La collaboration interprofessionnelle au sein de communautés de pratique œuvrant auprès de patients atteints de maladies chroniques : synthèse des expériences rapportées dans la littérature

Today’s health system is increasingly complex due to the growth of chronic illnesses. The anticipated increase in the prevalence of chronic illnesses means there is an urgent need for a different type of organization and approach to providing services to the patient. This adjustment in health care delivery calls for a paradigm shift based on inter-professional collaboration and openness to uncertainty, which will in turn facilitate knowledge sharing. In this regard, communities of Practice (CoP) appear to be a way to facilitate the development of inter-professional collaboration and the sharing of knowledge, and therefore merit further investigation in order to determine whether or not they can foster such collaboration and facilitate the co-construction of knowledge leading to an evolving practice that is patient oriented and adapted to complexity. Our research is consistent with this view and is driven by an interest in the interprofessional collaboration experiences, as reported in litterature, that have taken place as part of communities of practice and have centred on patients suffering from chronic illnesses.   In order to achieve this, we first developed a conceptual framework with the aim of identifying the theoretical and conceptual foundations of communities of practice. This has led us to 1) analyze the evolution of the concept of communities of practice in the major works of Wenger and of his collaborators; 2) position communities of practice by comparing them to other forms of collaborative work with which they are frequently associated and even substituted or mistaken for in the literature (such as community, learning community, learning organization, epistemic community); 3) compare the concept of collaboration with other similar concepts (including collaboration), as well as the notions of interdisciplinarity and inter-professionalism often associated with communities of practice; 4) support the cognitive and collaborative dimensions inherent to communitied of practice; and 5) identify the advances and limitations attributed to the implementation of the concept of communities of practice in the health field. Metasynthesis (Beaucher et Jutras, 2007) ), as part of a ‘‘comprehensive interpretative’’ approach, was determined to be the most appropriate research method for understanding the experiences of interprofessional collaboration as part of communities of Practice in the health field.. Metasynthesis provided us with an overview of the literature on the subject of CoP in the health field and allowed us to create a topology of the 194 collected articles. This overview led to the selection of 13 articles describing real experiences of CoPs. As such, in terms of contribution, this metasynthesis enabled us to 1) identify the reported conceptual vagueness associated with the implementation of CoPs; 2) identify the benefits and challenges of their implementation in the field of health; and 3) demonstrate that further research on the development process of communities of practice in the field of care practice, including but not limited to situations involving chronic illnesses, is necessary.

Keyphrases: Collaboration, Community of Practice, Inter-professionalism, Interdisciplinarity, Chronic illness, Chronic disease, Focused on the patient