Collectivism & Interdependence
Special thanks to Eusang Ahn, Kaitlin Endres, Stefanie Sebok-Syer, & Jerry Maniate.
Content generated as part of a workshop presented at 2025 APMEC (Asia-Pacific Medical Education Conference) in Singapore on January 16, 2025.
Background
The health system is comprised of an amazing group of individuals who come together for the purpose of improving the health of individuals and communities. These individuals can function as individuals, but increasingly they are found in team and team-like structures. This is often due to the need for broad expertise and support needed to provide safe, efficient, and effective health care.
Despite this, these teams have often struggled to work together. In the North American / Western context much work has been done over the past 20+ years to explore these concepts within the space of interprofessional education and collaboration, but yet the struggle remains to find groups of individuals that are high-functioning teams within the health system. They exist in pockets or in isolation, but are rarely found institution-wide. Is it because we come to these teams with a lens of individualism that places "me" ahead of "we"?
Key Definitions & Concepts
Individualism
Sociocultural, phenomenological lens. On the continuum with collectivism. Asks: "who am I?"
Collectivism
Considers the degree to which people are effectively integrated into groups. Places greater importance on the goals and well-being of the group, as compared to the individual. Asks: "who am I as part of the larger group in relation to others?"
Interdependence
"Patterns of interactions between individuals, working collaboratively, that can afford or constrain one's performance and potentially shape the practice of a broader healthcare team."
A choice: not the diffusion of responsibility asit requires being the best possible version of yourself so that you can answer the call when others need you most. Thus, a choice that only the truly already independent can make.
A competence: the highest performing teams are focused not only on the team's output as a unit, but rather on the success and growth of other team members.
Collective Competence
Refers to how a group of individuals work together to perform a task. Expands the notion of competence by moving from an individual to collaborative expertise.
Supportive Interdependence
An interaction between team members is triggered by one member's insufficient expertise to perform within their scope of practice.
Collaborative Interdependence
An interaction between team members that was triggered not by lack of experience or expertise within an individual's scope of practice, but rather recognition that patient care requires contributions from other team members.
Key Principles of Collectivism & Interdependence
G. Hofstede explores concepts of power distance vs. individualism-collectivism
​Hofstede, G. The Cultural Relativity of Organizational Practices and Theories. J Int Bus Stud 14, 75–89 (1983). https://doi.org/10.1057/palgrave.jibs.8490867
Concept of belong discussed within Maslow's hierarchy of needs
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Interdependence is the combined excellence of vulnerability and dependability
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Can we teach these concepts?
Identifying, measuring, and accounting for interdependence within our teams in the health system
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Competent individuals can form an incompetent team​.
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Teams can be competent even when a team member is incompetent.
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An incompetent team member can paralyze one team, while another team carries on around them.
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The same team can be competent one day, and incompetent the next.
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Interdependence:
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Not limited to humans.
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Can, and often does, include patients.
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Exists across specialties.
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2 types:
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Supportive interdependence​
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Collaborative interdependence
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Key Lesson:
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Everything we do and say, every way we act or show restraint, provides information - either consciously but often unconsciously - about our interlocutors who will subsequently interpret our words and actions through their own biases, frames of reference, and understanding of the situation. Even if we mean well, sometimes things can get misinterpreted through no fault of our own.
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Articles & Books
= Article
= Book
= EqHS Lab members
= Tool
= Website
Francophones en contexte linguistique minoritaire au Canada: défis et répercussions sur la santé mentale
H Archambault et al.
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English summary:
"Immigration experiences of Francophones in minority linguistic communities in Canada: challenges and impacts on mental health."