Communities of Practice in MedEd

Post #50: This blog was started three years ago with the aim of providing some easy-to-read medical education content, mainly for starting-out medical educators some of whom had expressed the view that they felt unsupported in their new environment and, further, felt unfamiliar even with the language of medical education.

This is the sort of problem that should be ameliorated by the experience of belonging to a community of practice – a fairly recent concept and one with potential, which you probably know from learning theory.  It seems to be an appropriate discussion for this fiftieth blog now that some of those newish MEs, that I met initially, might now be more senior MEs and already mentoring younger educators.  I’m not going to get very academic regarding this topic except to say it arose in the writing of Lave (anthropologist) and Wenger (educationalist) in the 1990s.  Another related concept was that of Situated Learning.

What is a Community of Practice (CoP)?  It’s a group of people who share an interest in, and concern for, a specific area, and interact with each other in order to work out how to do it better.  It can be applied very broadly but is often applied to disciplines or professions although it has been applied in business settings. It is fairly easy to see how it can apply to a general practice whose staff meet together face to face regularly but it can also be a virtual community of practice – perhaps around special clinical interests such as sexual health or mental health for instance. Medical Education is obviously also a special interest within medicine and you probably feel you experience your community of practice when you attend a conference or workshop for instance.

Do you feel you are indeed part of a CoP? Is your CoP inward looking or outward looking?  Sometimes such a group might be fairly parochial and inward looking, focussing on the practicalities of the organisation in which you all work.  The most value from a CoP is probably when it is also outward looking, when you can interact and exchange ideas with those involved in “medical education” but who are working outside your specific context.  So, university tutors and lecturers might interact with GP educators and supervisors at a conference when they all attend a workshop on assessment for instance.  You might gain new ideas and knowledge from an international conference. This idea aligns with one of the rather philosophical “tensions” that Wenger went on to describe in relation to CoPs – that between local and global.  These tensions help contribute to development and creativity. You could explore these ideas further if you wish.

What sort of workplace are you working in – both clinically and in education?  Are there supportive relationships?  Is there challenge and growth?  Is there time for sharing knowledge and experiences? Who is responsible for nurturing all that within your CoP?  Remember that motivation for actively participating in communities of practice can be intrinsic or extrinsic.

Why bother with a CoP?  You can probably answer this yourself from experience.  Being involved in a CoP may have improved your professional knowledge or performance and also your morale in your job.  However, a couple of reviews of the effectiveness of CoPs in improving health care performance for instance have been a bit inconclusive.  Some of these were in terms of the goal of improving productivity in the context of funding shortfalls in the NHS – a fairly limited goal.

Just calling a group of people a CoP does not necessarily mean they function as one. You can read more about them here.  Wenger described three characteristics of CoPs:

  1. A Community where individuals participate, commit and build collaborative relationships (NB in practice, there will be differing levels of participation).
  2. A shared Domain of interest
  3. A shared Practice

This article   looked at the growth of a rural medical education CoP in the US which involved the development of relationships over time. One can see that this is a more tightly focussed topic.  It also has what members must feel is an important purpose, which is one of the facilitators of a CoP.  CoPs can also function to maintain and share the more tacit and less measurable aspects of the knowledge that is core to the community.  The concept has been much used and discussed in the business sector – but bear in mind that health and education are different in many ways.

A 2012 article looked at the literature on GP Training and virtual CoPs, speculating that such virtual communities might be useful in decreasing isolation for registrars. It utilised a framework from the business literature – and found differences in the way concepts were applied in the different sectors. They reported that, at that point, there were no studies on Virtual CoPs in GP Training. For trainees these would tend to be more in the area of clinical skills and knowledge rather than education.  For Virtual Communities of Practice, the technology was crucial, with consideration of blending of online and face-to-face. 

In medical education, in the context of constrained funding and resources (a phrase repeated in so many areas), Virtual CoPs may also be favoured but attention should be paid to the effect on the quality of relationships and collaboration.So there is a challenge for you – find space to develop and utilise Communities of Practice to develop your professional skills, to enjoy your career more and encourage the next generation!

1 thought on “Communities of Practice in MedEd

  1. John Vaughan

    Hi Cathy,
    As always your blog is interesting and stimulating. The cormorant in the cover picture does remind me of the lone supervisor – a veritable shag on a rock! So the COP concept becomes a very important one in that context.
    On another note I am finishing up at North Haven today and Margaret and I are going to NZ where I will be doing a 6 month locum , firstly in Masterton just north of Wellington and then in Taihape south of Rotorua. Perhaps prescient in view of recent electoral results.
    Look forward to receiving more blogs and if you happen to be over in the land f the long white cloud , feel free to look us up.
    Warm regards to you and Brian

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