TY - JOUR
T1 - Communities of practice to facilitate change in health professions education
T2 - A realist synthesis
AU - Jenkins, Gemma
AU - Palermo, Claire
AU - Clark, Alexander M.
AU - Costello, Leesa
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/3
Y1 - 2024/3
N2 - Background: Communities of practice could contribute to transformations in health professions education to meet complex and emerging challenges. However, little is known about the underlying mechanisms of communities of practice in this setting, and how context influences outcomes. Objective: To understand when, why and how communities of practice with health professions education faculty work to facilitate higher education change. Design: A realist synthesis according to the RAMESES standards and steps described by Pawson and colleagues. Review methods: Early scoping of the literature informed the development of an initial program theory to describe underlying assumptions about how communities of practice in higher education, implemented with health professions education faculty, were likely to work. The theory was tested and further refined through a realist synthesis. A systematic search for evidence using search terms ‘faculty’, ‘communities of practice’ and ‘higher education’ and related terms was supplemented with citation tracking and hand searching of significant authors and journals. Following study appraisal, data were extracted and synthesised from 21 manuscripts describing 16 communities of practice. The realist synthesis focused on identifying patterns in context-mechanism-outcome interactions, and the alignment with substantive theory. Results: From the included manuscripts, ten context-mechanism-outcome configurations were identified that describe a range of individual, interpersonal and institutional outcomes of communities of practice with health professions education faculty and context-mechanism interactions that contribute to achieving these outcomes. Conclusions: This study expands theoretical understandings of how and why communities of practice work. There is value in communities of practice in the higher education sector, primarily in the field of health professions education. Communities of practice implemented in the context of complex change with participants who have a desire to participate can facilitate change in health professions education, including institutional level changes, through reflection, experiential learning and creating a shared agenda for change. Findings from this study can be used by policy and decision-makers within health education to best apply communities of practice to achieve meaningful outcomes.
AB - Background: Communities of practice could contribute to transformations in health professions education to meet complex and emerging challenges. However, little is known about the underlying mechanisms of communities of practice in this setting, and how context influences outcomes. Objective: To understand when, why and how communities of practice with health professions education faculty work to facilitate higher education change. Design: A realist synthesis according to the RAMESES standards and steps described by Pawson and colleagues. Review methods: Early scoping of the literature informed the development of an initial program theory to describe underlying assumptions about how communities of practice in higher education, implemented with health professions education faculty, were likely to work. The theory was tested and further refined through a realist synthesis. A systematic search for evidence using search terms ‘faculty’, ‘communities of practice’ and ‘higher education’ and related terms was supplemented with citation tracking and hand searching of significant authors and journals. Following study appraisal, data were extracted and synthesised from 21 manuscripts describing 16 communities of practice. The realist synthesis focused on identifying patterns in context-mechanism-outcome interactions, and the alignment with substantive theory. Results: From the included manuscripts, ten context-mechanism-outcome configurations were identified that describe a range of individual, interpersonal and institutional outcomes of communities of practice with health professions education faculty and context-mechanism interactions that contribute to achieving these outcomes. Conclusions: This study expands theoretical understandings of how and why communities of practice work. There is value in communities of practice in the higher education sector, primarily in the field of health professions education. Communities of practice implemented in the context of complex change with participants who have a desire to participate can facilitate change in health professions education, including institutional level changes, through reflection, experiential learning and creating a shared agenda for change. Findings from this study can be used by policy and decision-makers within health education to best apply communities of practice to achieve meaningful outcomes.
KW - Communities of practice
KW - Health professionals
KW - Higher education
KW - Organisational change
KW - Realist synthesis
UR - http://www.scopus.com/inward/record.url?scp=85184753435&partnerID=8YFLogxK
U2 - 10.1016/j.nedt.2024.106091
DO - 10.1016/j.nedt.2024.106091
M3 - Journal Article
C2 - 38241962
AN - SCOPUS:85184753435
SN - 0260-6917
VL - 134
JO - Nurse Education Today
JF - Nurse Education Today
M1 - 106091
ER -