Interdependence is one of many factors that influences collaborative health care practice

Sebok-Syer et al.1 describe that while clinical care is delivered collaboratively in a team, assessment of performance in that team is individual. This creates a conceptual paradox as we tend to think of competencies as residing in individuals yet the performance of a student or trainee is influenced by the team in which they work and by the clinical supervision they receive.

Sebok-Syer et al 1 describe that while clinical care is delivered collaboratively in a team, assessment of performance in that team is individual. This creates a conceptual paradox as we tend to think of competencies as residing in individuals yet the performance of a student or trainee is influenced by the team in which they work and by the clinical supervision they receive. This relationship has been termed interdependence and is defined as 'patterns of interaction between individuals, working collaboratively, that can afford or constrain one's performance and potentially shape the practice of a broader healthcare team' (page 2). 1 In their review paper, Sebok-Syer et al sought assessment approaches that included interdependent measures (ie those that consider both the individual and the team, with effort to capture both team and individual contributions). The concepts identified were diverse and only loosely related to health care assessment as it is typically operationalised: dyadic measurement (relevant to separating trainee from supervisor input), social network mapping (linking staff to certain clinical activities) and data mining and machine learning (eg linking Electronic Health Records to staff clicks). In doing so, the authors highlighted the importance of qualitative approaches to capture the complexities of health care and advised on the need for clarity of purpose for any future measure.
In considering these possibilities, we were struck by how our recent review of tools used to evaluate the impact of interprofessional education training programmes, 2 identified items that seem to capture the nature of interdependence without using that specific term. [3][4][5] Nonetheless, the items and descriptors of these tools align very closely with the concept of interdependence in the context of collaborative learning as described by Laal 6 where "interde- In conclusion, to achieve a better understanding of individual performance, within collaborative working, measuring one factor such as interdependence provides only a slice of insight. There are multiple variables within any given context that need to be considered and captured to gain a deeper understanding. The power of personalised, subjective but contextualised assessment and feedback cannot be ignored. This allows the assessor to capture and articulate complexity, provides rich information to prompt student reflection and development and offers comprehensive testimonials of current student performance for future clinical supervisors.
To achieve a better understanding of individual performance, within collaborative working, measuring one factor provides only a slice of insight.
There are multiple variables within any given context that need to be considered and captured to gain a deeper understanding.
The power of personalised, subjective but contextualised assessment and feedback cannot be ignored.
Contextualised assessment and feedback allows the assessor to capture and articulate complexity.
Capture and articulate complexity provides rich information to prompt student reflection and development and offers comprehensive testimonials of current student performance.

| INTRODUCTION
Balmer, Rosenblatt and Boyer call for those training medical educators to 'recast belonging to multiple communities of practice as knowledgeability, not as tension or identity crisis'. 1 Reinterpreting the experience of multi-membership as a strength is welcome. In this commentary, I suggest that graduate programmes may go further and aim to equip students to capitalize on this knowledgeability by calving out legitimate zones in the peripheries, by becoming brokers at boundaries, and by handling the conflicts that often emerge from claims to multiple competencies.
Reinterpreting the experience of multi-membership as a strength is welcome.
In earlier phases of Etienne Wenger-Trayner's work, he described how learners move from legitimate peripheral participation to core membership. 2 He situated this process within a community of practice, characterised by shared domain, shared practices, and community relationships. 2 The landscapes of practice model-