BACKGROUND:
Communities of practice have been proposed as a
workforce development strategy for developing
dietitians, yet little is known about how they
work and for whom, as well as under what circumstances. We aimed to understand the mechanisms by which
dietitians working in Aboriginal and
Torres Strait Islander health benefit from
communities of practice.
METHODS:
A realist evaluation of 29 interviews with non-Indigenous
dietitians and
nutritionists was employed, which was conducted over the
course of two
communities of practice (2013 and 2014) and follow-up interviews in 2019. Programme theory was developed from
analysis of initial interviews and used to recode all interviews and test theory. The identification of patterns refined the programme theory.
RESULTS:
Six refined theories were identified (1) a
community of practice fosters the relationships that support navigation of the many tasks required to become more responsive
health professionals; (2) committed and open participants feel supported and guided to be reflexive; (3) sharing, reflexivity,
feedback and support shift
awareness to one's own practice to be able to manoeuvre in intercultural spaces; (4) through sharing,
feedback, support and collaboration, participants feel assured and affirmed; (5) connection through
feelings of
understanding and being understood contributes to commitment to remain working in the area; and (6) through sharing,
feedback, support and collaboration, participants with varied experience and
roles see the value of and gain confidence in new perspectives, skills and practices.
CONCLUSIONS:
Further
research is required to test this model on a much larger scale, with
communities of practice inclusive of Aboriginal and non-Aboriginal
health professionals together, and across a diverse group of
dietitians.