By: Eusang Ahn (eahn@toh.ca)
It was a chaotic trauma bay – alarms sounding, monitors beeping, people moving in rapid choreography. I remember glancing around the room during a complex resuscitation and realizing that no single person was “saving” the patient. Instead, it was the seamless, almost unspoken interplay of actions within the team, one nurse reminding me to give certain medications, another resident speaking up to relay that their task was complete and providing critical information on a new development, and a colleague performing a bedside ultrasound without needing to be asked.
Yet later, when we debriefed, the conversation quickly shifted to individual performance: Who intubated? Who led the case? Is there a learner who needs an EPA for their task? Our language, and our assessment systems, were still tethered to the myth of the lone hero, or the assumption that it was a roomful of individuals performing individual tasks, rather than a single team. At best, this line of thought can lead to accountability. At worst, it is the basis for blame-game or credit-grabbing.
Individualist Training… Yet Team-based Healthcare Delivery
This disconnect between the team-based reality of healthcare and the individualistic way we train and evaluate health professionals has deep roots. Modern health professions education (HPE) emerged from a mid-nineteenth century Protestant-Capitalist tradition that resisted collectivist reforms, leaving us with a lingering pattern of “heroic individualism”.
Despite the absence of strong evidence to support “progressive independence” in many HPE systems, independence persists as the ultimate goal of training, baked right into most competency-based education assessment language. There is an urgent need to address this mismatch between how learners are trained and how healthcare is actually delivered, by rethinking the foundational paradigms of both healthcare and HPE.
However, it is important to note that the goal here is not to suggest the complete replacement of individualism, nor to ignore the value of personal agency, autonomy, and accountability. In fact, independence is not the “opposite” of interdependence – it is a prerequisite for it. To work interdependently, we must first strive to be the best we can as individuals so we can meaningfully contribute to, and rely upon, others.
Paradigm Shift: From “Me” to “We”
Two concepts offer powerful tools for rethinking how we educate and perform assessment:
- Collectivism: the degree to which people are integrated into groups and the value placed on the goals and well-being of the whole.
- Interdependence: the way people’s actions and outcomes are interconnected, co-constructed through reciprocal engagement.
These paradigms don’t replace independence – they expand on it. Here are some ways to start thinking about how interdependence and collectivism can impact your own learning environment:
1. Reshaping Culture and Learning Climate
Competitive, hierarchical, and siloed environments undermine collaboration and trust. By contrast, cultures that embrace vulnerability, solidarity, and epistemic solidarity—valuing each other’s knowledge and perspectives – create safer, more inclusive spaces for learning.
2. Recognizing Individual Contributions within Teams
Collective competence describes the distributed capacity of a team that outperforms what its members could do alone. High-performing teams thrive when members are committed – not to their own success, nor even necessarily to the goals of the team, but rather to each other’s growth and success. Assessment systems should measure both the what of skill and the how of team contribution.
3. Reimagining Leadership and Followership
The “heroic” leader model is ill-suited to modern healthcare. Shared and situational leadership reflects reality more closely. Followership, far from passive, is active, skillful, and now essential, more than ever.
4. Belongingness as a Foundation for Well-being
A strong sense of belonging protects against burnout and disengagement. Compassion—both for self and others—can be a cost-effective intervention. Teams with high psychological safety in a compassionate workplace may report more errors – not because they make more mistakes, but because they feel safe to share and learn.
Why This Matters Now
Healthcare systems are under strain. Burnout and moral distress reveal the limits of relying solely on individual resilience. By intentionally cultivating interdependence, we can align our educational culture with the collaborative reality of care and build environments that protect, empower, and sustain the people within them.
The trauma bay that day wasn’t a story of one person’s heroics. It was a story of interdependence in action. If we can teach, assess, and reward that – and not just the lone, decisive act – we might finally bridge the gap between how we educate and how we actually work.
About the Author:
Dr. Eusang Ahn is an emergency physician and trauma team leader with the Department of Emergency Medicine at the University of Ottawa, where he is the Program Director for the Medical Education Fellowship. Drawing on clinical experience in Korea and Canada and a background in international advertising, he focuses on how culture shapes learning environments and workplace-based learning in competency-based education.
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