Swaithes Laura, Paskins Zoe, Quicke Jonathan G, Stevenson Kay, Fell Kathy, Dziedzic Krysia
Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK.
Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership NHS Foundation Trust, Staffordshire, UK.
Implement Sci Commun. 2023 Jan 26;4(1):11. doi: 10.1186/s43058-022-00384-1.
Communities of Practice (CoPs) offer a strategy for mobilising knowledge and integrating evidence-based interventions into musculoskeletal practice, yet little is known about their practical application in this context. This study aimed to (i) explore the process of knowledge mobilisation in the context of a CoP to implement evidence-based interventions in musculoskeletal care and (ii) co-develop recommendations to optimise the process of knowledge mobilisation in CoPs.
A qualitative study comprising observation of a CoP and related planning meetings (n = 5), and interviews with CoP stakeholders (including clinicians, lay members, managers, commissioners, academics) (n = 15) was undertaken. Data were analysed using thematic analysis and interpreted considering the Integrated Promoting Action on Research Implementation in Health Services theory. Public contributors were collaboratively involved at key stages of the study.
Four themes were identified: identifying and interpreting knowledge, practical implementation of a CoP, culture and relationship building, and responding to the external context. Resource and infrastructure enabled the set-up, delivery and running of the CoP. Support for lay members is recommended to ensure effective participation and equity of power. CoP aims and purpose can develop iteratively, and this may enhance the ability to respond to contextual changes. Several recommendations for the practical application of CoPs are suggested to create the best environment for knowledge exchange and creation, support an equitable platform for participation, and help members to navigate and make sense of the CoP in a flexible way.
This study identified how a CoP with diverse membership can promote partnership working at the intersection between knowledge and practice. Several important considerations for preparing for and operationalising the approach in implementation have been identified. Evaluation of the costs, effectiveness and impact of CoPs is needed to better understand the value added by the approach. More broadly, research is needed to explore the practical application of online CoPs and the role of international CoPs in optimising the uptake of innovations and best practice.
实践社区(CoP)提供了一种调动知识并将循证干预措施整合到肌肉骨骼疾病诊疗实践中的策略,但对于其在这种背景下的实际应用知之甚少。本研究旨在:(i)探索在实践社区背景下调动知识以在肌肉骨骼疾病护理中实施循证干预措施的过程;(ii)共同制定建议以优化实践社区中知识调动的过程。
开展了一项定性研究,包括观察一个实践社区及相关规划会议(n = 5),并对实践社区的利益相关者(包括临床医生、非专业成员、管理人员、专员、学者)进行访谈(n = 15)。使用主题分析法对数据进行分析,并结合卫生服务研究实施综合促进行动理论进行解读。公众参与者在研究的关键阶段共同参与。
确定了四个主题:知识的识别与解读、实践社区的实际实施、文化与关系建设以及应对外部环境。资源和基础设施支持了实践社区的建立、开展和运作。建议为非专业成员提供支持,以确保有效参与和平等的权力。实践社区的目标和宗旨可以迭代发展,这可能增强应对环境变化的能力。针对实践社区的实际应用提出了若干建议,以创造知识交流与创造的最佳环境,支持公平的参与平台,并帮助成员以灵活的方式理解和融入实践社区。
本研究确定了一个成员多元化的实践社区如何在知识与实践的交叉点促进合作。确定了在实施该方法时进行准备和运作的几个重要考虑因素。需要对实践社区的成本、有效性和影响进行评估,以更好地理解该方法所带来的附加值。更广泛地说,需要开展研究以探索在线实践社区的实际应用以及国际实践社区在优化创新和最佳实践采用方面的作用。