Communities of Practice

1. Communities of Practice What, Why and How Leann Merla CAOT June 4, 2009

2. Outline • What: Definitions and structure • Why: Benefits and relevance to OT • Our experience • How: Different structures Requirements Template

3. Definitions • Communities of practice are groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly. Wenger, 2008 • Individuals engaged in mutual endeavors, associated with a joint enterprise, with a shared repertoire and history Lave & Wenger, in Davis, 2006

4. Benefits • New competencies and procedures learned McDonald and Viehbeck, 2007; Garcia and Dorohovich, 2005 • Exchange of tacit knowledge and “histories of learning” Parboosingh, 2002 • Development of professional identity Davis, 2006, Plak, 2006 • Cost effective Parboosingh, 2002 • Enhanced job satisfaction • Recruitment and retention

5. LHSC Experience • Multi site tertiary care teaching hospital • Inpatient and Outpatient physical and mental health • 32 FTE OT’s and 6.5 OTA’s • Matrix model of management with a 1.0 Professional Practice Leader and 1.0 Clinical Specialist

6. LHSC Experience • Hospitals amalgamated in 1995 • Program management introduced 1998 • Staff identified concern regarding loss of “OT identity”, fragmentation of profession • Key issues identified at all staff retreat in 1998 • Communication • Professional development • Professional identity • Working relationships

7. Structure developed to offer “meaning, learning, and a sense of community to peers in the midst of organizational change” • Combination of formal QM structure and strategies to provide opportunities for informal communication, sharing of information

8. Quality Management Structure - LHSC • Used a QM focus to ensure support • Professional Practice Steering Committee • Task Teams • Practice Standards, Practice Development, Evidence Based Practice • Ad Hoc Working Groups • Infomed, OT Month, Website, Communication

9. Additional Strategies • OT newsletter • Joint staff meetings 2x/year • Monthly staff meetings each site • Preceptorship program • Journal clubs • Inservices

10. Development of a Community of Practice • Qualitative study completed in 2007 • Staff identified COP as an important component of their job satisfaction and ability to practice in desired manner. • “the good thing about this particular hospital is that we have a rather large OT department and we have lots of OT colleagues that practice on the same principles and we support one another” Participant C

11. “We have a great OT department. Like we have great cohesiveness. We have a lot of experience and I think in terms of aiding and implementing a client centred practice, observing colleagues and discussing with colleagues what [practice] should look like … it’s a big help” Participant H • “within the discipline it helps. We talk, we talk a lot. We use each other as resources and sounding boards” Participant J

12. Developing a Community • Geographic proximity does not ensure development of a Community of Practice • Cannot be mandated by administration Sharpe, 1997

13. Informal or spontaneous Proximity Culture of environment Critical mass Need Open membership Activity will wax and wane Formal or “mandated” Specific issue or need Explicit support Formal structure and expectations Often closed membership Proximity not essential Variations on a Theme

14. Basic Requirements • Mutual engagement • Joint enterprise • Shared repertoire Wenger, 1998 in Macdonald & Viehbeck, 2007

15. Requirements • Facilitator – not expert but enthusiastic • Relevance; clear goals and purpose • Opportunities for collaboration • Involvement of front line staff • Trust; critical thinking and open debate • Support • Evaluation

16. Creating a Community of Practice

20. Conclusion • Communities of practice provide a viable and cost effective way for OT’s to engage in professional development, strengthen their professional identity and enhance their professional practice. • Communities of practice may involve a variety of formats but are a “good fit” for our profession with its strong body of tacit knowledge and history of learning through shared experience. Contact: Leann.Merla@lhsc.on.ca

21. References Confessore, S.J. (1997). Building a learning organization: communities of practice, self-directed learning, and continuing medical education. The Journal of Continuing Education in the Health Professions 17, 5-11. Davis, J. (2006). The importance of the community of practice in identity development. The Internet Journal of Allied Health Sciences and Practice 4,1-8 Garcia, J. & Dorohovich, M. (2005). The truth about building and maintaining successful communities of practice. Defense Acquisition Review Journal, 10, 18-33. McDonald, P.W. & Viehbeck, S. (2007). From evidence-based practice making to practice-based evidence making: creating communities of (research) and practice. Health Promotion Practice, 8, 140-144.

22. References Parboosingh, J. T. (2002). Physician communities of practice: Where l earning and practice are inseparable. The Journal of Continuing Education in the Health Professions 22, 230-236. Plak M.M. (2006). The development of communication skills, interpersonal skills, and a professional identity within a community of Practice. Journal of Physical Therapy Education, 20 37-46. Sharp, J. (1997). Communities of practice; a review of the literature. http://www.tfriend.com/cop-lit.htm Retrieved May 21, 2009. Wenger, E. Communities of practice. A brief introduction. http://www.ewenger.com/theory. Retrieved April 22, 2009. White, C.M, Basiletti, M.C, Carswell, A., Head, B.J. & Lin, L.J. (2008) Online communities of practice: enhancing scholarly practice using web-based technology. Occupational Therapy Now, 10, 6-7.