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Welcome back. Last episode we talked with Dr. Matthew Byrne to explore what it means to innovate in the third space. Today we return to revisit the third space and discuss more about opportunities for health care to problem solve in this creative and diverse space. Thank you for joining us. You know when you say that when it doesn't have a name it's hard to talk about it's hard to formalize it as an idea as something valuable, it's hard to build it and create it and foster it.
But then once you put a name on it then...all of a sudden it loses some of its magic, maybe? Like then it becomes a thing that you have to become or thing you have to do and or thing that people may try to fit into and maybe it's not as organic and then it becomes like a like another role, like another thing. You know what I mean? It can lose some of its...
power? Specialness? Power is the wrong word but yeah. I think maybe this is connected to boundaries because when you start to name it, it starts to become this entity, this thing. Well, an entity and a thing has boundaries right? It has competencies and yeah exactly it has boundaries. Right, and the whole way, if I'm hearing you right Matt and understanding this, is the whole idea is letting go of those boundaries, right, and opening our minds to seeing and thinking
in different ways. So I'm with you Michelle on this meta thinking here. I think it does... It's a dilemma. It is a dilemma, but I think some of the idea here is that when you do open those boundaries and create that sort of intellectual diffusion that doesn't mean you
stay in that state forever. I mean, ideally you leave that space and return with maybe reconstructive thinking or a better understanding of where it's good to have diffuse boundaries and where it isn't, but also you've maybe expanded your intellectual footprint because you're now more empathetic and more understanding of another person's perspective. I mean, that's part of why
we do the work we do around building cultural humility. We expose our students to situations and people that they normally wouldn't be exposed to to build their empathy and humility. I think the same thing can happen in the third space where you want to expand yourself and expand your comfort zone for the greater good of whatever you're talking about. But yeah, it can be tricky and I don't think it's going to lose specialness by naming it. If
anything, I think it'll help. It'll help us move into a situation where we can intentionally create third spaces to address the thorny problems we have in front of us, and one of the things I've been thinking a ton about lately is this ChatGPT. I don't know if you guys have heard about that yet. It's basically a piece of artificial intelligence software you type in - write me a birthday card in Shakespearean language and it will spit that out by looking
at everything on the internet. Well, it's about to have a radical impact on teaching and learning for us because students could just type in - write me a treatise on how Florence Nightingale impacted modern nursing and it will just go score the internet and write you a paper about that.
When I think about third space, it's like, well I have to approach this problem, this learning problem, as an academic, as a technologist, as a philosopher, as an academic administrator, and figure out like is the tool inherently evil or is it just a tool?And how do we navigate this for students? I think this third space is going to become super...it is super important and will become progressively more important as our problems become thornier
and more complex. They're not just a single lane issue like ChatGPT, they're a multi-lane issue that requires us to think in really different ways than we have before about how to address it. That's a phenomenal example. I appreciate you sharing that because that brings this to life more for me to help me understand more about this concept of third spacings. Looking back I can recognize moments in time in my career where I really have...tried to create
a third space. I don't know whether we got there or not, or maybe we needed one and it wasn't totally. There's so much processing and running for me. I think that I agree with you. I agree both when you name it, right, then it
becomes this thing. I also agree that we still need to name it, right, because we got to name it to be able to recognize it so that we can figure out how do we help create more opportunities and equip people with the skills to be able to cognitive, it's I think it's a cognitive shift, right? It's a mindset and then I think about the cognitive fatigue that goes into that.
I see a ton of research in this area of just understanding not only more about it but how do we help be able to transition into it, transition out of it? When do we transition into it, when do we transition out of it? I think that's what's new in this space for me. I've been reading all this multi-disciplinary articles about it and whatever else. I think there's still a lot of
conceptual confusion. There's a lot of mixing up of like what is participatory design, which is a research approach that might use a third space to bring participants in, but those are conflated. I think you see confusion about a third space professional and a third space where you might bring third space professionals together and then you see all these different words. You see transformative collaboration.
You see knowledge synergy. You see all this and I'm even adding to it with my own co-creative confluence. I think that's some of the challenges like, what is this thing? Once we figure out what that thing is we can figure out how to bring people into it, make it optimally effective, but also figure out like maybe people can't sit in that space for more than two hours because it's going to exhaust their sort of
cognitive RAM. They only have so much intellectual capacity to let go of self and professional boundaries and whatever else. That is the frontier of this work. How do we...it's not a light switch, you know? You have to have the right people and I think that's what I'm exploring is like, how does this really work? And I'm looking at things like what is the environment? Can you do it virtually? Does it have to be in a room and what does the
room have to look like? And you have to have the lights down and what are the personal qualities people have to have? What are the interprofessional dynamics that can make it good or bad? And what are the context because maybe some problems aren't amenable to a third space discussion. So you could throw all these different problems out there and and maybe a ChatGPT isn't amenable
to a third space discussion. I think it is, but there's a lot to factor in and I think that's where there's a lot of gaps in this literature because of the naming problems, but also because it's just not something we as nurses or we in the academic community have talked a lot about.
This is a really important point this lexicon because it's going to be a huge barrier to really advancing the state of knowledge in this area and I think about something related in the space of standardized patients and
simulation. So several years ago I was involved in some work where we were surveying on a global scale what was the lexicon that was used around standardized patients and how different it is and how conflated it gets and how it's not consistent and how that can really serve as a barrier to advancing our knowledge and understanding of the practice of standardized patients and simulation. I see that very parallel to this,
right? If if that lexicon is not teased apart and we don't have a shared mental model about what the different words mean and the concepts on a conceptual definition, on an operational level, this really could stifle the growth of this. I'm going to pose a question to you, Matt. It leads me to think about the folks just like myself, when I first had the opportunity and the honor to hear your expertise in this area. My first question was, where can
I go to learn more, right? So for those of you, those who may be listening and thinking, man this is fascinating. I want to dig my teeth into this. What recommendations would you have? Where should they go to really start to unpack this idea of third spacing in a way that's reliable so they don't get lost in the conflated vocabulary? Yeah, okay, so in terms of naming I had the very great fortune to study under Norma
Lang. You probably you guys probably don't know that name, but she was and is one of the pioneers of nursing informatics. And you've probably seen the quote that her and Dr. Clark had in one of their articles about if we can't name, it we can't fund it, we can't research it, that comes from her. So I had the great fortune to study under her. So I think naming is super, super
important. There's a Shakespearean contradictory a rose by any other name would smell as sweet, but when it comes to research, you know we can tell the concept is immature if it has a lot of different names and I think this is a case where there's an immaturity to this concept because we don't all call it the same thing. We don't all you know talk about the attributes of this phenomenon in the same way so there's room to sort of coalesce the interdisciplinary knowledge
around it. I think when you do that then it's easier to fund it, to teach people about it, to recognize it, to do all those things. I think naming is super super critical and really messy right now in terms of where do I learn more. Just yesterday I found the book I wanted to write on this topic. There are some...and it was in an obscure place. It's Hansen, Fourie and Meyer. They wrote a book called "Third Space, Information Sharing, and Participatory Design. I read
as much as I could as quickly as I could. I was like, well, yeah, this is the book I wanted to write. It's in some synthesis of lectures in some esoteric book that's out on the internet I had to go buy the ebook and the the marketplace they directed me to said, oh we don't sell that anymore. You have to go to a different marketplace, so finding more about this is not easy because of the name.
But because you know this isn't like Covid, so it's not something everybody's publishing on, but I think if they want to learn more about it, I think often starting with something like participatory design, which is a very mainstream design practice as well as
something called communities of practice. I don't know how familiar you guys are with that term but that's a very academic thing where we bring people together to talk about different principles and I think communities of practice there's a lot of informing of what how a third space can work. So I've read a lot about communities of practice and participatory design so I would say those are very accessible areas of research and phenomenon where you can dig in and say, okay ,
what is this? What are things adjacent to this weird mystical third space that is going on? And on about those two definitely I think you could read those and get a sense of how you bring a group together to do really cool things. Participatory design is very us-them. It's the designers and participants coming together and trying to create an environment where those end users, those participants create something special.
Third space is all these different people gathered at a table to tackle an issue which is what makes it a little bit different in terms of just designers end users. Third space we bring a whole bunch of interprofessional colleagues together and talk about even more complex things and there's not a, hey, I need to gain information from you. It's that we all need to gain information from each other and build this completely unique and different intellectual palace to solve
whatever thorny problems we have. I don't know if I got to your question, Rachel. You did, thank you. I don't know if this question is like dumb or if it's just too out there. This is a safe space Michelle! This is a safe space! You know, I mean but here's my question. Do we need a third space to identify and name the third space? That is so meta, Michelle. Very meta. I would expect you to ask that question. I would expect that to be your question.
That is a meta Michelle question. It's so predictable. It's so predictable. I mean, but seriously though if you're going to talk about getting a lexicon around these concepts and the who and the how and the why and the when and the where. That's not something because I'm like all fired up and I'm like, well, let's start naming it. Let's start doing it, but we're just...that's a bad word, but we're nurses, we need
all the other people, right? You need the other disciplines to to help us like the social sciences and the behavioral scientists and the stuff you know? Right. Right. Am I right about that? Am I understanding it correctly that we this isn't something just nursing could be like, so we like all this and we're gonna just start using a third space like it needs to be
collaborative right. I think it does and and I think where this is what gets tricky and you're stealing my thunder a little bit because I'm absolutely very interested in bringing together multiple disciplinary groups to talk about third space in the third space. So I'm very interested in that like I said. I reached out to colleagues all over the world and and I think they're just like any of us who are nerdy researchers or nerdy about whatever.
They were very excited to talk about these things, but you have to figure out who to bring together and let's talk about I think there are smaller scale models that people can take away from this to think about. So I'll give you a good example. I was thinking this morning about course evaluations and faculty evaluations. Students have an opportunity to tell us how the course was and how we did, but it is very rare for us to bring students in at the front of a course
and say what do you think? They are not in a participatory design space. They're telling us afterwards what worked or didn't work using an anonymous survey. That is not
participatory design. A part of me says well, why aren't we rethinking the way we teach using the cognitive science, using what we know about online teaching and taking an instructional designer, some faculty, some students, some researchers, external experts, maybe stakeholders that are students, you know go work at their institution and sitting down and throwing some thorny questions at them? So even in academia we don't use a participatory
design. We just ...'m going to use this word...but sort of patriarchically say to students, well this is how I think you need to learn and here's how it's going to all be laid out before you. We don't bring them in at the front end. I mean, there's probably some people that do, but I've never seen that. I don't read that that's happening.
We don't do that, so maybe even on a small scale we can think about even at our home institution where we can take instructional designers and faculty and students and whomever else and put them in a room and talk about a particular topic that's tricky. But I'll give you a good example. We had a question come up about online
synchronous class participation. There's all the students are gathered at 10 am on their Zoom call the faculties talking about whatever, maybe they have some breakout rooms, whatever we were running into challenges with what do we tell students about how they can participate and what are the expectations of engagement. So for example, cameras on or cameras
off well? Then we get into this debate about, well some people have body image issues or have stuff going on at home and they can't have cameras on.
So it's like okay, well then we can't have that rule or we can have that rule sometimes so we really just have been reactionary about some of these challenging issues in academia and not necessarily bringing students in at the front and to address them and to give us feedback about how was the moulage in this simulation or how was the unfolding of this for you? We debriefed the simulation but we don't often debrief the sort of logistics and the learning
experience. I think in terms of what can you do right now that's third spacey I think it's thinking about bringing together sort of broad base of stakeholders and creating that safe space environment that people who do simulation really understand that creating that environment where people can talk about things and dream up new ways of approaching sort of our normal
teaching or clinical practice work. The entire time we've been talking I've been making this parallel to what we know in simulation because I will never forget the first time I saw students in a simulation. It was at a community college down the street. It was very new. There was no pre-briefing. I don't even think there was a debriefing. It was just put them in with the manikin have them do a mock code. But with that, I was like this
is something. You felt this kind of like this is magical. This is an important way to learn and then we built all the structure around it. We built the pre-brief and the debrief. We added the theory and the support and the robustness to it. I feel like this feels similar. There's third space. There's magic but...we or somebody or the third space has to create all the the other stuff and maybe in a way naming it and reducing that magic is okay to me.
I'm always skeptical when somebody's like, oh it was magic, it was a miracle. I'm like, I'm
a scientist. Yes, I understand we have limits to humans understanding but typically when there's something that I would describe as magical or mystical or that my kids would I would go well there's probably some science underneath there somewhere and sure enough there will be and so in the case of third space I'm buying demystifying that for myself and others because I think it can be a powerful tool to address learning problems. Again. it can't, it's
not a fit for every problem. Dealing with an administrative project is not something we're going to bring students into to solve but looking at these new innovations like ChatGPT, that's a great place to bring students in and go hey are you guys talking about it? What do you think about it? Where do you see that it could be used or misused? Then how do we talk to students about it at the top of a class. Is it just the new breed of plagiarism?
Where are you at on that? I think demystifying third space is great and I think there's a lot of utility in academia especially because you have this environment full of interprofessional colleagues. It's just organically there for you to pull people together in a conference room and say you know here's the thing. Let's talk about it. Here's some of the ground rules. Go to it and include students in that.
I think students have been often the missing ingredient just like patients have been the missing ingredient in a lot of patient care problems. We know what's best for you. We know what's best for you. Yeah. I co-sign on all of that and what's now becoming even more resounding in my mind is the inherent importance that everybody that is part of this third space be in it for the greater good.
I think that may be in from my perspective a difference between having an interprofessional conversation or a conversation with students and faculty administrators, whoever's around that table. One important ingredient from transforming it to that to a third space because I can imagine if we have a third space and someone is in the third space that does not share the greater good, what is this perspective for
the greater good? I imagine that third space now is not a third space for very much longer, and all it takes is that one person to sort of breach that sort of artificial community that's created. I always think about when you fly in a plane like it's forced community. You're all stuck together for two hours whether you like it or not. You're in a forced community and there are some norms and rules and you have to adhere to them and when people don't chaos
ensues and that experience falls apart. I think the same thing can happen in the third space. If you have somebody who's there who has very turf-focused goals like they walk into this meeting as a nurse and go, I'm here to protect nursing practice. That's cool that we're going to talk about something interesting but my perspective is always going to be nursing, nursing, nursing, nursing. You can't be in that space then.
It won't work and that's probably why like my theory is that that's probably why I haven't been in a lot of what I would call true third space experiences. I feel like I can count on one hand in 20 years when I've been in situations where I felt that magic where I felt that true synergy where something greater than the sum
of its parts actually happened. I know it's a cheesy word, but I think third space is that true is a true embodiment of synergy where something I sitting in my office I could never come up with or even with sitting in at a table with a team of people I wouldn't have come up with it but when all those planets align when that when those attitudes and shared goals and good group process hygiene occurs. That's when the
magic happens. I do think naming it, I do think demystifying, I do think trying to find ways to get people into that space can be extremely valuable for all the reasons that we're talking about. Well I really appreciate this conversation because there's been a lot of times in academia where I
felt very alone. I felt isolated. I felt like I had to solve whatever problems at my desk, with my computer, with my brain ,with my hands, and it felt and I'm being honest, it's not always that way but it felt like that a lot. I think it's because inherently I value knowing that I can't solve...there's missing pieces. There's things that my brain just doesn't gravitate to. There's ideas that I just can't generate and I need another person.
So you're either left, I think, currently in most of the models I see in academia, we're left to initiate that ourselves and create a committee. There are committees, right, that is where you have people come together so it's not that it
doesn't exist. I'm talking about like at 9:00 AM on Monday morning, that kind of feeling but you have to initiate it yourself and you have to extend yourself and pull people in to solve some of these problems, but there's not always a structure in the day-to-day workings of academia to do that
and that's hard. I've often wondered like we have so many issues that need administrative support, can we just have a Friday huddle where every Friday from 12 to 1 the administrative doors open and we all can come together and hash out some stuff with the people, with the student success person, there with like interprofessionally can we just
have a space where that can happen. We can instead of sending the 67 emails to try to figure out some of these really thorny problems, can we just have a weekly place a space to do that? I've always wished for that but that sort of like how do we do committees and meetings better is probably a whole other podcast. There's so much broken about all the ways that we have to communicate and how incapable we are and terrible we are at communication. It's sort of laughable that
we have all these modalities but just really can't seem to figure it out. I think the huddles and the interprofessional rounds that we see in healthcare, I think academia could really benefit from that in a lot of different ways, especially as we've become so technology dependent. I look at what's happening at
St. Kate's where I teach adjunct. They've moved to a new course management system and we've really relied on our instructional design partners to sort of send out little newsletters and blurbs saying here's what's happening and here's what's going on and having those huddles with them about things they're uncovering as people transition to this new platform. I think there could really be value in rethinking how we communicate and interact and taking some lessons from third
space because those aren't third spaces. Those are very specific sort of what I would call team spaces where you sort of stay for the most part, stay in your lane and people are trusting you to stay in your lane and advocate for your perspective and talk back and forth but there's probably some good lessons there from the third space world to how we can do meetings better and do committees better by letting go of self sometimes and having maybe a little
more diffuse boundaries rather than just being so rigid about what you care about and what you're what you're advocating for because there's a time and a space for that, but certain problems that's not the best way to approach it. Matt, I think you just signed yourself up for our next conversation! [Laughter]
Anytime, anytime! This one this has been super special for me because, like I said, I've been thinking about this for 20 years and I've never had an opportunity to like sit down and talk with it at length with anybody so it's fun for me to finally get some of this out there and bounce it off other people. I did want to come back to what you said Michelle, just for a moment, because I think the things you named, those laments about feeling isolated and feeling like I
have to fix this on my own. Those are the woes of a third space professional, people who straddle both worlds and say, wow, this works really well at Laerdal. This works really well at my health care employer. Why can't we do this thing in academia? I need to figure this
out. I think when you live in that weird world it's hard to figure out how you solve problems and you may not have compatriots who are either able or willing to come to the table with you and think in that way, in a different way. I think figuring finding those
people is always wonderful. I talked about these two DNP students who found each other and really reveled and wrote and created great things from that partnership because they were, they had very different perspectives but they valued that transformative collaboration they found in each other.
I think some of it is finding compatriots who are able and recognizing who might be be able to enter a third space-ish conversation with you, if not create opportunity to to intentionally say, hey, you're somebody in academic administration, you're somebody in the budget office, you're somebody in
sort of our tech back end. Let's all come together and talk about why we can't solve whatever it is or to come back to that ChatGPT question, like to put all the right people together to have an open and innovative discussion about what we do and then you can maybe move on to the pragmatics like do we need to write a policy? Do we need to add this specifically to our plagiarism
policy? Or whatever else. I think sometimes going into that open diffuse space it can be really hard and if it is too hard I would say you're not in that space. So if you have people who don't want to be there then it sort of negates the thinking that we're in this mystical place. I think those laments
are very common to third space professionals. All the books I read and articles I read and even my own experiences that isolation seems very commonplace, but I think where I have found value is finding like-minded folks and I used to do that very accidentally and now I do
it very intentionally. I make it a habit to meet with those folks regularly and when I have a thorny problem to collaborate with them and sometimes to put three or four of us on a call and I didn't used to think of that as third space work, but I now am very intentionally saying I need these three different layers of expertise and sometimes I think it's okay as nurses that it's all nurses who have maybe different perspectives.
I think we can expand that definition of third space and say this can be a nurse researcher who also does a little bit of stuff in pharma and this is a nurse educator who's been a hardcore educator. It can all be nurses and we can use those lessons and those invitation points and sort of common goal stuff that we're learning about third spacing and create good opportunities to come up with good ideas.
It's been an absolute pleasure. Thank you so much for sharing your passion for this and really, my mind feels really blown not to overuse that phrase of mind feeling blown, but thank you for expanding my thinking and giving me lots more to think about. I'm sure Michelle and listeners will feel
the same, so thank you. Well I appreciate you guys listening to my geeky rambling because like I said, I've had 20 years of thinking about this and really very few opportunities to kind of hash
it out. I really value that you guys were willing to play along and to let down your boundaries and think about how this might be applied to your personal and professional life because I do think this is a great area that we can bring into academia and clinical practice and even into more niche worlds like mine in the in the tech development side so I'm grateful for the opportunity and for the fun and laughter and melting of ideas.
Thank you for joining us on this episode of NLN Nursing EDge Unscripted Surface. We hope you join us next time. Until then, remember, whether your water is calm or choppy, stay connected, get vulnerable, and dare to go beneath the surface. [Music]