Reflections from the Liminal Space:   The Future of Teams

(From the EiC: The liminal space references the active transitional state of moving into a new reality or place.  It is from the Latin for “limen” or threshold.  Check out Teresa’s previous posts on her transition into becoming a Clinician Educator:

– Jonathan (@sherbino))

By Teresa Chan (@TChanMD)

Health professions educator Lorelei Lingard has spoken extensively in the last few years about collective competence and its role in the healthcare setting. From this I have learned of the need further discussions about teams in medical education.

An Observation

Since becoming a junior faculty member, I’ve noticed a funny phenomenon: much of medical education is done by individuals or very small teams. Program directors often shoulder the load of their programs with, perhaps, an assistant program director and/or program administrator by their side. Deans may have a small cluster of assistant or associate deans – but each individual is simultaneously responsible for
additional large education portfolios. This phenomenon can be similarly observed in clinical departments, where there are a select group of ‘leaders’ and then everyone else. Looking to research, again centres have a few rock star researchers who serve as a nidus for most research activity.

And yet, if we look outside of the discipline of medicine for perspective, we find a contrast where most of the world functions in teams. Teams that work accomplish great things because individuals can augment each other.

My Background

Growing up, I have always been asked to function in teams – choir, debate, student council… And in each of these experiences, I have learned that I might play a different role.  At times, I will lead. And at times I will strive to be a supportive follower, who stands up to contribute, lending strength to a leader. These environments were always the most fun for me – as they surrounded me with interesting, inspiring, dynamic people.

These experiences have shaped what I now look for as a junior faculty member – I crave team experiences, where I can actively contribute. I gravitate away from individualistic environments, where there is no synergy and coordination.

And yet, sometimes the right people are not all in one place.

The MedEdLIFE experience

Recognizing this dilemma of geography, I have tried to recreate the fun and function of the teams I used to know. This past year, I have been working with a group of people to form the MedEdLIFE research collaborative. This research collaborative has mainly focused on teaching and learning using online technologies. Joining scholars from a number of geographically disparate locations (from Hamilton, ON to San Francisco, CA), we have created a team that might not otherwise have so easily connected. In fact, this group has never met altogether in “real life”, but we are currently working on our eighth paper together.

Our hallway conversations are now held on the digital corridors of whatever chat interface we choose (usually Google Hangouts), and when we need to have conference calls we use video conferencing to convene. We use online sharing platforms (e.g. Google Drive, Dropbox) and email to stay in touch and progress through rapid sequence editing.

And the best part, really, is that these teams involve a diversity of members – from more junior medical students and residents to more senior faculty. All members are acknowledged and appreciated for the contributions they make, since each person provides a unique contribution or skill.


Building teams, including teams that extend past local environments, is key for health professions education and CEs. Creativity is required in forming and coalescing virtual teams. Data protection and security will be paramount, of course. (I have been lucky enough to do projects that have not yet required enhanced security since most of the work of our virtual team has used open data.) Nonetheless, breaking free of the limitations of geography will open up new avenues for collaboration and new opportunities for individuals transitioning through the liminal space.

Image from Ambro via