Abstract

BackgroundProfessional isolation is an important factor in low rural health workforce retention.ObjectiveThe aim of this study was to gain insights to inform the development of an implementation plan for a virtual community of practice (VCoP) for general practice (GP) training in regional Australia. The study also aimed to assess the applicability of the findings of an existing framework in developing this plan. This included ascertaining the main drivers of usage, or usefulness, of the VCoP for users and establishing the different priorities between user groups.MethodsA survey study, based on the seven-step health VCoP framework, was conducted with general practice supervisors and registrars—133 usable responses; 40% estimated response rate. Data was analyzed using the t test and the chi-square test for comparisons between groups. Factor analysis and generalized linear regression modeling were used to ascertain factors which may independently predict intention to use the VCoP.ResultsIn establishing a VCoP, facilitation was seen as important. Regarding stakeholders, the GP training provider was an important sponsor. Factor analysis showed a single goal of usefulness. Registrars had a higher intention to use the VCoP (P<.001) and to perceive it as useful (P<.001) than supervisors. Usefulness independently predicted intention to actively use the VCoP (P<.001). Regarding engagement of a broad church of users, registrars were more likely than supervisors to want allied health professional and specialist involvement (P<.001). A supportive environment was deemed important, but most important was the quality of the content. Participants wanted regular feedback about site activity. Regarding technology and community, training can be online, but trust is better built face-to-face. Supervisors were significantly more likely than registrars to perceive that registrars needed help with knowledge (P=.01) and implementation of knowledge (P<.001).ConclusionsImportant factors for a GP training VCoP include the following: facilitation covering administration and expertise, the perceived usefulness of the community, focusing usefulness around knowledge sharing, and overcoming professional isolation with high-quality content. Knowledge needs of different users should be acknowledged and help can be provided online, but trust is better built face-to-face. In conclusion, the findings of the health framework for VCoPs are relevant when developing an implementation plan for a VCoP for GP training. The main driver of success for a GP training VCoP is the perception of its usefulness by participants. Overcoming professional isolation for GP registrars using a VCoP has implications for training and retention of health workers in rural areas.

Highlights

  • IntroductionProfessional isolation is an important factor in low rural health workforce retention [1]

  • The main driver of success for a general practice (GP) training virtual community of practice (VCoP) is the perception of its usefulness by participants

  • Professional isolation is an important factor in low rural health workforce retention [1]

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Summary

Introduction

Professional isolation is an important factor in low rural health workforce retention [1]. Training for doctors in general practice in Australia can be isolating [3,4]; trainees, or registrars, can be spread across large geographic areas, moving between different practices in urban and regional placements, and are usually alone in their consulting room with a patient These factors of geography and structure are barriers to knowledge sharing, impeding the natural communities of practice that form in medical training. Most importantly, CoPs help participants share tacit knowledge [7] This is the know-how of putting that knowledge into practice; for example, how to ensure a clinical condition is identified from a primary care database, that the patient is recalled, that patients are encouraged to take medications, and how to anticipate and treat a range of side effects.

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