A Case Study of a Community of Practice among Pediatricians at BC Children’s Hospital, Vancouver, British Columbia

Background: Medical advancement and complex healthcare practices require pediatricians to learn continually. However, they struggle with their Continuing Professional Development (CPD) due to a shortage of pediatricians, which leaves them with heavy workloads and insufficient time for CPD. The problem leads to poorer quality care and higher mortality rates in pediatric departments. Participating in Communities of Practice (CoP) at their workplaces seems to be beneficial for improving their CPD. Despite a body of literature supporting CoPs impact on pediatricians’ practice, there is a lack of understanding about their nature, functions, and their role in improving pediatricians’ CPD. Methods: This qualitative case study was conducted at BC Children’s Hospital (BCCH) in Vancouver, Canada, to examine the BCCH CoP and its role in pediatricians’ CPD. The study was guided by a community of practice learning framework, and four Research Questions (RQ) were discussed with nine pediatricians with different specialties about CoP participation and their CPD. The data collected from the semistructured interview was analyzed using ATLAS Ti to determine the main themes. Findings: This study demonstrated that participating in the community helped pediatricians keep up with current knowledge in their fields. They shared information and ideas with other members and colleagues. Together, they created tools, guidelines, websites, and educational materials. In conclusion, all participants agreed that joining the BCCH CoP benefited their ongoing professional development (CPD). Conclusion and Interpretation: Highlights of this research concluded that community membership positively impacts members’ professional development. The majority of respondents indicated that the community enabled them to stay up to date on the latest developments in their fields. They also exchanged information and ideas with their colleagues. Citation: Helen-Sarmast H, Bandlow R, Smith T, Afshar K (2023) A Case Study of a Community of Practice among Pediatricians at BC Children’s Hospital, Vancouver, British Columbia. J Community Med Public Health 7: 338. DOI: https://doi.org/10.29011/25772228.100338 2 Volume 7; Issue 03 J Community Med Public Health, an open access journal ISSN: 2577-2228 Background A chronic global shortage of pediatricians leads to overcrowded pediatrics departments. According to the Vancouver Sun, Canada had 2.4 doctors per 1,000 residents in 2019, despite being one of the four countries with the highest healthcare spending [1]. Based on the 2018 report of Child Health BC, British Columbia has approximately 175 general pediatricians, which means that 2.2 pediatricians are available for every 10,000 children. A total of 30 out of 175 general pediatricians are affiliated with BCCH [2]. Lack of enough pediatricians forces them to multitask, resulting in unfocused clinical procedures and lack of time for their Continuing Professional Development (CPD). The situation that affects the quality of their work, increases medical errors and mortality/ morbidity rates among children [3,4]. While it is essential for pediatricians to keep up with CPD, the majority of them enter the workplaces after their formal studies with a perception that they have completed their formal education and should now only focus on their practices [5]. Although it is true for the most part that their formal education is over, it does not mean that they can rest back and practice as healthcare providers, doctors, and pediatricians for the next 20 or 30 or even more years without CPD [5]. CPD, on the other hand, is an issue among HCPs. The problem is that upon entering workplaces, they quickly find themselves overwhelmed with heavy workloads, leaving them with little or no time to pursue their CPD [6]. This is the case especially with traditional CPD, which is passive learning requiring attending lectures. Studies demonstrated that traditional CPD is ineffective and even though it may increase physicians’ knowledge, it usually falls short in improving professional practice or patients’ outcomes [7]. According to Feldacker, et al. an effective CPD should improve HCPs’ knowledge and improve their attitude and practice [8]. The need for Continuing Professional Development (CPD) CPD is essential not only for HCPs but also for improving the quality of health care. In contrast to the formal medical education, CPD is fundamentally different. Formal training is governed by specific rules and regulations, while CPD involves self-directed, practice-based, and informal learning. The purpose of CPD is to maintain and enhance the competencies of HCPs (knowledge, skills, attitude) in order to meet changing patient needs, respond to scientific advances, and incorporate the evolving expectations of licensing bodies and society [9]. CPD in medical profession refers to “a process of documenting and tracking the knowledge, skills, and experience of doctors and HCPs which they attain both formally and informally at their work, beyond initial school training” [10]. CPD helps maintain professional development by including various learning methods, such as interactive workshop sessions, educational events, conferences, best practice techniques, e-learning programs, and idea-sharing [10]. Kennedy has identified and categorized a range of models of CPD that professionals might adopt to overcome their CPD needs. The category includes nine models: training, awardbearing, deficit, cascade, standards-based, coaching/mentoring, community of practice, action research transformative model [11]. Communities of Practice (CoP) One of the CPD models is the Community of Practice (CoP), which has been asserted to be a powerful site of transformation and Knowledge Management (KM) where the unique knowledge and experience of individuals is significantly enhanced through collective initiative [11]. CoPs are defined as “groups of people who share a concern, a set of problems, or a passion about a topic and who deepen their knowledge and expertise in this area by interacting on an ongoing basis” [12]. Knowledge creation and management are fundamental components of any CoP. It combines personal and professional development with organizational development to foster a collaborative culture and encourage reflection on problems and challenges encountered (13). Due to the advancement of technologies and social networking that make it possible to connect people over distance and time, several organizations have adopted Community of Practice (CoP) methods to improve their KM [14]. Although communities of practice can take many forms, they all have three fundamental components: a domain of knowledge, a community that has been developed around this domain, and shared practices that the community is developing to be effective [12]. Purpose of the Study This study was a case study of a selected community of practice in a single children’s hospital in Vancouver, British Columbia (BC Children’s Hospital (BCCH)). The purpose of the study was to learn more about the selected community in terms of its dynamics and features, such as: its topics of interest, its members and their engagement in productive and sustained interactions among themselves via the community, as well as its functionality, productivity and the way knowledge, experiences, and stories about work experiences are shared across the community. Citation: Helen-Sarmast H, Bandlow R, Smith T, Afshar K (2023) A Case Study of a Community of Practice among Pediatricians at BC Children’s Hospital, Vancouver, British Columbia. J Community Med Public Health 7: 338. DOI: https://doi.org/10.29011/25772228.100338 3 Volume 7; Issue 03 J Community Med Public Health, an open access journal ISSN: 2577-2228 Research Questions Four-research question led this study: • What is the domain of interest to the community? • What are the members’ experiences of engaging in productive and sustained communication among themselves? • What are the members’ experiences with creating and sharing knowledge, experiences, and stories about their work across the community? • In what ways do members perceive community participation to be beneficial to their professional development?