“This is my take-home for life!”: professional practice learning on a Community of Practice^*

Abstracts

The learning of practice demand educational strategies focused on reflective and collective processes, such as the Community of Practice (CoP). From an action research directed to the contributions of a mentoring program for professional development, organized in a CoP, with the participation of six junior occupational therapists and three experienced ones, this paper tries to elucidate relevant features for professional learning on the program. The speech and diaries of the participants at the last evaluation meeting were submitted to thematic analysis and the results indicate the importance of: a space for reflection on a continuous basis; the mentor’s actions in fostering reflection; the exchanges between experts and beginners. The CoP, as a rich design for learning, enabled breaking stereotypies and creating new meanings, favoring the development of all involved.

Inservice Education; Qualitative research; Health knowledge, attitudes and practice; Health manpower; Occupational Therapy

A aprendizagem da prática demanda estratégias formativas focadas em processos reflexivos e coletivos, como a Comunidade de Prática (CoP). A partir de pesquisa-ação interessada nas contribuições de um programa de mentoria, em uma CoP, com participação de seis terapeutas ocupacionais iniciantes e três experientes, este artigo busca elucidar as características do programa consideradas importantes para a aprendizagem profissional. Os dados provenientes do discurso e dos diários dos participantes no último encontro de avaliação final foram submetidos à análise temática, e os resultados indicam a importância: de um espaço de reflexão de modo contínuo; das ações da mentora no fomento à reflexão; das trocas entre experientes e iniciantes. A CoP, como um projeto rico para aprendizagem, possibilitou a quebra de estereotipias e a construção de novos sentidos, favorecendo o desenvolvimento de todos os envolvidos.

Educação continuada; Pesquisa qualitativa; Conhecimentos, atitudes e práticas em saúde; Recursos humanos em saúde; Terapia Ocupacional

El aprendizaje de la práctica exige estrategias formativas enfocadas en procesos reflexivos de colectivos tales como la Comunidad de Práctica (CoP). Con base en una investigación-acción interesada en las contribuciones de un programa de mentoría, como la CoP, con participación de seis terapeutas ocupacionales principiantes y tres con experiencia, este artículo busca aclarar las características del programa consideradas importantes para el aprendizaje profesional. Los datos provenientes del discurso y de los diarios de los participantes en el último encuentro de evaluación final se sometieron a un análisis temático y los resultados muestran la importancia de un espacio de reflexión de modo continuo, de las acciones de la mentora en el fomento a la reflexión, de los intercambios entre los principiantes y los que tienen mayor experiencia. La CoP, como un proyecto rico para el aprendizaje, proporcionó la ruptura de estereotipos y la construcción de nuevos sentidos, favoreciendo el desarrollo de todos los participantes.

Educación continuada; Investigación cualitativa; Conocimientos, actitudes y prácticas en salud; Recursos humanos para la salud; Terapia ocupacional

Introduction

Professional practice can be understood as a phenomenon that happens at a certain time and in a certain context, being characterized by situations of singularity, complexity, uncertainty and conflict of values. Thus, it does not belong to the paradigm of technical rationality, according to which practice is the application of theory¹. In the view defended here, practice is sustained by tacit knowledge, which is essential to daily situations, even when the professional uses scientific theories and techniques in a conscious way. So that the professionals understand what is implicit in their working process (beliefs, knowledge and values), they need to get involved in a process of reflection on their action – an intentional process that is linked to doing, happens after its occurrence, and demands a consequent action that is qualitatively different from a routine action².

Thus, reflection becomes a process of doing-meaning that takes the subject from one experience to the other, enabling a better comprehension of the relations that are established to other experiences and ideas, favoring the redefinition of the actions’ meanings and the production of new knowledge^1,3,4, and creating conditions for the continuity of learning². In addition, this movement of knowing-in-action is dynamic and hard to be apprehended; it should be understood as partial interpretations that represent attempts to impose some stability on this process⁴.

In Occupational Therapy, since the end of the 1980s, studies about professional practice have focused on the nature of clinical reasoning, understood as thought directly related to knowing how to act, involving deliberations on what is appropriate for a specific case, with a specific client, in a specific context⁵. This reasoning is qualitatively different throughout the professional career^6-8 and there is the hypothesis that the key difference between a novice professional and an experienced one are not the years of experience, but their skills of reflection in and on action⁷.

Thus, reflective strategies have been increasingly fostered for the teaching of practice in Occupational Therapy^9-11. Supervision is the most used strategy in the teaching of clinical practice, both in initial and continuing education. In some countries (like Canada, England and Australia), mentoring programs in which an experienced professional guides professionally a less experienced occupational therapist are offered on a regular basis^12-14. Some authors^15-17 believe there are no differences between supervision and mentoring, as both are targeted at professional development in a general way. However, in Brazil, the main objective of supervision seems to be the development of clinical handling and reasoning skills, and professional development is a sub-product of this process¹⁸.

Furthermore, collective educational experiences can help to conduct this process, offering parameters for reflection and confronting the professional so that a deeper and more directed dimension can be reached^12,19-21. In this perspective, the framework of the Community of Practice and Identity (CoP), proposed by Ethiènne Wenger²², has been used by many professions^23-25 and by Occupational Therapy^15,26-28 to foster the learning of professional aspects in different educational scenarios.

The framework of the Community of Practice and Identity

The Community of Practice and Identity (CoP)²² is constituted from the mutual engagement of people who are interested in a project of common interest, which is developed by the negotiation of meanings (knowledge, stories, information, ways of doing) in the interaction between the individuals’ participation and what is produced with this participation (reification). The CoP potentializes the construction of new meanings and new forms of participation, always focusing on practice, understood in its twofold dimension: an action in a historic and social context, in its structure and meaning, and also a field of construction of identities, favoring identifications or non-identifications of the forms of being a person in this context.

To belong to a CoP, the subject can be a full member – older and more experienced participants who own the economics of meanings -, or a peripheral member – who are, usually, beginners or collaborators. The tension between these modes of belonging can facilitate or hinder the production of new meanings for the practice, making the process of practical knowledge be dynamic.

In addition, a CoP’s way of producing can be influenced by its members’ involvement in meaning negotiation processes (engagement), by the creation of mental connections and images that extrapolate known experiences, creating new images of the world and of ourselves (imagination), and by how its members align themselves both with the common project and with social, cultural, and organizational structures (alignment). The combination among engagement, imagination and alignment produces specific characteristics, like reflective practice¹, when it combines the imagination of other perspectives, which trigger new interpretations both to practice and to identity (imagination and engagement), or even a practice that considers a broader image of the world (imagination and alignment).

When the common project of the CoP focuses on learning, Wenger²² calls it Community of Learning (CoL), emphasizing that learning, in itself, cannot be designed, but it is possible to build designs that facilitate or inhibit it. To form a context that is rich for learning, the author highlights the importance of designs that favor the combination among engagement, imagination and alignment, in a specific design architecture (which will be presented below).

Thus, based on an action research interested in understanding the contributions of a mentoring program for the professional development of novice occupational therapists, set in a Community of Practice²², this article aims to elucidate the program’s features that were considered important for professional learning.

Methodology

We were involved in an action research^29,30, a modality of qualitative investigation interested in knowledge production about practice and in its improvement. It is characterized by being participatory, both in the sense of including all the people involved (researchers and participants) and in its way of working.

The action research was constructed as a CoL with the participation of: six occupational therapists who were in the second year of a specialization course in Mental Health Occupational Therapy; the researcher, playing the role of mentor and coordinator; and two experienced occupational therapists, teachers-supervisors of the specialization course. The course lasted two years, with full-time dedication, and offered clinical and care provision activities in different mental health services, in which the six students took turns every three months. In each service, there was one supervisor in charge and specific times for supervision.

The project of the Community of Learning

In light of the scenario presented here, we attempted to develop a project centered on Wenger’s²² propositions and which could complement postgraduate education, considering four dimensions (participation versus reification; designed versus emergent; local versus global; identification versus negotiation) that potentialize learning, for each mode of belonging (engagement, imagination and alignment).

The first dimension approaches the interaction between participation and reification (what is produced by subjects’ participation), as what is produced registers a mark on the world, a characteristic that is different from participation, which is ethereal and hard to be accessed. Thus, the project offered tasks and materials that favored the production and sharing of stories about practice (engagement), the imagination of practices from different situations and contexts and the questioning of attitudes and understandings (imagination), and helped the group to take possession of the discourse related to the investigation of their own practice and to produce a collaborative style of working (alignment).

Another dimension encompasses the tension between what is designed and what is emergent, fostering the skill of negotiating new meanings for practice and identity based on what emerges in the context, in response to the project. In our CoL, we favored the development of skills to work in the group’s here-an-now and/or redefine paths and produce meanings in a collaborative way (engagement), aiming to design tasks and offer materials that stimulate the perception of possible contexts and possible dilemma situations, as well as the perception of the narrative course of making decisions (imagination). In addition, the project provided feedback for the participants’ productions constantly, so as to align production to the objectives of the action research and to be open to redefine the research’s objectives according to the group’s needs and demands.

The interaction between local practice and global relations is the third dimension, as what is relevant to learning demands global parameters. Thus, the project favored the establishment of connections among each participant’s lived experience in different contexts, in order to enable the construction of new meanings about the practice (engagement), the sharing of existing models and representations about the practice, and stimulate the production of new meanings about them, relating them to the singularities of individual practice and of practice that is locally produced (imagination). Moreover, we aimed to open space to reflect on the local learning needs, related, however, to the global production in the fields of Occupational Therapy and Education (alignment).

The last dimension involves the offer of a structure to identify and take possession of meanings that are in constant negotiation. The CoL project was constructed to share experiences, increasing the possibilities of identification and negotiation of meanings, and stimulating the negotiation of the ownership of meanings – both when it offered theoretical material to favor the access to the economics of meanings related to the research, and when it appropriated meanings related to practice, belonging to the other participants (engagement). Furthermore, the project encourages the identification with new professional trajectories, the reflection on professional stereotypes and stereotyped practice models (imagination), and the possibility of identification with a critical and reflective professional practice. Finally, it fosters reciprocal power relations, in the sense that all the individuals should assume responsibilities for the continuity of learning in the group (alignment).

The action research process

The CoL met during ten months (from March to December 2007), every fifteen days. There were 18 meetings that lasted one hour each. They were audio recorded, transcribed and, based on this transcription, the groups’ chronicle was prepared³¹ – a narrative of the meeting’s events that remained available for the participants before the subsequent meeting. Thus, if some participant had been absent, she would be able to know what had been discussed; in addition, it served as a basis for other discussions.

Besides participating in the groups, the novice occupational therapists produced a reflective journal that was handed to the mentor-researcher every fifteen days, before the group’s meetings. The diaries were read and feedback was provided for each participant, in order to favor the deepening of the process of reflection on practice.

Furthermore, the researcher prepared a list of themes that were being discussed in the journals and took it to the group’s meetings, as another reified material to organize the discussion. Therefore, during the action research process, a movement of feedback between journals and face-to-face meetings was gradually constructed, as participation in the meetings also offered new ideas for the reflective writing of the diaries.

The researcher also maintained a research journal in which she registered, on a daily basis, her impressions and reflections on the collaborative action research process, mainly about her understanding of the group’s vicissitudes and of her action in the intervention (both in the group and in the feedback she provided for the diaries). Moreover, she registered her impressions and reflections on the relations that were established to the literature of the area and the difficulties and problems that had to be tackled.

The combination of these different strategies to foster learning was evaluated in the last journal writing and in the last face-to-face meeting of the CoL, which was registered and transcribed. This material was submitted to a Thematic Analysis³², which is characterized by aiming to unveil the meaning nuclei that are relevant in communication.

The research was submitted to and approved by the Ethics Committee of the Centro Universitário de Araraquara.

Results and discussion

Four thematic categories that indicate the most relevant characteristics of the mentoring program were found: 1) Supervision versus Mentoring; 2) Actions taken by the mentor-researcher in the conduction of the teaching-learning process; 3) Exchanges between experienced professionals and beginners; 4) Engagement in the process of reflection on action as a transformative element aiming to improve practice and to maintain the constancy of the experience.

Supervision versus Mentoring

Throughout the group’s entire process, there was a constant discussion about the difference between the supervisions received by the participants in different mental health services and the proposal of investigating their practice through the process of reflection on action. Supervision was characterized as a space for thinking about actions in response to patients’ demands and needs in the context of care. The mentoring program, in turn, offered possibilities of investigating practice, reflecting on what was implicit in the occupational therapists’ actions, without, initially, the concern for responding to those demands. This characteristic was considered essential to deepen their reflection, raise their awareness of dilemmas and produce new meanings, investing in an improvement in practice.

“I realize that I started to reflect more and more on very delicate questions, difficulties, anxieties, fears and feelings that involve my practice and that, many times, can’t emerge in other spaces due to the very nature of these spaces or to the need to meet a demand that is usually discussed in meetings and supervisions”. (Isadora)

Thus, the action research project that was proposed favored the offer of spaces for reflecting on practice, in a perspective in which, by suspending the emergencies of practice and focusing on the processes of clinical reasoning and on contexts involved in the practice, it was possible to bring to light what is characteristically implicit. This allowed the participants to look at meanings constructed about norms and standards³³, enabling the redefinition of meanings and the production of new knowledge^1,3,4.

Actions taken by the mentor-researcher in the conduction of the teaching-learning process

The mentor-researcher’ actions focused on sustaining the constitution and functioning of the CoL, facilitating the negotiation of meanings, and aligning the participants’ with the proposals for the investigation of their practice. Such actions were cited as essential characteristics to facilitate the establishment of trust relationships, the understanding of the proposal and exchanges among the participants^28,34.

“[...] through the care you showed in the way you returned our journal and invited us to reflect, […], it’s one of the only spaces in which many things that seem to be taboos for us could emerge…” (Clarice)

According to Wenger²², learning in itself cannot be designed. It demands a rich context so that it can be constructed, in projects that favor the combination of the three modes of belonging. Therefore, the coordinator of the learning project plays an educational role, considering the specificities of each subject and investing, affectively, in their development³⁰. The “care” mentioned in the discourse above implies the construction of a relationship with the subjects and with the collective project, which is what enables an alignment with what is sought by the professional community.

Exchanges among experienced professionals and beginners

The exchanges among the experienced professionals and the beginners during the work were also pointed as an important characteristic of the program. The exchanges were based on telling and sharing experiences, both as a form of offering parameters to organize the beginners’ reflection, and as form of stimulating the experienced professionals’ reflection and awareness-raising about their repertoire, favoring the continuity of their professional development.

“[...] what I feel is greater tranquility at the moments in which I get scared, [...] when I don’t know what to do in a difficult situation, and I think that, before, I was more like ‘oh, my, I think I should know this’, […] and […] during this process […] we could share our experiences and it was great […] listening to you, I think this gradually calmed us down, so I think that, in this sense, I feel […] a great difference in my practice…”. (Mariana)

“[...] I experienced this process of [...] entering a new place, […] that also filled me with insecurities and uncertainties, and being able to be here, ‘[…] I’ve already had the same questions!’, and I really think that experience makes a difference […] on the other hand […] feeling nourished […] by sharing with you […] very similar questions […] it was very nice listening to you, […] this is still our practice! And being able to share with the girls was cool and I think it was positive to our professional life…”. (collaborator Tatiane)

To the Community of Practice and Identity²², the ownership of the economics of meanings and of the competence regime belongs, initially, to the more experienced professionals, full members of the professional community, while the beginners are interested in moving from peripheral to full members. This process was monitored in our CoL and it generated conflicts³⁵ that, when they were tackled, breaking stereotypes and enabling the emergence of the new, they favored the development of both (beginners and experienced professionals).

Engagement in the process of reflection on action as a transformative element aiming to improve practice and to maintain the constancy of the experience

The constancy of the developed activities (meeting in a group, writing journals and giving/receiving feedback) was another important characteristic pointed by the participants to guarantee the success of the mentoring program.

“[...] because I think this [...] constancy […] of us knowing that this place really existed and that we were always here every fifteen days, and we could think together, and we received feedback, and here we could share and realize that, many times, the other people had the same questions, this was a great relief”. (Mariana)

“[...] it was when I could listen to the others’ questions and realize [...] they were very similar to mine, so they were natural and didn’t make me be a bad therapist. And when I had never thought about the question someone brought? A new discovery! We reflected together, I think this is a word that lingers on for me from this group: Together!!”. (Mariana)

“I also see that I’m different in some aspects, because each encounter with the journal, the group, the feedbacks, was a way of taking a stance concerning myself and then narrate an experience or thought to the others. This I’ll take to life…”. (Fernanda)

The constancy of the reflection process as doing-meaning reveals relationships to other experiences and ideas, and creates the necessary condition for the continuity of learning².

The negotiation of meanings (sharing and producing repertoires, ways of doing, knowledge, stories) was the axis that conducted learning, in the interaction between participation (in the group and in the writing of the journals and their feedback) and the reification produced by this participation (group’s chronicle, narratives in the journals and feedbacks). Thus, the constancy of this experience enabled to organize actions and interactions, producing new meanings and new forms of participation and identity²².

Final Remarks

This paper aimed to present characteristics of the design of a CoP targeted at learning and at the improvement in the professional development of novice occupational therapists. The results indicate that the use of educational tools (face-to-face meetings, reflective journals, interaction between experienced professionals and beginners, the group’s chronicles, the feedback provided for the journals), included in a project constructed to foster learning, proved to be capable of improving practice by transforming professionals into investigators of their own practices – professionals who are critical in relation to what they think and do in the care provided in Occupational Therapy.

The format of the mentoring program demanded a differentiation from the proposals of the supervisions experienced by the participants, which focused on the development of clinical and contextual skills targeted at the urgent demands of practice. However, these supervision processes, so common in the Brazilian reality of practice teaching, can also benefit from this type of strategy, which prioritizes education from the perspective of developing investigative attitudes. Understanding clinical reasoning in Occupational Therapy as knowing how to act in a singular context⁵, the investigation of how the professional constructed the meanings of her actions could favor awareness-raising in relation to the theories, beliefs and values implicit in her practice, their questioning and possible changes, as well as the construction of new knowledge.

When Fernanda says “This I’ll take to life!”, referring to her capacity for perceiving herself in order to construct meanings about her practice, this reveals the transformation of this occupational therapist who is at the beginning of her career (like other professionals) into a professional who investigates her own practice.

Furthermore, the results presented here also indicate the importance of the mentor’s or supervisor’s work – as someone engaged in conducting the process, facilitating negotiation and meaning construction -, of the exchanges between experienced professionals and beginners as a field of learning based on experience exchange, and of engagement in the process of reflection on action and of exchanges in the collective dimension – which contributes to align development with what is sought by the professional community.

We know that this experience was framed by a doctoral research and, in this sense, its full replication in education programs can be criticized, mainly in relation to: the mentor-researcher’s availability to carry out all the tasks; the fact that the participants had many supervisions during the week and, thus, the demands of their practice could stay in the background; and even in relation to the large period of time that was dedicated to the intervention. However, with the discussion of the results and our reflections, we hope to contribute to amplify the discussions that surround professional learning processes that are situated/contextualized (in the period of initial education and also in continuing or permanent education). In addition, we hope they foster the use of the framework of the Community of Practice and Identity²² and its potential in learning processes within educational and/or action research projects.

Acknowledgements

To the professionals who participated in the CoL (the six novices at the time), whose names were protected in this article, and to the experienced professionals Cecília Cruz Villares and Tatiane Luize Cecatto.

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• *
  This article is part of the doctoral dissertation authored by Taís Quevedo Marcolino and supervised by Aline Maria de Medeiros Rodrigues Reali, entitled “A porta está aberta: aprendizagem colaborativa, prática iniciante, raciocínio clínico e terapia ocupacional” (The door is open: collaborative learning, novice practice, clinical reasoning and occupational therapy), which was financed (under no. 06/07152-7) by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP). A part of it was published as a complete work in the Proceedings of the XI National Meeting of Occupational Therapy Professors (Rev Ter Ocup Univ São Paulo. 2008; 19 Supl 1:1-189).

Publication Dates

• Publication in this collection
  20 Oct 2016
• Date of issue
  Apr-Jun 2017

History

• Received
  05 Mar 2016
• Accepted
  09 July 2016