Leading by virtual interaction: an application of cultural-historical activity theory

Introduction The pandemic spread of SARS-CoV-2, a novel, highly contagious and easily transmissible pathogen, has profoundly affected all aspects of human interaction. Guided by the need to reduce face-to-face contacts, medical organisations have rapidly shifted group activities to virtual platforms. Over 1 year into the pandemic, the necessity to maintain public health restrictions ensures that virtual meetings will be the norm for the foreseeable future. It has yet to be understood how virtual technologies shape healthcare and academic cultures, affect interactions, or influence strategic decisions and policies within these systems. Conclusion In this article, the authors reflect on the move from historically situated activity systems of team leadership in healthcare to ones that now exist in virtual formats. Cultural-historical activity theory (CHAT) is a framework that explains complex human actions, and how they unfold over time through interaction with mediational tools (eg, technology) and various people representing their own communities, roles and perceived divisions of labour. The authors use the lens of CHAT as a framework to understand the shifting dynamics at play and offer strategies for leaders to co-establish activity systems with team members to make goals of group activities explicit and to deliberately work toward them. Five specific strategies proposed are: (1) use software platforms that fit your needs and give voice to all attendees with technical support present in meetings; (2) converse explicitly about roles and emerging role fluidity during times of change and pandemic response; (3) co-construct something new intentionally; (4) engage in implementation science at this time; and (5) lead intentionally while honouring cultural norms and values. It is imperative that any changes, even the ones that are a part of the pandemic response, are made consistent with the core shared values of the medical community as this necessary new way of coming together is embraced with collective wisdom.