J. Med. Internet Res. - Implementing a virtual community of practice for family physician training: a mixed-methods case study.

Tópicos

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Resumo

CKGROUND: GP training in Australia can be professionally isolating, with trainees spread across large geographic areas, leading to problems with rural workforce retention. Virtual communities of practice (VCoPs) may provide a way of improving knowledge sharing and thus reducing professional isolation.OBJECTIVE: The goal of our study was to review the usefulness of a 7-step framework for implementing a VCoP for general practitioner (GP) training and then evaluated the usefulness of the resulting VCoP in facilitating knowledge sharing and reducing professional isolation.METHODS: The case was set in an Australian general practice training region involving 55 first-term trainees (GPT1s), from January to July 2012. ConnectGPR was a secure, online community site that included standard community options such as discussion forums, blogs, newsletter broadcasts, webchats, and photo sharing. A mixed-methods case study methodology was used. Results are presented and interpreted for each step of the VCoP 7-step framework and then in terms of the outcomes of knowledge sharing and overcoming isolation.RESULTS: Step 1, Facilitation: Regular, personal facilitation by a group of GP trainers with a co-ordinating facilitator was an important factor in the success of ConnectGPR. Step 2, Champion and Support: Leadership and stakeholder engagement were vital. Further benefits are possible if the site is recognized as contributing to training time. Step 3, Clear Goals: Clear goals of facilitating knowledge sharing and improving connectedness helped to keep the site discussions focused. Step 4, A Broad Church: The ConnectGPR community was too narrow, focusing only on first-term trainees (GPT1s). Ideally there should be more involvement of senior trainees, trainers, and specialists. Step 5, A Supportive Environment: Facilitators maintained community standards and encouraged participation. Step 6, Measurement Benchmarking and Feedback: Site activity was primarily driven by centrally generated newsletter feedback. Viewing comments by other participants helped users benchmark their own knowledge, particularly around applying guidelines. Step 7, Technology and Community: All the community tools were useful, but chat was limited and users suggested webinars in future. A larger user base and more training may also be helpful. Time is a common barrier. Trust can be built online, which may have benefit for trainees that cannot attend face-to-face workshops. Knowledge sharing and isolation outcomes: 28/34 (82%) of the eligible GPT1s enrolled on ConnectGPR. Trainees shared knowledge through online chat, forums, and shared photos. In terms of knowledge needs, GPT1s rated their need for cardiovascular knowledge more highly than supervisors. Isolation was a common theme among interview respondents, and ConnectGPR users felt more supported in their general practice (13/14, 92.9%).CONCLUSIONS: The 7-step framework for implementation of an online community was useful. Overcoming isolation and improving connectedness through an online knowledge sharing community shows promise in GP training. Time and technology are barriers that may be overcome by training, technology, and valuable content. In a VCoP, trust can be built online. This has implications for course delivery, particularly in regional areas. VCoPs may also have a specific role assisting overseas trained doctors to interpret their medical knowledge in a new context.

Resumo Limpo

ckground gp train australia can profession isol traine spread across larg geograph area lead problem rural workforc retent virtual communiti practic vcop may provid way improv knowledg share thus reduc profession isolationobject goal studi review use step framework implement vcop general practition gp train evalu use result vcop facilit knowledg share reduc profession isolationmethod case set australian general practic train region involv firstterm traine gpts januari juli connectgpr secur onlin communiti site includ standard communiti option discuss forum blog newslett broadcast webchat photo share mixedmethod case studi methodolog use result present interpret step vcop step framework term outcom knowledg share overcom isolationresult step facilit regular person facilit group gp trainer coordin facilit import factor success connectgpr step champion support leadership stakehold engag vital benefit possibl site recogn contribut train time step clear goal clear goal facilit knowledg share improv connected help keep site discuss focus step broad church connectgpr communiti narrow focus firstterm traine gpts ideal involv senior traine trainer specialist step support environ facilit maintain communiti standard encourag particip step measur benchmark feedback site activ primarili driven central generat newslett feedback view comment particip help user benchmark knowledg particular around appli guidelin step technolog communiti communiti tool use chat limit user suggest webinar futur larger user base train may also help time common barrier trust can built onlin may benefit traine attend facetofac workshop knowledg share isol outcom elig gpts enrol connectgpr traine share knowledg onlin chat forum share photo term knowledg need gpts rate need cardiovascular knowledg high supervisor isol common theme among interview respond connectgpr user felt support general practic conclus step framework implement onlin communiti use overcom isol improv connected onlin knowledg share communiti show promis gp train time technolog barrier may overcom train technolog valuabl content vcop trust can built onlin implic cours deliveri particular region area vcop may also specif role assist oversea train doctor interpret medic knowledg new context

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