Communities of Practice: An Innovation in Experiential Education

Gears and people

Grant Recipients: Nancy M. Waite and Emily Milne, School of Pharmacy

Project Team: Nancy M. Waite, Emily Milne, and Samantha Yau, School of Pharmacy

(Timeline: February 2015 - December 2018)

Project Summary

School of Pharmacy PharmD students complete three 8-week patient care rotations in one of 14 Ontario regions. Communities of Practice (CoPs) are the rotations’ guiding framework – to promote collaborative learning between health care practitioners and the students. To the best of our knowledge, UWaterloo is the only school in North America to add this model to traditional work-integrated learning.

We investigated how regions develop CoPs that best meet their learning needs, how students, preceptors, and regional clinical coordinators (RCCs) experience the CoP model, and what barriers/facilitators to learning occur because of the model.  A comprehensive report was generated that summarized aspects that did (e.g., knowledge sharing and collaboration) and did not (e.g., logistics and coordination) work well, along with areas for improvement (e.g., clearer CoP assignment guidelines and examples). This was used as part of the curricular quality assurance process for improving our patient care rotations in subsequent iterations.

Intended Project Outcomes and Research Questions

  1. Identify the key functional and educational characteristics of CoP, and categorize our 14 regions based on these characteristics (examples of categories include: size, types of members, level of participation of students and other members, activity level, type of learning activities, new or pre-existing)
  2. Better understand the impact of the CoP model on students, preceptors, and RCCs and the barriers/facilitators to learning
  3. Use this information as a part of the curricular quality assurance process for improving the model in subsequent iterations, and creating curricular tools (i.e., a CoP toolkit) that support enhancements.


A Community of Practice: Assessment & Feedback report was completed that summarized student, preceptor and regional clinical coordinator (RCC) survey results, and analysis of CoP assignments and course feedback evaluations. It also provided recommendations for improvement and was shared/discussed with the experiential team as part of our quality improvement process.   

Key findings included identifying aspects that did (e.g., knowledge sharing and collaboration) and did not (e.g., logistics and coordination) work well. Interestingly, preceptors and regions adopted the CoP concept with varying degrees of immersion and formality. Survey data also revealed the need for more clarity around the CoP concept and model and associated activities. This is illustrated by the difficulties respondents had differentiating the CoP model and concept from the CoP assignment and Patient Care Rotations in general. This can be interpreted as a need for further student education or the fact that the CoP is so integrated that students don’t “separate it out” from the other rotation components (which is actually a positive sign).

Findings presented in the report show that the CoP concept and model embedded within UW’s Primary Care Rotations has traction and is having a positive impact on student learning as well as preceptor and RCC experiences. However, more time is needed to develop the concept and refine the curricular tools to support its further refinement and impact.

Dissemination and Impact

  • At the individual level: Students participating in rotations have benefited from this research for their 2017 rotations as their RCCs and preceptors received enhanced CoP training.
  • At the Department/School and/or Faculty/Unit levels: In response to the CoP report, the experiential team has revised its RCC and Preceptor orientation sessions and implemented targeted instruction around the CoP.  The role that RCCs have in establishing CoP hubs in their Region is now more clearly articulated.
  • At the national level: Tolmie, A., N. Waite, and E. Milne. “Communities of Practice: An Innovation in Experiential Education.” Poster presentation at the Association of Faculties of Pharmacy of Canada Annual Conference and Meetings. Richmond, BC, Canada, June 2016.
  • At the international level: Milne. E.,A. Tolmie, N. Waite. “PharmD Patient Care Rotations: Student and Preceptor Feedback.” Poster presentation at the World Association of Cooperative Education 2nd International Research Symposium. Victoria, BC, Canada, June 2016.

Impact of the Project

  • Teaching: The CoP report generated a lot of discussion amongst the experiential team and the RCCs.  As discussed above, our RCC and preceptor training programs were changed to better explain the CoP concept but more importantly provide them with examples so they can better see what it “looks like” in their clinical practice.  Since we studied the CoP in the first year of the program, it was helpful to gather feedback and be able to make modifications.  Upon reflection, the team also thought it wasn’t surprising that further time was needed for the concept to become solidified with our practitioners and students.  Students had no explanations/examples from previous students to guide them and pharmacists who were supervising our students were doing so for the first time and had a lot of other requirements such as assessment tools to become familiar with. It will be interesting to see the feedback from the upcoming group to see if experience and our revised training package enhanced their use of the CoP model.
  • Involvement in other activities or projects: This research was valuable in helping a fairly inexperienced experiential team become involved in a curricular quality improvement initiative. As a result, we have now generated similar reports for our co-op and rotation offerings. In both cases, changes have been made to the programs based on the analyzed results. The experiential team has requested that we continue this process with targeted quality assurance questions on an annual basis.They have also become interested in disseminating this work beyond the School as they have found little in the literature that informs work-integrated learning activities in pharmacy. The School’s Assessment Committee has been very appreciative of the work completed by the experiential team with respect to the Community of Practice. We have an upcoming accreditation report that has questions specifically targeted to experiential education and the outcomes achieved. The three reports mentioned above are being used by this Committee and they have commented on the strong quality and practical nature of this work.                        


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