How Communities of Practice Generate Knowledge Translation Outcomes to Support Public Health Issues: A Realist Synthesis

Abstract

Communities of practice in health settings often serve to address contemporary public health issues by sharing knowledge and experiences about accelerating implementations and innovative solutions. Because there are gaps between the practical application of communities of practice and the scientific knowledge about their effectiveness, this realist synthesis aimed to identify how and why members of communities of practice translate the shared knowledge and apply it in their daily practice. In a six-step process, this realist synthesis included a scoping review that led to an initial theory map (Step 1), followed by searches (Step 2), appraisal (Step 3), extracts and organisation (Step 4), and analysis and synthesis (Step 5). These steps organised the literature into context–mechanism–outcome configurations that guided the development of a realist framework that can support research and practice (Step 6). We identified three key ways in which knowledge translation may occur: (1) Members bring (new) knowledge to their parent organisation; (2) members change the (daily) practice in their parent organisation; and (3) members improve health outcomes through systemic changes. We found that an initial outcome of knowledge sharing within the community of practice is conditional to achieving outcomes of knowledge translation outside the community of practice. This knowledge sharing within the community of practice is more likely to occur in a structured and trusted environment where members feel safe, as well as where members recognise individual and organisational benefits from participation. To achieve knowledge translation outside the community of practice, support from the parent organisation becomes important, alongside learning and developing confidence to implement the knowledge. The synthesis of the different contexts that potentially trigger mechanisms that lead to desired outcomes provides insight into how best to inform community of practice initiators and facilitators about supporting effective public health responses.