On participating in academic conversations

Academic journals serve an important function in the evolution of a field or profession. For some, journals are where they can share ideas, tell others about the interesting work, or to disseminate information. We would argue that these are limiting and at times flawed views. We prefer to think of Paramedicine as a means of promoting scholarly ‘conversations’ not just among ourselves and our readership, but with the broader academic community who most likely have something to say about our selected ideas and topics. Scholars have talked about this ‘journal-as-conversation’ or used this conversational metaphor before. ¹ Scientific contributions and the preparation of manuscripts is a social conversational act, and we believe, should be thought of as equivalent to having turns saying something that contributes to conversations and debates that surround us. In our experience considering manuscripts for these academic conversations, all too often, it involves authors narrowing the conversation only to those immediately next to them. In this editorial we call on authors to engage in this conversational metaphor by considering when broadening that conversation beyond paramedicine is needed and appropriate.

Consider an academic who is just starting to join a ‘conversation’. In their enthusiasm to get started, several study ideas, research questions, and even methods flood their thinking. Suppose the topic area is assessment of clinical competence, specifically the assessment of dyads (paramedic crews or teams) in the jurisdictional paramedic service context. They scour the paramedicine literature and recognize, appropriately, that assessment in paramedicine has been narrowly focused on decisions regarding an individual, ² when really, patient outcomes are dependent on the ability of teams (in our case dyads) to function optimally together, when working together. The issue is that when decisions about individuals need to be made about readiness for independent practice for example, we often assess individuals and silence the contributions of others. Those who are involved in summative assessments (e.g. for hiring, for licensure/certification) will recognize this challenge. An idea emerges to create a new tool or process, one that permits the assessment of dyads and their contributions and synergies or threats, and that somehow allows for decisions about individuals while permitting the influence of another individual. The academic proposes the idea, arguing that no one in paramedicine has sufficiently resolved this issue—and they might even be correct. The study is designed and conducted, interesting results are generated, and the academic prepares and submits the manuscript for publication to Paramedicine. In doing so, the author sets up the study in the introduction, arguing that paramedicine has excluded this concept, and uses that as justification for the work, rather than the conceptual puzzle. The discussion section then positions the contribution as novel, and as a meaningful contribution to paramedicine (the profession) and Paramedicine (the journal). They would be correct, except for two significant issues.

First, this academic made the mistake of only considering the paramedicine literature. A common misconception that we see manifested in manuscripts submitted to Paramedicine is that the ‘conversation’ is with and about paramedicine (the profession). It is not, at least not entirely, and writing this way ought to be the exception, rather than the rule. Instead, we would expect this academic to have engaged in the ‘conversations’ surrounding the topic, even if outside of the paramedicine community, to identify conceptual frameworks, arguments, advances and gaps that our profession could then leverage. For example, the work of Sebok-Syer et al. seems relevant in the aforementioned assessment example despite being removed from the paramedicine community. ³ In education and elsewhere, there are several other examples of this. For instance, when leveraging the advancement of continuing professional development, Levinson et al. explored the ways researchers are navigating quality improvement initiatives and the relationship these concepts should then have with one another. ⁴ When trying to understand the unique contributions of various ‘learning conversations’ following experiential events, Tavares et al. examined several conceptual frameworks to gain insights. ⁵ Early on, when starting to advance simulation in health professions education, Gaba explored and leveraged the conversations occurring in aviation. ⁶

This leads us to the second conceptual mistake this academic made, and that we would like to avoid in Paramedicine. When we ask authors to evaluate and situate their work in the literature more broadly, rather than focusing solely on paramedicine, they often respond that paramedicine is special enough to warrant its separation. At times we are also ‘reminded’ of methodological conventions that prevent the kind of engagement with the literature we are seeking. We agree to a point. Context is meaningful and relevant and can be the phenomenon or construct under study, and there are certainly methodologies that treat engagement with the broader literature in specific ways. However, we cannot think of examples that would prevent joining a broader academic conversation regardless of paradigm or broad methodological traditions. Even when studying paramedicine directly, this can and should be anchored in the broader literature. For example, in studying the role of integration of community paramedicine programs, Allana et al. positioned the work within the broader integrated healthcare literature and the tensions that are relevant to not just paramedicine, but to integrated healthcare concepts overall.^7,8 Similarly, Brydges et al., in studying the professionalization projects of paramedicine (e.g. role of professional autonomy or higher education), anchored her work in the broader sociology of professions literature. ⁹

There is a reciprocal part of the ‘conversation’ that can be lost when we engage in ‘navel-gazing’, or when we believe our work is so rarified that it warrants its own space. When it is your turn to say something, say it with a broad community who is already having the conversation, and that likely means with those in and beyond the paramedicine literature. Also, allow the opportunity for what you have to say in Paramedicine to be heard and considered by others in that academic space for shared progress.

There are several other reasons for connecting the research to the broader literature. Our aim is not to provide guidance on how to conduct literature reviews. Instead, it is to encourage authors to leverage and engage readers in the contemporary (and classic if appropriate) discourse for a particular space; also, to prepare and invite readers into a fulsome and fair representation of the academic conversation. Engaging in academic conversations ensures contributions reflect the most recent advancements, both within and outside of paramedicine. In this still early evolution of paramedicine there is a need to engage with the work of others, to build upon existing knowledge and avoid isolating our profession. Connecting research to the broader literature can help to establish the significance of the work within the wider academic community. That is, by setting your research within the context of previous scholarship, you may illustrate the uniqueness and value of your work to the field.

We must continue to become increasingly sophisticated in expecting and participating in robust academic conversations within and adjacent to our profession. In the book by Graff and Birkenstein titled ‘They Say, I Say’, the authors use the ‘conversational’ metaphor throughout, and provide a series of rhetorical strategies. ¹⁰ For example, starting with what others say, the art of summarizing, different ways of responding, including why what you say matters, and how to enter conversations. ¹⁰ In Graff's earlier work on the broadening of academic conversations, he wrote, ‘listening to viewpoints different from one's own, summarizing them in ways others can recognize, comparing and contrasting positions, spotting contradictions and non-sequiturs, and coming to conclusions [is what] contributes to a continuing conversation of ideas’.^11(p.23) Our point is that failing to do so risks obscuring these continuities and again isolates our profession.

We leave you with a highly cited analogy by Kenneth Burke in ‘The Philosophy of Literary Form’, also used by Graff and Birkenstein:

You come late when you arrive, others have long preceded you, and they are engaged in a heated discussion, a discussion too heated for them to pause and tell you exactly what it's about…You listen for awhile, until you decide that you have caught the tenor of the argument; Then you put in your oar… someone answers, you answer him, another comes to your defence, another aligns himself against you…The hour grows late, you must depart and you do depart with the discussion still [hopefully] vigorously in progress.^{10(p.15,16), 12(p.110,111)}