Table 2 Thematic analysis of non-empirical papers
Theme | Kislov et al. [24] | Thomson et al. [25] | Bate and Robert [23] |
|---|---|---|---|
Characteristics and capabilities | • (The CoP approach) "demonstrated to enhance interprofessional clinical practice, facilitate quality improvement, encourage buy-in among participants, promote knowledge transfer" • Require a domain of knowledge, defining a set of issues, community of people who care about this domain, create, expand and exchange knowledge, develop individuals, self-selection, passion, commitment, and identification with the group and its expertise, evolve and end organically | • “Groups of people informally bound together by shared expertise and passion for joint enterprise” • Include social interaction, knowledge-creation, knowledge-sharing, and identity-building • Builds on the powerful influences of natural networks—groups of clinicians who interact professionally to share information, support, consult, refer and jointly manage patients | • Relies upon the adaptation of existing knowledge to multiple settings to accomplish common goals • Enable a wide range of professionals in a large number of organisations to come together to learn and ‘harvest’ good practice from each other, • Create horizontal networks cutting across hierarchical and relatively isolated organisations • Empower relatively junior staff to take ownership for solving local problems by working with clinicians who have taken change leadership roles |
Infrastructure | • Requires knowledge brokers, boundary objects, boundary interactions among people from different CoPs • Boundaries are fuzzy • Link those who conduct applied health research with all those who use it | • Open to change and change management • Bottom-up strategy • Map participants and identify missing stakeholders • Development informal and spontaneous, • Participants possessing qualities and characteristics necessary to develop and sustain community • Financial support for providing facilitators, materials, paying for backfill for clinicians’ absences when they attended CoPs • Creation of dedicated posts to support evidence-based practice training within healthcare organisations • A continuous learning culture | |
Knowledge transfer and translation | • A transdisciplinary project can act as a bridge to enhance knowledge transfer and learning at the boundaries • Shaped strongly by the personal, political, and professional agendas of the participants | • Approach to knowledge translation based on socially situated learning • Sharing evidence-based examples more likely to change practice than disseminating new knowledge • Guiding existing practices within natural networks more effective than directing clinicians to change their practice | • Knowledge dissemination and transferability only occur when there is a collective identity |
Challenges | • Incompatible epistemic cultures • Biomedical paradigms vs ethnographic approaches • Formalisation of organic CoPs can disrupt knowledge-sharing • Boundaries between clinical and management practice | • Implementation gap • Maintaining motivation and commitment in the face of clinical demands • Identifying skilled frontline staff to lead and participate • May not lead to sustained change—'single-loop learning' | |
Evidence-base | • Development, functioning, and effects of multi-professional and multi-agency CoPs remains under-researched | • Need to assess how closely the theory of developing these CoPs matches reality • Ongoing monitoring and evaluation of how CoPs develop around the clinical themes important | • Use of CoPs driven more by faith than research • Scarcity of empirical work on the 'people issues' |