Simulcast Journal Club February 2020


Introduction :  

Simulcast Journal Club is a monthly series that aims to encourage simulation educators to explore and learn from publications on Healthcare Simulation Education.  Each month we publish a case and link a paper with associated questions for discussion.  Inspired by the ALiEM MEdIC series, we moderate and summarise the discussion at the end of the month, including exploring the opinions of experts from the field. 

The journal club relies heavily on your participation and comments and while it can be confronting to post your opinions on an article online, we hope we can generate a sense of “online psychological safety” enough to empower you to post!  Your thoughts are highly valued and appreciated, however in depth or whatever your level of experience.  We look forward to hearing from you. 

Title :  “First Contact 

The Case :  

David morosely turned off the lights in the sim lab.   He’d had high hopes for the interdepartmental sim but two crying staff members and a tribe-based psychological knife fight later it appeared his goals were a little too ambitious.  The fact that his $40,000 mannequin’s circuitry was unintentionally embalmed with fake blood during a log roll wasn’t exactly going to go down well with executive either.  But that was Monday’s problem. 

He sighed. 

Going to IMSH and connecting with so many passionate colleagues had seemed… joyous?  It was a wonderful thing, after all, to share time with like-minded educators who wanted to make a difference and change patient care.  He’d spent a decent portion of his income for the international flights and accommodation, but the expense had been worth it in the moment.  He’d learned new techniques and come back invigorated. 

But now? 

Flying back to his community hospital alone had felt like a one way trip to Thunderdome.  San Diego had been teeming with mentors and inspiration, but here he just longed for a friend he could talk through this stuff with.  With the next regional hospital 300km away that wasn’t going to happen easily. 

He scrolled through his phone habitually and noted his neglected twitter app.  Maybe it was time to check out those handles he’d added politely overseas.  “Relationships take work”, he thought, “Maybe I need to invest some effort into maintaining the online ones too.” 

He clicked down with his thumb.  A new world beckoned. 

The Article : 

Thoma, B., Brazil, V., Spurr, J., Palaganas, J., Eppich, W., Grant, V. and Cheng, A. (2018). Establishing a Virtual Community of Practice in Simulation. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare, 13(2), pp.124-130. 

Discussion :  

How do you connect with other educators?  And how do you maintain that connection long term? 

In this month’s article from Thoma et al, the authors explore the options available to connect with other educators through virtual communities of practice.  Let us know your thoughts on the article, as well as any personal perspectives on communities of practice in general.  What have you found works for you?  What are the barriers and what are the motivators that keep you engaged? 

We’d love to hear from you. 

References : 

Thoma, B., Brazil, V., Spurr, J., Palaganas, J., Eppich, W., Grant, V. and Cheng, A. (2018). Establishing a Virtual Community of Practice in Simulation. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare, 13(2), pp.124-130. 


About Ben Symon

Ben is a Paediatric Emergency Physician at The Prince Charles Hospital in Brisbane and a Simulation Educator at Lady Cilento Children's Hospital. He currently teaches on a variety of paediatric simulation based courses on paediatric resuscitation, trauma and CRM principles. Ben has a growing interest in encouraging clinical educators to be more familiar with simulation research.

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39 thoughts on “Simulcast Journal Club February 2020

  • Melissa Morris

    Twitter has been a great resource for me. It has allowed me to find new and up and coming ideas and information, as well as stay in touch with simulation champions that I have met at various events I have attended. The other on line community that has been very helpful is the SSiH connect community. Without these resources, as a “one” I would not be able to develop, move the ball forward in regards to simulation in my academic setting or easily stay abreast of all that is happening in simulation as it pertains to health profession education.

    • Ben Symon

      Hi Melissa,
      Thanks so much for getting this month’s conversation started!
      You mention that twitter in particular has been a great resource for you to connect with champions and new ideas, as well as the SSIH connect community.
      Can I ask a few questions?
      – Are there any particular people/organisations that you find particularly useful to follow that you could share with us?
      – How do you filter the large amount of information out there on twitter enough to be able to find what you need/want on twitter?

      Cheers!
      Ben

      • Melissa Morris

        At first years ago it became overwhelming and I turned off for bit. But I established for
        myself what my focus is. As I do mostly faculty development and IPE sim for allied health professions (communication, basic assessment and history taking) and I tend to stick to the posts that pertain to my focus and keep me connected with those I have met in my 10 years of being part of the sim community.

        I find CMS, SSH , the debriefing academy, simulcast the ones I tend to go to the most. SSH listserve has been immensely helpful as I am a “one” and an “other”.
        I also have repeatedly visited INASCL, SIRC and Sim Ghosts.
        Without the on line community I would not be able to keep moving forward. I am forever grateful for all that you and “they” provide on line.

      • Ann Mullen

        I have truly enjoyed making new friends and staying connected with the community of practice. Thanks Ben et al for all the work involved in maintaining the environment.
        One strategy for managing the volume: I have a separate account for my sim interest; I choose to go there for that purpose. Also unfollow accounts with too much “clutter”. One person’s clutter is another person’s treasure…

          • Ann

            Regarding the separate accounts: I stumbled on this by accident, so I hesitate to call it my strategy! 🤣
            I created Twitter and Instagram accounts for the Foundation for Healthcare Simulation Safety, while keeping my personal accounts. I started to realize that it was useful to maintain boundaries on social media between work and personal interests. For the work side: I don’t “follow back” on accounts that mostly have photos of babies, pets or food.
            On my personal page, I love seeing all those adorable kiddos!

          • Ann Mullen

            Well- that’s embarrassing! I got an error message on my first reply so I wrote it again.
            Feel free to say “OK boomer…”

  • Susan Eller

    G’day mate,

    I love that you chose this article and topic to explore post-IMSH. I was just thinking to myself that I had that “summer camp” mentality: where you spend intense time surrounded by friends who all know the words to your favorite – and sometimes annoying to others outside the community – songs, and have to come back to reality and deal with mundane issues. Just me? 😉

    This journal club is my favorite way of connecting with other educators. I think that I had heard of the online hierarchy of needs, but had not formally read about it prior to seeing the reference in the article this month. I had to chuckle when I realized that I am perhaps the poster child for the steps in engaging in a social media community in this particular community, as first I lurked, then I started posting, and have worked my way towards collaborating with other educators on scholarly projects. Your diligence in answering all the comments posted on the journal club demonstrates respect and generates further discussion.

    As the article stated:”Higher levels of engagement potentiate these advantages.” I think that can start with posting, then answering comments on your own posts, and then looking at other’s posts and engaging with them as well. I know that it has started some great conversations for me, and led to richer dialogues via email, whatsapp, or Zoom.

    I will say that you have done a mindful and masterful job of creating psychological safety in this community. One of the best examples that I have for that is the “epistemology” episode. The group had thoughtful critic about how language could enhance or inhibit participation in discussions. I loved that the lead author of the article in question sent out a tweet about reflection she had done based on the respectful online comments. I am not sure that two years ago I would have imagined that I would have a live conversation with Vic about this topic at IMSH. So kudos to you, Jesse, Vic, and the whole crew for creating and maintaining this space for simulation educators to connect and grow!

    I will say Twitter has been a great medium for me, as I have interacted with so many incredible educators online – and presented at conferences with two or three that I first met online at Twitter. It has enhanced my conference experience not only by sharing links and thoughts, but by prompting IRL interactions. I can’t tell you how many times someone has come up to me and said, hello Susan, it’s great to meet you in person – I know you from twitter. Twitter is also great for sharing links to articles, information about conferences and courses, and greetings to geographically challenged friends.

    The article discussed great benefits and challenges to social media. There is one challenge that I didn’t see listed, and I feel that it merits a little discussion. Social media can play havoc with people’s sense of self-esteem if they don’t understand the way it works. I like to think that as a highly educated person, I should not be susceptible to lowly emotions such as FOMO, or imposter syndrome. But social media can trigger these things: why does that person not follow me back on Twitter? Why when I contributed such a pithy comment on Twitter is it being ignored? I will provide my own personal example. The Thoma et al. article came out in 2018, and was highlighted during healthcare simulation week. One of my fellow prolific simulation tweeters commented that neither one of us were on the list in Table 4: Prominent Health Professions Educators on Twitter in the Simulation Virtual Community of Practice. Although the parentheses indicated it was “Not an Exhaustive List”, I did have a moment of why not me? It was good for me to recognize that I could have that momentary feeling, reflect on what else was going on in my life that triggered it, and realize it was an internal versus external trigger. It speaks to the safety that you have created that I feel comfortable telling that somewhat whiny story. I do see some of my twitter friends also acknowledge having FOMO at times – kind of half kidding/whole in earnest? I think that acknowledgement can lessen the impact, and allow others to reach out. Curious as to what others think of this phenomenon.

    So – cheers for creating this community of practice and allowing me to share – and know that others can freely comment and interact with my perspectives.

    • Ben Symon

      Hi Susan,

      Thank you so much for the praise and breakdown of some of the things we’re doing well in Journal Club! We definitely work hard at making this as welcoming an online environment as possible, and it’s interesting reading about this and experimenting with methods to promote engagement.

      More importantly, thanks so much for bringing up a really important aspect of online risk taking : the opportunity for perceived or real ‘virtual rejection’ without the backup of mitigation techniques reliant on tone, eye contact or > 280 characters to explain your thoughts. I think that’s one thing I like about JC is that we use social media as a breadcrumb rather than the main course : luring people in with a tweet, but allowing more in depth discussion via the blog.

      Let me join you in the ‘why not me’ zone : I certainly can remember similar episodes of FOMO, or the experience of saying something that gets little attention, until somebody with more social capital paraphrases or retweets it. Sometimes there’s a mild sense of indignation or invalidation in that moment.

      So I think it’s important that we acknowledge that as a risk. For me, dealing with that risk involves internal reflection and confidence. As I have felt more confident in my acceptance within the simulation community, that fear of rejection has lessened. The challenge being, those most at risk of perceived hurt from dipping their toe into the online world are likely the ones who see themselves as ‘unimportant contributors’. So how do we build confidence in those too nervous to contribute enough that they eventually become comfortable with their ‘online social value’?

      Any thoughts Susan?

      • Susan Eller

        Brilliant normalization of my “why not me” moment. I do think that is important that recognized leaders in simulation can acknowledge the risks of social media, and admit they have felt the challenge too.

        I share your thought that we need to mindfully build up confidence on those who are hesitant to participate.

        On this forum, you have the time to answer replies – especially when you and I are the only ones talking at times :P. It is not always as easy to reply to comments on Twitter, as the questions and comments can get lost if you are not tagged and able to respond. I will say that one of the ways that I first learned how to navigate Twitter was through a weekly #RNchat. There were a couple of different moderators, and they were very good about spot checking each other and seeing that comments/questions were answered. The numbers were reasonable for that chat. I also participated in a Healthcare Social Media chat – and it was too easy to get ignored in that one. It is good if people would follow the nuggets you drop on Twitter and come here to comment AND how do we extend that conversation for those who would like to try Twitter.

        The other advantage for journal club is that the time difference is not as critical. I just got off a Zoom with Sarah and Steph, so I know that this time is okay, but it would need careful planning to choose a time that works for those most interested in contributing. Just some initial thoughts . Also, please keep doing all that your team is doing, including the podcasts. I have simulation people who tell me that they listen to the podcasts and learn, even if they are still just “lurking”, you are reaching them.

  • Christina Choung

    Hi sim friends,
    As Susan and Melissa have mentioned, thank you for being such thoughtful and great contributors to the sim vCoP! The sim community’s use of social media as an open access sharing platform is, for real, one of the contributing factors for why I’ve chosen to dive deep into sim over the past few years. I’ve always been a huge fan of the community’s ethos of open access sharing, discussion, creative uses of technology, and thirst for improvement. Likely because of the time and environment I grew up in, I’ve been I’ve always been a fan of virtual communities and communications – from mIRC and Geocities, to Reddit and Instagram, I’ve learned a lot from folks with niche interests. We may only be a few here and there, but worldwide, there are lots of us! =)
    Even within our province (British Columbia, Canada), we have a sim vCoP. As an active participant in the group, I really appreciate the ability to share and learn from others who are working in a similar context and facing similar challenges. What I particularly enjoy about the virtual part of this group is the mix of synchronous and asynchronous activities. We video conference once a month in real time (whoever can or would like to join is invited), and do follow-up and sporadically reach out to each other over e-mail in-between. There’s also a monthly, synchronous sim journal club hosted by one of the sites via video conference. To be honest, some of the video conferences can be a bit socially awkward and stilted due to the medium – what I find really brings it all together is when we meet IRL. This doesn’t happen often – maybe once a year at various events such as local conferences or special events – but like David in the story at IMSH, being together in person makes a huge difference.
    What I’d like to hear about from others is whether they were brought into the world of vCoPs because of simulation or academia or, like me, were already drawn to the medium and found great alignment? I ask this for a few reasons: when this article was first published, I found myself very excited as I now had a primer to direct social media n00bs to. (Along with this fantastic resource from the BC Patient Safety ad Quality Council: https://bcpsqc.ca/resource/twitter-guide-health-care-professionals/twitter-for-healthcare-professionals/ ) Many folks ask me about social media (especially Twitter) and how to use it for academic or professional reasons because they’re not at all familiar with it. They’d like to be, but as Ben mentioned, are overwhelmed when trying to digest the content and “keep up”. Also, in discussions with those whom (I hope) I’ve successfully aided in approaching our sim vCoP, many people’s stories of how they find it and their level of participation varies greatly. I find it fascinating how it’s easier for some to dive right in, while for others (as Susan has mentioned) it can be incredibly nerve-wracking. I often wonder whether those of us who are active participants online do so because of familiarity with the medium, enjoyment, confidence in the subject matter, moral obligation to grow our collective knowledge, or something altogether different?
    Finally, the possible negative consequences to engaging in our sim vCoP – the echo chamber, and the influencers. I think both have to do with representation and diversity of ideas. The echo chamber’s been mentioned quite a bit on Simulcast – are those of us who are active online all drinking the same Kool-Aid? Is there something about people who choose to participate online which skewers the representation of ideas about sim? There are heaps of folks doing sim who have lots of original ideas, innovative solutions, and contributions to make which are different from what’s posted and available online – we can’t forget about them! The idea of influencers is similar, but a little different in that it’s a question of whether the online sim folks with the most reach are directing or nudging sim culture and knowledge in a particular direction. Are these concerns valid? Do they mirror academic publishing? How do we protect against them?

    Thanks, as always, for a great discussion!

    • Ben Symon Post author

      Hi Christina, what a great response with such thought provoking questions.
      Re : motivation for joining vCoP , I would say that my main initial motivation (for the journal club anyway) was for a sense of accountability. If I made a commitment to myself to read a paper a month I knew I’d eventually fail and rationalise, but I’ve always found myself better at keeping commitments when I’ve made them to others (not always! But the internal pressure is stronger!).

      For example my original journal club was an email list, but after a few months there was a marked enthusiasm gap and a drop in responses and an increase in me begging. With mentorship from Jesse and Vic, I was lucky to join them and move to a more effective open access platform.

      Your question about the echo chamber and role of influencers is an interesting one. I agree #FOAMSim influences may indeed have a larger degree of influence on conversations in Sim than those who do not jump in on social media. I hope that reflects in some way their passion and contribution to the community, but I would say I’ve seen in other fields as well sometimes an inexperienced trainee being put forward as an expert in their field based on their Kardashian Index more than their training or clinical acumen. Having said that I think many enthusiasts start with being translators and promoters, harvesting their enthusiasm for good use in sharing good work, before moving up Blooms Taxonomy to sharing their own thoughts.

  • Melissa Morris

    In response to Christina who asked “What I’d like to hear about from others is whether they were brought into the world of vCoPs because of simulation or academia or, like me, were already drawn to the medium and found great alignment”?
    I stumbled upon all of it. When I first started, I had no background and no mentor. I literally was shown the sim lab on a Wednesday as a grad student, the last day for the previous sim coordinator, and was the sim coordinator on Monday. I knew how to turn on the computer and the lights. Through word of mouth, I used my natural disposition for research and diving down “rabbit holes” and found information online. Facebook was new; twitter was new; Instagram may not have even existed. I don’t think I even knew what a blog or listserve was. But as the webpages started including signups for newsletters and “blogs,” I started signing up, and it all led me to be online. So it was for me because of simulation and wanting to know more and having a desire for best practices for academic simulations for training health care professionals. In many of my “other” positions before academia, my role included identification of best practices, and I wrote and rewrote policies and procedures, and aligned practices in various healthcare provider settings to standards for best practices and accreditation. It was while I was looking for that type of guidance that I fell upon VCoP.

  • Huon

    A. timely paper and a nice synthesis of what is out there. I confess that although I was an early adopter of social media – Twitter, WhatsApp groups, blogs etc – my enthusiasm waned as I became overwhelmed by the sheer quantity of interactions and time necessary for thoughtful engagment. And yes, the nervous anxiety of having to check or respond or be insightful too because although its ‘social’ it’s professional. I need to learn to filter more effectively and a casual look at some of the sites in the paper has rekindled by interest to re-engage.

    • Ben Symon Post author

      Thanks for coming Huon!
      It sounds like a pretty common experience to be a bit flooded with resources initially to the point it’s all off putting. I wonder how we as a Sim Community can better curate our resources?
      Thoughts?

    • susan somerville

      Hi Ben, what a timely journal club article this month.
      I am a typical lurker on social media generally so I am bobbing up here to share some stuff for the first time. My day job in Med Ed in Dundee, Scotland is to deliver a blended learning module on simulation and we have signposted to your website and in particular the podcasts which relate to the articles in our reading list. Our program students are distance learners but our sim module has a f2f component. So this article really strikes a chord as we aim to nurture a virtual learning community over a period of 4 weeks then meet and work collaboratively f2f (happened last week) and then stay in contact sharing video and text based samples of their simulation work and engage in peer feedback as part of our formative assignment activities. All of which resonates with this paper and participatory learning.
      Whilst our module has online discussion boards and activities to engage in small group work the asynchronous nature of this given the varying time zones and busy lives of our clinical participants does not always lend itself to being a vibrant platform for maintaining the energy levels and dialogue before and after the f2f experience. I’d love to hear from others with this kind of experience or advice to share, and interested in what Christina is suggesting.
      Student led WhatsApp groups tend to be our online students’ preferred mode of communication, and the feedback about these is very positive amongst students, although it probably creates a degree of FOMO amongst the tutors!  I might propose that the cohorts take it in turns to share a weekly module post to tell us what we are missing or to ask questions on behalf of the group. I say this also because we have had recent experience, albeit isolated, of negative behaviours breaching psychological safety in WhatsApp chats which we have no means of moderating.
      My social media preference is using twitter to connect with simulation, and I follow lots of sim people to keep in touch with what’s happening, or what I maybe missed such as your ‘simulcast old stuff’ posts from Jess Spur. The list of names on P126 of the article has given me a few more twitter names to add. I’m also hugely grateful for signposts to academic literature on twitter, and seem to recall there was a publication about the use of twitter for literature searching, anyone remember that?
      As Susan (Eller) has suggested I often have a FOMO moment when I see what others are up to at conferences, but it’s great to hear the positive reflections being shared, and feeling in contact and part of the community of practice. I also have imposter syndrome anxiety about posting online outwith the confines of my own setting, but since I am regularly telling colleagues and signposting students to the fantastic work you do on SIMULCAST I think it’s time I put my money where my mouth is!
      Sorry this is turning into a long thread!, but one more thing to add, I am a realist research student and one of the most amazing online communities of practice I have ever encountered is the RAMESES network which brings together experts and novices in a vibrant email exchange if you are interested look here: http://ramesesproject.org/Mailing_list.php and here: https://www.jiscmail.ac.uk/cgi-bin/webadmin?A0=RAMESES
      Gabe Reedy has recently emailed through the same jiscmail platform regards the Simulation Research Network – SIREN for SESAM, so I hope this also becomes another way to connect and network with the simulation community?
      Thanks for the excellent work you do here and making the simulation world smaller and more connected. :))
      P.s. off to look up the wenge-trayner link now

      • Benjamin Symon

        Hi Susan!
        Thankyou so much for coming along and making an active contribution! I’m not sure but I think you’re our first post from Scotland? That I’m aware of anyway :p

        Your post was fascinating in that it brought out some specifics that I hadn’t really thought about heaps. Firstly, I note that you state your students strongly prefer WhatsApp but that you cannot facilitate or moderate the discussion. Do you think the student preference is influenced more by the familiarity with the technology or with the fact that you can’t moderate? It’s always been fascinating how hard it is to break down implicit hierarchies early in relationships, and I wonder if having a private conversation on WhatsApp with other students is similar to how people are often keen to lurk on the Simulcast Journal Club but nervous about commenting?

        I guess my question to you would be, “Is there a way you can make the experience on your moderated platform so good that the benefits of using WhatsApp are outweighed by the educational benefits?”, and you also inquired about tips for creating an engaging online discussion. One resource that I found really useful for facilitating asynchronous online conversations is the work of Jakko van der Pol : Facilitating Online Learning Conversations.

        Within that work, van der Pol argues that at their base level, online discussion can have a tendency to be a series of monologues rather than an effective dialogue. In analysing arguments in general, he quotes ‘Kuhn and Goh ‘ who describe this phenomena as allowing the activity to “relapse into nothing but consecutive self expression, first on the part of one student, then another. It does not matter much what each student says, and no student need listen to another. In this worst-case scenario, the only attention the next student pays to the speaker is to wait to observe a signal that this speaker is about to finish, so that he or she can begin. As long as everyone gets their share of turns to speak and no one speaks too long, there is a wealth of opportunity for self-expression. Yet, no further purpose is fulfilled.”.

        To me this is a reminder that when facilitating online discussion, it’s important to deliberately make conversational connections between different participants. In doing so, the facilitator can shift “a critical and opinion centered debate” to “a more constructive conversation that is aimed at the processing of content and a deepening of understanding.” .

        Thankyou so much for joining us Susan, I hope you stay with us for some further discussion and that maybe you’ll inspire some of your students too !

        • susan somerville

          Hi Ben, thanks for the warm welcome, I know other colleagues in Scotland are fans of Simulcast.
          In response to your thought-provoking reply, I do consider the students comfort with WhatsApp is technology and visibility driven.
          The Moodle platform which we use is one I like compared to Blackboard which I have prior experience of, however, it is not one I have used on a handheld device, although it is possible, tho’ some of its functions don’t work in tablets. So it is very likely the convenience and comfort of WhatsApp – being able to reply on the move and moreover being safe in the knowledge there aren’t too many people ‘watching’ since they probably engage in smaller groups and with an element of those you’ve self-selected to participate with as well. There are many other variables as ‘online learners’ as opposed to peers meeting at a conference – the original focus for this journal club, what is their motivation for engagement?, the considerable cultural diversity in our cohorts likely influences the perceived hierarchy and formality of the teacher-learner relationships online, and perhaps peer to peer as well? ….. Lots to think about, and so I really appreciate the additional reading you’ve pointed to because it exactly describes some of the behaviours we have observed and the conversations colleagues and I have been having about monologues and dialogues and long ‘discussion’ threads, and we have started thinking about what works, for whom and why …. etc – my Realist hat again! :)) Talking of which here is an article of relevance which others may be interested in: Wong, G., Greenhalgh, T., & Pawson, R. (2010). Internet-based medical education: a realist review of what works, for whom and in what circumstances. BMC medical education, 10(1), 12. So thank you again for demonstrating this practice so effectively, I will look for an opportunity to respond to someone else’s post now, definitely feeling hooked in! Speak again soon.

    • ben lawton

      Hey Ben – just a quick comment specifically in regard to your question about the Wenger model. This is the first time I have come across it but it strikes me as one of those papers that does a good job of clearly stating the obvious. I think many people consciously involved with a community of practice would look at Wenger’s model and find it easily recognisable but, as we have discussed with regards to other concepts (SimZones, Kerns model) I think sometimes these ways of precisely framing a concept that is widely but loosely understood are helpful for a) clarifying what we are talking about and b) framing a concept for those who do not yet have a tacit understanding of that concept. This article is a good example of using that frame to present an academically rigorous account of a cultural phenomenon that many people could have described but less articulately and less precisely than the authors of this paper have done.

      • tina haffenden

        Hi everyone,
        So I’ve been deliberating on whether to reply on here or not all afternoon for exactly the reasons discussed in some of the above comments. I have always been the social lurker I guess, terrified of making that one tweet that nobody responds to or quoting some reference that is already old news but I thought it was fab!
        But here I am taking the plunge! This paper and all of the above comments have given me the green light! I have decided to stop worrying about the consequences of placing a tweet or post or whatever the term is these days…..So many times I’ve sat and wanted to ask a question within a CoP but didn’t for fear of retribution then the person in the next row asks that one question and a whole discussion commences….damn! Why didn’t I ask?!
        As for the Wenger-Trayner model I wish I had known about this when trying to create a vCoP for my recent post grad, the group may have been more successful! The concept is perfect and applies to so many areas in our lives not just at work. I do wonder how to overcome stronger personalities within a large group who can once again belittle colleagues. I guess role modelling positive behaviour particularly towards learning is a must.
        Right I feel like I’m waffling know, Looking forward to reading more comments!

        • Ben Symon Post author

          Hi Tina! Thanks so much for coming, I’m so excited to have you join us! It’s interesting how universal that imposter syndrome feeling can be, although the more comfortable I feel asking seemingly stupid questions the more I’ve realised other people don’t know the answer either. (Try asking why we give phenobarbitone to infants with status epileptic is rather than phenytoin for example, and I rarely get anything beyond ‘it’s in the protocol’). Each time that happens I feel more comfortable realising that asking the question contributes to the psych safety of others : if they can see me ask a question and not get slammed for it, and not be ashamed of not knowing something, then maybe I’ve helped make not knowing something Ok.

          With regard to dominant/hypercritical personalities I agree it’s a risk, although I feel like in the online world we sometimes have more tools to prevent this than in real life! For example if someone says something inappropriate on Simulcast JC I can just delete their message. It’s only happened twice in 3 yrs though, and more often I’ll have a comment I’m concerned crosses some boundaries and instead of editing it I’ll publish it but respond with my concerns transparently, so that other people know the behavioural expectations as well.

          Glad you liked the Wenger model, I agree it’s a useful checkpoint for reflection when trying to create any online community.

      • Ben Symon Post author

        Thanks B1,
        Yes as we’ve discussed IRL I vacillate between being underwhelmed with papers that seem obvious in retrospect and then marvelling at how well they improve the sophistication of the conversation due to clarifying the things that don’t seem obvious until somebody summarises it well.

        To me this paper fits well as a great introduction to social media and tips for engagement for those who have not engaged previously or need some motivation to re-engage.

    • Komal Bajaj

      What a lovely kick-off to 2020’s journal club! I will say, when I was first advised to join social media, I sobbed and said I couldn’t fathom how I would do it (picture the scene – 10 month twins – one in each arm). I was advised by some very wise folks @harvardmacy to schedule in 10 minutes per week in my work life to start. Needless to say, I haven’t looked back. It’s so much fun to learn and share with the vCoP, not to mention the joy of actually meeting someone IRL (I was walking at IMSH one year and ran into this journal club’s very own Ben Symon for the first time – through my grin for meeting the master of sim-drama vignettes, all I could manage to say was “you look like your photo!”).

      On the topic of maintaining a personal and professional account, I found that to be too challenging to manage so I stopped. For me, the lines between Komal the mom, wife, CQO, simulationista were so foggy that I just went with bringing my messy human self to one account.

      • Ben Symon Post author

        Haha I can hardly imagine the sophisticated and media savvy Komal Bajaj being overwhelmed at the thought of social media interactions! (Well the twins bit made sense though, one was enough drama for me!).

        Starting with a regular toe dip makes sense though! I remember messaging Ben Lawton after installing twitter, cynically stating that it seemed to be an echo of self congratulation and promotion, to which he replied an enigmatic ‘sometimes’. But slowly I got sucked in :p

        I love the point you make about the cost of dividing yourself up into different virtual aspects of yourself, and it makes sense to me to not divide that way.

    • Jenny Rudolph

      Hello Ben and Journal Club Colleagues,
      Have really enjoyed watching this conversation inspired by “Establishing a Virtual Community of Practice in Simulation” by Thoma et al. unfold. Reading through the posts, I realized that the dialogue itself illustrates many key aspects of CoP’s*. I’d like to highlight two: Creating a community of practice by “enacting” it; 2) Constructing our identities as we learn.
      1) “Enacting” our community of practice. Lave and Wenger think that communities of practice act “as a living curriculum for the apprentice” and, I would add, for any colleague in the community wanting to learn or innovate. A number of contributors to this conversation have generously conveyed how they learned via a Virtual Communities of Practice (VCoP’s):
      • Melisa Morris: “Twitter has been a great resource for me. It has allowed me to find new and up and coming ideas and information, as well as stay in touch with simulation champions that I have met at various events.”;
      • Susan Eller: “I will say Twitter has been a great medium for me, as I have interacted with so many incredible educators online – and presented at conferences with two or three that I first met online at Twitter. It has enhanced my conference experience not only by sharing links and thoughts, but by prompting IRL interactions.”
      • Christina Choung: I really appreciate the ability to share and learn from others who are working in a similar context and facing similar challenges

      By talking about how and what they learn and value, Melissa, Susan are creating (aka enacting) the learning community.

      At the same time, Ben Symon’s encouraging yet rigorous facilitation enacts norms of 1) valuing psychological safety (making the CoP secure for interpersonal risk taking); 2) listening and responding (by tying comments together) and 3) a high standard for engagement (by asking more of us via follow up questions). As Susan Eller noted, “[Ben’s} diligence in answering all the comments posted on the journal club demonstrates respect and generates further discussion.

      2) Constructing identity is also part of learning.
      • VCoP’s help us construct our identities by allowing us to “try on” or express who we want to be or how we wish to be seen. (e.g. I am “signaling” my identity as a social scientist by way I am writing this post :- )). Though we may think about learning as “acquiring knowledge” and a primarily individual activity, “workplace learning [in CoP’s] is best understood, then, in terms of the communities being formed or joined and personal identities being changed.” (Seely Brown & Daguid, 1991).
      • Risk-taking to become an “insider”. Learning in a CoP is about the journey to becoming an insider. Lave and Wenger’s somewhat arcane term for learning as a newcomer was “Legitimate peripheral participation.” Moving from the periphery toward an insider identity requires some risk-taking as Houn noted: “…the nervous anxiety of having to check or respond or be insightful too because although its ‘social’ it’s professional.” Part of what we are doing in this journal club, they would argue “is becoming a practitioner not [only] learning about practice.”
      • But also a safe path to becoming an insider: But VCoP’s provide a relatively safe path for that as Susan Eller describes: “first I lurked, then I started posting, and have worked my way towards collaborating with other educators on scholarly projects. “

      * The concepts of “enacting the community” and “identity construction” drawn from: Organizational Learning and Communities-of-Practice: Toward a Unified View of Working, Learning, and Innovation by John Seely Brown and Paul Duguid; Organization Science, Vol. 2, No. 1, (1991), pp. 40-57. https://pdfs.semanticscholar.org/92f9/30c82c44515622cc04819ae2f1cdfb2746ca.pdf?_ga=2.128003532.13478516.1582416789-1835426515.1582416789

      • Ben Symon

        Hello dear Jenny,

        Thank-you so much for your comments and ‘meta’ look at the process of the journal club itself.
        I enjoyed your explanation and break down regarding the ‘enacting’ of the virtual community of practice and the examples from within our own conversation that came with it. But to me you really pushed my understanding of virtual communities of practice with your focus on part 2) Constructing identity as part of learning.

        While I was aware of the concept of ‘legitimate peripheral participation’ thanks to a paper we’ve been working on, I had thought of it very specifically as part of the work to become socialised/accepted within a specific group. I hadn’t thought about it from the perspective of being able to ‘try on’ different aspects of ourselves within that group’s space. When I think of this within the simulcast journal club, for example, I think I emphasise approachability and fallibility very heavily within this context, and I think there are other areas in my life where I do this less. (There are risks, for example of demonstrating excessive fallability in my clinical workspace for example, even though I strongly value those principles in my work life, I don’t think I would emphasise them to the extent I do here.).

        I would also like to take a moment to appreciate your role modelling as well : your examples make sure to acknowledge the thoughts of multiple members of our group, appropriately quoting and giving structure to their responses by incorporating it within your argument. Thanks for pointing some of these things out to me in your email, I wondered if you would consider sharing more of your knowledge on CoP given there will be readers here keen for a deeper dive?

        • Jenny Rudolph

          Thanks for the invite, Ben! One of the goals of my post was to take our community back to two of the roots of the research and the “the point” of communities of practice, to help us get our work done, and the “hidden curriculum” of professional identity constuction. The explicit “common enterprise” to which you refer, Ben, in your query is getting our work done; the implicit enterprise is building, signaling, and in a supportive community, nurturing new identity formation.

          Work: When Orr first studied communities of practice in Menlo Park California (?) in the late 80s he was looking at Xerox repair people. There were no cell phones and nobody even knew what is xerox machine (Dry copier) even was. So the community of repair (mostly) men had to call each other on pay phones meet after work and figure out how to fix the machines. They needed each other to figure out how to do the work.

          You pointed us to this resource:

          “Communities of practice enable practitioners to take collective responsibility for managing the knowledge they need, recognizing that, given the proper structure, they are in the best position to do so.”

          Identity: However, the copier repair technicians were also establishing identities in a new profession and that identity journey is part of the (hidden) curriculum in communities of practice. How do we become the (accepted) professionals or practitioners of our new profession?

          As I read through the posts, I noticed that as many of us have tried to figure out how to use online resources, “dip a toe into” or “plunge” into a community, we’ve needed each other to figure it out. We’ve emulated people who are more comfortable or are ahead of us in using different media, have more established voices, and we rely on emulating them and getting support from each other to get better.

          What does it mean to construct an identity as a (fill in the blank)? This identity construction is part of what makes learning such a relational process, because it involves the important distinction Brené Brown has identified between “trying to fit in” and “belonging”. Part of the learning supported by journal club appears to be what org behavior scholar Hermina Ibarra calls trying on “provisional identities” as part of the learning process.

          In the journal club, you have supported the journey newcomers or “apprentices” take to move from the “periphery” to “fit in.” I believe your kindly, yet rigorous approach helps people work at the edge of their expertise to move toward a feeling of belonging.

          Any of us, at any time, can be newcomers or learners with respect to a community of practice new to us. Therefore, incumbents or veterans have the responsibility of supporting these “provisional identities” with positive regard and curiosity while also helping others understand and reach the standards or norms of the community.

          As an “incumbent” or “veteran” in the scholarly content of the community, (but a relative new-comer in the social media enhanced on-line learning space), I thought I’d also clarify some choices I made in my original post: you may have noticed I used full names and explained my thinking as much as possible, with the impact of making it sound a little more formal than I normally would. This is because I am not sure how many of the lurkers on the Journal club are familiar with the people who are posting, or the abbreviations used in those posts such as (SSH, CMS, INACSL).

          Learning the specialized language of a new profession is, in and of itself, an exemplar of from the periphery to the core in your participation is part of the learning process. (E.g. The “patient is tachycardic and tachypneic” versus “granny says her heart is racing and she is breathing too fast!”).

          I’m not saying we should unpack those details (every last name, every abbreviation) it is just that as we write posts were implicitly making choices about whether we’re writing for the core, the committed, or the periphery. As educators, I think we often try to toggle among those things. I made a choice to some degree of being more explicit in service of communicating both to people “in the know” as well as those more “on the periphery” to some degree.

          Welcome your and others’ thoughts on this!

  • Tricia Pilotto

    OK, so this is me going from a stage 3 consumer to a stage 4 collaborator! Just dipping my toe in on this one Ben. Thanks for including this article in your journal club. Reading this has helped me “normalising” the concerns I have and many have expressed on here in regards to exposing our thoughts/opinions/experiences in an online vCOP. I had that “Ohhh, so it’s not just me” moment. I too have spent many hours trawling through twitter feeds, only to feel a bit lost in the volume of content and subsequently giving up! I have since resorted to using twitter only for when I’m at a conference. I’m feeling inspired to give it another go after reading the tips in the article and from fellow collaborators.

    • Ben Symon Post author

      Welcome Tricia! So glad to have you take a dive and join us! Tina mentioned the imposter syndrome as well, and it fascinates me how much power that holds over all of us. Like going to a conference and seeing everybody avoid the front set of tables or rows, it’s a very universal experience. Hopefully good responses can slowly build your confidence, and that of others!

  • Sarah Janssens

    Mater Curry Club – posted on behalf of Katy Culliney, Sonia Twigg, Prue Upson and Sharon Clipperton.

    “Inspired” was the opening theme of our conversation which I jotted down on the back of the article between mouthfuls of poppadum’s. Prue and Katy admitted they were inspired to join Twitter after reading this article; only to discover that they already had accounts! They pondered if they had joined many years ago at some unspecified conference, only to forget the very existence of the account, and of course the password! Perhaps this time, surrounded by an ongoing “live” COP, they’ll jump back into the virtual one and stick around. They commented that the Maslow’s hierarchy of needs analogy has empowered them to feel comfortable with “lurking” at first. The concept of the synergistic action of in person and on line activities within the COP got a lot of traction at our Curry Club. During the in-person activities, not only does one get to enjoy the fine spices of Northern India; social risk is lower, and contributions to the conversation seem less permanent (until now). By observing others in the group live tweeting empty curry bowls and being responded to, they can see how easy and fun Twitter can be– one doesn’t always have to say something profound when tweeting – right?
    The concept of live events drawing people into the vCOP wasn’t really discussed in the paper, rather the authors talked about how conferences are an opportunity for the vCOP to meet in real life. In this vein, Sonia brought up how SMACC and DFTB encouraged many people not previously engaged in social media to join up. This cycle of face to face, online and face to face encounters, seems to be a re-inforcing cycle driving ongoing engagement. So – more regular curry is a must! (Perhaps we can name this the “curry-tweet-curry-tweet” effect)

    We agreed with the importance of highlighting the risks of social media. To be cognizant of the power of the echo chamber and careful of misinterpretation, superficiality or blind spots. Prue added in “champion bias” – when our heroes unduly influence our thinking. Should Twitter chats become Twitter debates to encourage diversity of views? Despite the drawbacks, we discussed the concept that vCOP’s allow communication and learning in the “interstitial spaces” of our lives, delivering information in increasingly accessible and bite sized chunks – a significant advantage for busy clinician educators. While the entry bar to participate is low in social media, which the authors suggest encourages “democratization”; in reality the list of “prominent” sim educators on Twitter was strongly Anglo-American with only three countries outside of UK, AUS, Canada and USA represented. We pondered why this was – what do others think?

    • Ben Symon

      Hi Sarah and the Mater Curry Club ™!
      Thanks so much for coming together to join the paper in both your virtual and irl communities of practice! I was so happy to see Sonia there as well!
      I really loved that you emphasised the synergistic benefits of mixing virtual and real life communities together, and I would have to say that even though we’ve been going for 3 years now, most of the people who post regularly on the journal club are people I’ve at least had the pleasure to meet face to face a few times, and I do think that lowers the social risk.
      It is interesting to me (as someone frequently overwhelmed at the social complexity of large gatherings of people and the small talk that I might need to produce in that context) to hear you mention at the social risk is LOWER in the face to face group, than it is in an online group. Part of me was surprised, because in some ways to me the interactions and relationships I have with people in real life have higher social value to me than a relationship on an online message board. Do you think that the perception of higher social risk in an online community reflects the fact that we can’t measure the response well? I can adjust my tone and words at the curry club on the fly to respond to non verbal or verbal cues from other group members, but on the internet I don’t have that feedback to help sugarcoat or mitigate my thoughts?

      Some of my colleagues mentioned that the reputation for conversations on the internet is so low that the journal club has to ‘overcome the burden’ of internet message board’s reputation, and people need to try it out themselves to realise the response won’t be acidic.

      Interesting stuff! Thankyou so much!

      • Sarah Janssens

        Ben your thoughtful comments on social risk on line vs in person do reveal a paradox. Maybe it is tied up with Jenny’s comments on how participation in COP creates an identity. Many social media contributions (FB,Twitter) might be considered low risk due to relative anonymity or the use of pseudonyms, but in our vCOP this isn’t quite so – I feel I have to be “Dr Janssens Sim Director” online, and sound smart and thoughtful (really hard to do following posts by Jenny Rudolph!). At face to face meetings, particularly less formal, I can relax into being more the “social me” as there will be no permanent record of my doings – lower risk. But, give me a pseudonym or group where I have less on the line from an identity perspective – then perhaps I’d be much less professional. It would be an interesting experiment to take away the requirement for name and email address and observe for a difference in the volume, tone or content of the online discussion!

        • Ben Symon Post author

          Interesting! Thanks for that perspective, funnily enough anyone can write under a pseudonym here, occasionally people do, or with their first name only, but it’s pretty rare to do so.

  • Walter Eppich

    Hello to Ben and so many friends and colleagues who have chimed in on this thread!

    So lovely to read the most thoughtful comments and gratifying to see that our paper could inspire so much rich discussion. I echo the all of the sentiments in honor of our fearless leader, Ben. You have not only enacted the vCoP, you also masterfully sustain it!

    I apologize for the brevity of my post, yet the potential for social media to pull time away from other important goals makes it one of the challenging aspects for me. Before you know it, 30 min have passed.

    Greetings to all!

  • Veevek Thankey

    Many apologies for coming into this journal club late in the month!

    I agree with many of the contributors (Melissa, Susan, Christina) and Jenny has provided a great summary with regards to how people have learned via a vCoP.

    The paper highlights that “social media facilitates the development of vCoP by connecting people with common areas of interests and making their contributions/knowledge publically accessable”.

    Having been a serial conference attender (which definitely sees a spike in my tweets), I agree that the in-person connectivity compliments the vCoP. I have made friends from interacting with people on the social media platform, and then meeting them in real-life at a conference.

    Tricia’s comment on normalising concerns regarding “exposing our thoughts/opinions/experiences in an online vCOP” is very real and often can prevent people from fully engaging in the online community. The notion of “long time lurker, short time poster” shows that the psychological safety in the virtual realm would be more difficult to attain.

    • Ben Symon Post author

      Thanks for coming Veevek! I’m just about to start recording the podcast with Vic, so you made it with ample time to spare :p
      The in-person connectivity + social media as ‘relationship maintenance’ seems to be a pretty effective model for a lot of people. I find it a bit limiting in that if we limit our online academic relationships to people we’ve met in real life we are in some ways limiting the possibilities, but given how consistently this is commented of, face to face meetings clearly answer an important relational need.
      Any idea what it is?