Initiating communities of practice for teaching and education scholarship in hospital settings: a multi-site case study.

Abstract

This article was migrated. The article was marked as recommended. Background and Rationale: Numerous calls have been made for faculty development programming to better address faculty members' ongoing needs, to situate training strategies within the workplace and to utilize social learning perspectives, communities of practice in particular. Reviews have pointed to a paucity of published qualitative research on faculty development communities of practice and, more generally, on the processes of change and the organizational contexts in which interventions are implemented. Intervention: An initiative was started to instigate education scholarship communities of practice in three highly distinct academic health care settings, to address faculty members' ongoing needs for community and, ultimately, to serve as a source of support for the application of new knowledge to routine education activities. A research project was launched jointly to describe the process and progress of attempting to develop communities of practice at the three sites and to identify common and unique influences on sites' progress. Data Collection: Phone interviews were conducted with group facilitators from each site following group meetings, for the duration of the initiative. Analysis: Multiple case study methodology was employed to describe and compare the processes and progress of attempting to initiate communities of practice at the three sites and to identify obstacles related to organizational context. Findings: All three sites made limited progress in developing a shared domain of interest and a shared history of regular interaction (i.e. regular meetings). Participants identified different professional backgrounds and different education practices as challenges to establishing shared interest. More prominently, they identified busy schedules, geographic barriers, and absence of protected time as obstacles to regular and consistent meetings. Discussion: Difficulty establishing shared interest and shared history are considered in light of the unclear meaning of "education scholarship", cognitive and ethical boundaries between professions, and time constraints within modern, highly complex academic healthcare settings. Conclusions: While CoPs may appeal as self-sustaining, low-cost alternatives to formal programming, limited progress is possible without institutional investment and allowance commensurate with the implied scope and challenges.