a ‘danger that disparate streams of research develop in parallel without cross-fertilizing each other – thus lowering the speed of deriving practical implications for better medical education’.1

In his recent book, Range, David Epstein lays out a variety of compelling examples from sport, business and science that suggest generalism is a key to exceptional performance.2 One cannot always predict (or oftentimes recognise), he argues, how the ideas and skills from one domain will enable innovation and excellence in another field, but putting oneself in the position to learn diverse things and, thus, draw unexpected connections appears very important.

With that call for cross-fertilisation in mind, we sought to explore ‘the inevitable triad’ by asking a series of authors whose research focuses on some aspect of the self, the social or the situational to offer a State of the Science summary of how one component of the triad is currently conceived in their area of expertise. We did so knowing full well that it would be difficult to isolate one component from another even if one was charged with writing specifically about personal, relational or contextual factors that influence health professional education. In the end, that is exactly what happened. For example, Branson et al. talk of socially shared regulation when exploring ‘self’ regulated learning3; Bochatay et al. use reflections on ‘social’ identity as a means towards improving the situation of learning environment4; and Sheehan and Wilkinson explore how the ‘situation’ inherent in culture interacts with individuals' identity development.5

Not content to use our own imaginations regarding what connections might productively be made by drawing together distinct aspects of our field into one issue, however, we are using this State of the Science iteration to encourage scholars to demonstrate how juxtaposing articles from different research programmes can enable novel insights. That is, we are announcing the creation of a new series called Medical Education Connections, the primary purpose of which is to advance (or begin) conversations by drawing meaningful linkages between the articles we publish. The papers that begin this issue offer models of the circumscribed format that is expected, and the author guidelines at mededuc.com outline the goals and constraints in more detail.

In a nutshell, authors will be expected to describe a compelling issue, briefly summarise 3 or 4 Medical Education articles that offer distinct takes on that issue (saying enough for a reader to appreciate the basis for each article's inclusion) and then to explain how Connections between the articles can be drawn to think better about (i.e., offer further insight into) the challenge that opened the paper. During this early trial period, authors must limit themselves to connecting articles from Medical Education because we hope to use these pieces to stimulate further cross-talk, linking the addressed articles online in ways that are achievable only if Wiley holds the copyright on the work.

Priority will be given to submissions that draw together manuscripts from distinct authorship teams, distinct regions of the globe and distinct research approaches while crafting a thought-provoking argument that is well grounded in the evidence cited and coalesces along an important theme. Depth of scholarship is a must as we will similarly give priority to manuscripts that share observations that are timely, generate novel insight and advance the field's thinking. Lessened priority will go to those that read simply as summaries of papers the authors find interesting or that offer ideas that are not dependent on the juxtaposition offered (i.e., that could have been generated without an explicit effort to draw connections between the work of diverse groups).

Every editor I know claims they value the role because it pushes them to read beyond what they would normally read and to think beyond what they would normally think. I am no exception to that rule. We recently tried to highlight that similar benefit derives from becoming a peer reviewer.6 Consider this announcement to be a comparable challenge aimed at authors, providing a stimulus for creativity and unanticipated directions of thinking by deliberately seeking connections between previously unlinked scholarship. Happy reading, happy writing and good luck.

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