Making the Relational Field Visible: A Transdisciplinary Map of Relational Awareness for Health Systems

Health systems are social systems through which technical functions are carried out. Existing scholarship addresses relationality through social, organizational, and structural lenses, but the biological and physiological dimensions of interaction remain largely outside the frame. Without these dimensions, the mechanisms through which everyday interaction shapes what people can perceive, coordinate, and do together remain invisible to the systems designed to support them. Across several bodies of research, substantial evidence links the quality of relationships to patient safety, clinical outcomes, and workforce performance and sustainability. Relational Coordination Theory, social connection research, compassion research in clinical care, trauma-informed approaches, and autonomic regulation each demonstrate this from different angles. Yet these literatures remain largely separated by discipline and level of analysis. They are rarely brought together in a form that helps health and care workers recognize and navigate the complex relational dynamics unfolding in and shaping everyday practice. This poster introduces the Map of Relational Awareness, a proposed transdisciplinary perceptual scaffold consisting of two interdependent poles (Awareness and Expression) and six relational movements (Noticing, Anchoring, Pacing, Signaling, Bridging, and Naming). The Map draws on three converging scientific streams: Polyvagal Theory (Porges, 2011; 2022), Interpersonal Neurobiology (Siegel, 2020), and Communication Complex (Parrish-Sprowl and Parrish-Sprowl, 2023). Communication Complex conceptualizes communication as a bioactive process capable of influencing physiological state within and across an interaction. The Map's two poles and six movements emerged through more than two decades of public health practice, including WHO emergency response and community engagement, and advances the relational orientation of the WISH-WHO Policy Report on Relationality in Community Engagement (2024). The poster proposes the Map as a non-pathologizing, testable integrative scaffolding and invites empirical collaboration to examine whether the six movements can be reliably recognized, how they interact with relational quality across clinical, team, and organizational contexts, and whether the Map can help generate an integrated empirical account of relational capacity to help health and care workers recognize and navigate relational dynamics in practice.