AWARENESS AND USAGE OF ONLINE COMMUNITIES OF PRACTICE FOR KNOWLEDGE DISTRIBUTION AMONG PRACTICING MIDWIVES IN KATSINA STATE, NIGERIA  

ABSTRACT

This study investigated the Awareness and Utilisation of Online Communities of Practice for knowledge sharing among Practicing Midwives in Katsina State. In order to achieve this objective, five (5) research questions and three (3) null hypotheses were formulated. A cross sectional survey design was employed to conduct the study. The population of the study comprised of all the hospitals under Katsina State Health Service Management Board. Out of the twenty (20) hospitals, eight (8) hospitals were selected using stratified sampling procedure. An open and close-ended questionnaire was administered to 180 Midwives in the hospitals selected with a total of 113 (62.7%) copies returned. The data collected for the study were presented and analyzed using both descriptive statistics and inferential statistics. It was discovered that, majority of the Midwives in Katsina State hospitals are aware of the existence of Katsina nurses forum (Facebook) and it is being utilize  for knowledge sharing, whereas all the Midwives in Katsina State are not aware of the existence of Global Online Communities of Practice for knowledge sharing due to lack of awareness, lack of trust, Workplace acceptance and support, Lack of internet access, Lack of active participation of members, Lack of time, and slow internet speed. It was found that, networking with peers, user friendly and multi media oriented, and professional development were the reasons for utilisation of Online Communities of Practice for knowledge sharing. The study recommends the design of awareness campaign programs, formulation of policies that support the use of Online Communities of Practice for knowledge sharing, use of consultancy services to mount training, and creation of local platforms using social networking sites across all the Hospitals to sensitize, motivate, and encourage the Midwives in Katsina State Hospitals to embrace the use of both local and global Online Communities of Practice for knowledge sharing.

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

A successful online collaborative knowledge sharing among geographically dispersed professionals depend upon the level of awareness and utilisation of various online technologies use for knowledge sharing. The need to improve standardization and spread of best practices among practitioners brought about knowledge sharing within and outside organization. Knowledge sharing is the flow of knowledge from someone who has it to someone who wants it. Lee (2001) defined Knowledge sharing as "activities of transferring or disseminating knowledge from one person, group or organization to another". In other words, knowledge sharing is the process of exchanging and communicating knowledge between employees in an organization.

Knowledge sharing can be created in many forms such as: “a story describing a similar experience whereby a method or technique was developed or used to solve a problem. If unable to provide a solution directly, knowledge may be shared in relation to contacting someone who might know and be willing and able to help”.

Today, there is no doubt that one of the biggest and strategic assets of an organization affecting its success and competitive advantage is its knowledge and Knowledge sharing activities. However, what knowledge actually means is still widely debated. A definition provided   by Davenport   and   Prusak (2000)   is   currently more commonly   adopted in   the literature: "fluid mix of framed experience, values, contextual information, and expert insight that provides a framework for evaluating and incorporating new experiences and information". Knowledge can be defined as human expertise, which is found in peoples mind and gained through experience, interaction and the like. Knowledge can be used for learning new things, creating core competences, solving problems, and initiating new situations for individuals and organizations (Kumaresan & Liberona 2013). Organizations that need to grow, compete, and function in an ever evolving environment, naturally must consider how to exchange and communicate knowledge between employees within and outside the organization, this is because knowledge sharing offers the benefits of building on past experience and knowledge, responding more quickly and efficiently to problems, developing new ideas and insights, avoiding reinventing the wheel or repeating past mistakes.

Knowledge sharing may deliver a strong benefit by way of increasing efficient operations, better decision making, improved project delivery and services, improved ways of working and minimization of unnecessary duplication, improved client/customer service, speed and effectiveness at which key organizational issues are addressed, also improved the identification and dissemination of best practices, enhanced organizational development and the creation of new opportunities, inspired creativity and innovation, and enhanced employees' retention rates.

Exchanging and communicating of knowledge between employees within organization is referred to as intra knowledge sharing, while knowledge shared or accessed outside organization is referred to as inter knowledge sharing. Seleamat and Choudrie (2004) revealed that, inter knowledge sharing is an important factor in improving the quality of work, efficiency of decision making, productivity, competitiveness, customer service, production of goods, accuracy of task performance, and achieving major savings in time for individuals and organizations. Unlike other organizational assets, knowledge tends to increase when used or shared: "ideas bread new ideas and shared knowledge stays with the giver while it enriches the receiver"

(Devenport and Prusak 1998).

Healthcare Knowledge Sharing

It has been argued that capturing and sharing of knowledge within and outside organization, is a top priorities for most organisations today (Quintas 2002). This is even more important in healthcare organisations than in other organisations as patient care is very complex and challenging. Knowledge sharing among healthcare professionals is considered to be critical for improving the quality of patient care; it may involve sharing of clinical experiences, skills, know-how known to have significant impact on the quality of medical diagnosis and decisions.

Lin and Hsieh (2006) are of the view that, delivering safe and high quality services to patients is highly dependent on sharing the following types of knowledge, i.e. medical knowledge, scientific knowledge, incident knowledge, and experience knowledge.

Medical knowledge is defined as the required information for diagnosis and treatment (Aron, Dutta, Janakiraman, & Pathak, 2011). Scientific knowledge is about applying research findings in practice. Incident knowledge refers to learning from medical errors. However, experience knowledge refers to experienced healthcare providers educate less experienced practitioners about the best practice procedures. Failure to share the above mentioned types of knowledge can impact on patient safety (Lin and Hsieh, 2006). Thus, all these types of knowledge require special attention, in order to create an environment to improve the quality of healthcare services. One of the mechanisms to support knowledge sharing among professional practitioners is through Communities of Practice platform.

Communities of Practice

The notion of Communities of Practice as a milieu for knowledge sharing has gain significant ground in recent years particularly in the cooperate world (Hung, Huang, Lin, and Tsai 2005; Wenger and Synder 2000). Lave and Wenger (1991) have defined Communities of Practice as a group of people who come together to share common interests and goals, with the aim of sharing information, developing knowledge and developing themselves both personally and professionally. Other definitions of community of practice are: “groups of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise in this area by interacting on an ongoing basis” (Wenger, McDermott, & Snyder 2002), and “a group of people informally bound together by shared expertise and passion for a joint enterprise” (Wenger and Snyder 2000).  Quintas and Ray (2002) paraphrase Wenger (1998) by describing Communities of Practice as an informal social network in which individuals engage with each other to share applied knowledge and experience. This relationship is facilitated by a shared repertoire of concepts, actions, tools, stories, artifacts and discourse. Lesser & Storck, (2001) defined Communities of Practice as a group whose members regularly engage in sharing and learning, based on their common interests. It is clear from these descriptions that when referring to Communities of Practice the recurring terms and emphasis is on the informal nature of the relationship, and on the sharing of applied knowledge / experience. These 'communities of practice', as they are often called, play a critical role: they are the major building blocks in creating, sharing, and applying organisational knowledge.

Wenger et al. (2002) identified three essential characteristics of Communities of practice: domain, community, and practice. The 'domain' creates common ground (i.e. the minimal competence that differentiates members from non-members), and outlines the boundaries that enable members to decide what is worth sharing and how to present their ideas.  The „community‟ creates the social structure that facilitates learning through interactions and relationships with others. The 'practice' is the specific knowledge that the community shares, develops, and maintains.

Communities of Practice was initially considered to be predominantly a situated learning or co-located learning that involve face to face exchange of knowledge. However, due to geographical distance, dispersion, and time differences of professional practitioners, the traditional Communities of Practice sharing of knowledge on regular basis can be costly, time consuming and more difficult. However, the spread of technology and globalization has resulted in the emergence and development of different Online Communities of Practice. The Internet as an agile, flexible and low cost communication means was the propulsion factor for the adoption, in large scale of Online Communities of Practice. An Online Communities of Practice is a network of individuals who share a domain of interest about which they communicate online. The practitioners share resources, experiences, problems, solutions, tools, methodologies. Such communication results in the improvement of the knowledge of each participant in the community and contributes to the development of the knowledge within the domain.

Online Communities of Practice facilitates the sharing of experience by enabling people with common interests and objectives to engage in discussion, debate, and reflection through the web. An important Online Communities of Practice characteristic is asynchronous communication, i.e., it is not limited to having all parts interacting at the same time. With this, using the Internet, a disperse group of professionals can talk asynchronously according to their convenience (Cesar, Bulterman, Guimaraes, & Kegal 2010). Online communities of practices are organized using online forums, mailing list, social media, and website/web portals such as:

Facebook

• Katsina Midwives Forum (https://wv\''w.facebook.com/KatsinaNurscsForum),
• World Midwives Community (https://www.facebook.com/WorldMidwives).

Twitter

National Association of Nigeria Nurses and Midwives

(https://twitter.com/nannm1)

LinkedIn

Nursing & Midwifery Council (https://www.linkedin.com/company/thenursing-and-midwifery-council).

YouTube

International Confederation of Midwives

(https://www.youtube.com/user/worldIVlidwives/feed')

Web portals

• The Global Alliance for Nurses and Midwifery (GANM) (https://knowledgegateway.org/ganm)
• Postpartum Family Planning Communities of Practice (https://knowledgegateway.org/ppfp)
• Family Planning and Immunization Integration (https://knowledgegateway.org/fpimmunization)
• RH Global (https://knowledge-gateway.org/global)
• Urban Reproductive Health (https://knowledge-gateway.org/urbanrh) • Elimination of Mother-to-Child Transmission of HIV (https://knowledge         gate way. org/emtct)
• The Maternal, Infant and Young Child Nutrition and Family Planning

Communities of Practice (https://knowledge-gateway.org/miycnfp)

The Online Communities of Practice provide Midwives around the world access to the relevant information they need, at the time they need it, and in a venue in which they can immediately share local and international experience in order to improve reproductive health programs.

However, the creation of Online Communities of Practice may not guarantee that knowledge sharing will actually take place. The success of any Online Communities of Practice depends primarily on whether the users are willing to adopt and make a proper use of the platform (Gu and Jarvenpaa 2003). It is believed that Online Communities of Practice may not generate value itself. For it to achieve the expected potentials, its users are required to adequately and properly utilize it in the intended way.

In developing countries like Nigeria, knowledge sharing is predominantly through traditional Communities of Practice where the participants of traditional Communities of

Practice meet face to face to discuss and share knowledge. This is unlike developed countries where the use of Online Communities of Practice for knowledge sharing is increasingly popular and most preferred tool for knowledge sharing among Midwives

(Romano, Gesualdo, Pandolfi, Tozzi, & Ugazio 2012; Severin,  Kurosinksi, Verbraeken, Simonds, & Palange 2012). A survey on Physicians who use social media and other internet-based communication technologies shows that more than 70% of the United State Midwives use it to obtain and share relevant knowledge with peers in order to minimize professional isolation, and bridge knowledge gaps that exist between them (Cooper, Gelb, & Rim,2012).

1.2    Statement of the Problem

Knowledge sharing among healthcare professionals is considered to be critical for improving the quality of patient care, such as the sharing of scientific knowledge, incident knowledge, and experience knowledge, is known to have a significant impact on the quality of medical diagnosis and decisions making. The absence of knowledge sharing in our hospitals can lead to professional isolation and what is called "Knowledge to Practice gap". The gap that exists between what is already known and what is actually done in practice (Lin and Hsieh, 2006; W.H.O., 2005). The knowledge to practice gap, is an important cause for the occurrence and reoccurrence of various medical errors such as missing-diagnosis, wrong treatment, and unexpended deaths. Bridging the knowledge to practice gap is achieved through sharing of relevant knowledge and scientific evidence based practices on regular basis (Richey & O' Brien, 2011, W.H.O. 2005).

However, traditional or face to face methods of knowledge sharing on regular basis (such as seminars and workshops) can be costly, time consuming and more difficult due to geographical dispersions of professionals. Thus, proper and adequate use of Online Communities of Practice is a viable alternative to live conversation, spread of best practices on regular basis, irrespective of different geographical locations and time differences. Online Communities of Practice offer a unique low-cost way to work towards closing knowledge to practice gap by making latest scientific evidence based practice available to reproductive health professionals and provide other supports that would otherwise be unavailable to healthcare professionals. Several researches show that Midwives in developed countries use Online Communities of Practice to minimize professional isolation, and bridge the knowledge to practice gaps that exist between them

(Antheunis et al. 2013; Cooper, et al. 2012; Lulic and Kovic 2012;  McGowan, Wasko, & Vartabedian, 2012). Similarly, the use of Smartphone and tablets for online Communities of Practice has increase significantly among Midwives around the world (Antheunis, Tates, & Nieboer 2013; Lulic and Kovic 2012).

Despite the potentials of Online Communities of Practice, a preliminary investigation of five public rural hospitals in Katsina State conducted by the researcher showed that, the available platforms for Midwives in Katsina State Hospitals to share knowledge were traditional or face to face methods (such as seminars and workshops), which is not on regular basis, time consuming, high cost, and more difficult due to geographical dispersions of professionals, which gives room for high level of professional isolation and knowledge to practice gap among the Midwives, the result of which can be seen in high occurrences of missing diagnosis, wrong treatment, and unexpected deaths of women during birth. The consequences of the professional isolation and knowledge to practice gaps are evidence in unacceptable high level of maternal mortality rate of

1,000/100,000 live births in Katsina state, and a shortfall in achieving the 5^th Millennium Development Goals (W.H.O. 2005; Katsina State Ministry of Health, 2010). This brought the question that; could the above mentioned matter be attributed to low awareness and usage of Online Communities of Practice for knowledge sharing among practicing Midwives in Katsina state? In light of the foregoing, there is the need to investigate the extent of the awareness and utilisation of Online Communities of Practice for knowledge sharing among practicing Midwives in Katsina State Hospitals.

1.3    Research Questions

The research seeks to find answers to the following research questions:

• What types of Online Communities of Practice are available for knowledge sharing among Midwives in Katsina State Hospitals?
• To what extent do Midwives are aware of Online Communities of Practice for knowledge sharing in the Hospitals under study?
• To what extent do Midwives utilise Online Communities of Practice for knowledge sharing in the Hospitals under study?
• What are the reasons for using Online Communities of Practice for knowledge sharing by the Midwives in the Hospitals under study?
• What are the challenges associated with the utilisation of Online Communities of

Practice for knowledge sharing by Midwives in the Hospitals under study?

1.4 Objectives of the Study

The research was designed to achieve the following objectives:

• To find out the types of Online Communities of Practice available for knowledge sharing among Midwives in Katsina State Hospitals.
• To ascertain the extent Midwives in Katsina State Hospitals are aware of Online Communities of Practice for knowledge sharing.
• To ascertain the extent Midwives in Katsina State Hospitals utilise Online Communities of Practice for knowledge sharing among them.
• To find out the reasons Midwives in Katsina State Hospitals utilise Online Communities of Practice for knowledge sharing.
• To reveal the challenges to utilisation of Online Communities of Practice for knowledge sharing among Midwives in Katsina State Hospitals.

             

1.5   Hypotheses

The research sought to answer the following null hypotheses:

Ho1. There is no significant difference among Midwives in Katsina State Hospitals in their level of awareness of Online Communities of Practice for knowledge sharing.

Ho2. There is no significant difference among Midwives in Katsina State Hospitals in their level of utlisation of Online Communities of Practice for knowledge sharing.

Ho3. The challenges to Online Communities of Practice utilisation for knowledge sharing have no significant effect on the level of utilisation among Midwives in Katsina State

Hospitals.       

1.6    Significance of the Study

The focus of this study was to determine the level of awareness and utilisation of Online Communities of Practice for knowledge sharing among Midwives in Katsina state

Hospitals. The expected outcomes of the study will help in creating wider awareness of the various Online Communities of Practice and the benefits of utilising it for knowledge sharing and professional development among Midwives in Katsina State, and it will also help in creating awareness among information professionals.

The findings of the study will help in providing information that will assist Katsina State Health Service Management Board and the Federal Republic of Nigeria to identify the extent at which Online Communities of Practice are being utilized among Midwives for knowledge sharing and the challenges of their utilisation, so as to provide alternative platform as well as provide suitable measures, strategies, and infrastructure to improve the adoption and utilisation of online communities of practices platforms for  standardization and adoption of best practices among Midwives in Katsina State and elsewhere in the country and beyond. Similarly, it would contribute to the existing body of knowledge.

1.7       Scope of the Study

The study covered only two categories of Midwives i.e. Nurse-Mid wives and Midwives in the General and Maternity Hospitals under Katsina State Health Service Management Board. The exclusion of the Midwives from the Federal and Local Government Area Hospitals in Katsina State was based on time and resource constraints to cover such Midwives scattered in different geographical locations in the state.

 

 

 

1.9       Operational Definition of Terms

The following are the operational definition of the key terms used within the context of this study:

Availability: awareness or knowledge about the existence of a technology that is accessible or obtainable.

Awareness: knowledge about the existence and capabilities of a technology, its features, and benefits.

Communities of Practice: is a platform or network of professional practitioners who share a domain, concern or a passion and interact on regular basis to share skills, experiences, problems, and solutions in order to improve the knowledge of each

participant and the overall discipline.

Hospitals: is a place or health care institution providing patient treatment with specialized medical and nursing staff and medical equipment.

Knowledge Sharing: is an activity through which knowledge (namely, skills or expertise) is exchanged among professionals, people, friends, families, communities, or organizations.

Midwives: Are health practitioners educated in midwifery only. They provide primary care to women and their babies during pregnancy, labor, birth, and the postpartum period (care after birth).

 

Nurse-Midwives: are healthcare practitioners educated in the two disciplines of nursing and midwifery. They provide primary healthcare to women of childbearing age including: prenatal care, labor and delivery care, care after birth, gynecological exams, newborn care, assistance with family planning decisions, preconception care, menopausal management and counseling in health maintenance and disease prevention.

Online Communities of Practice: is a Communities of Practice that is developed on, and is maintained using the Internet.

Utilisation: To make use of something especially in practical form or for practical purpose and benefit.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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AWARENESS AND USAGE OF ONLINE COMMUNITIES OF PRACTICE FOR KNOWLEDGE DISTRIBUTION AMONG PRACTICING MIDWIVES IN KATSINA STATE, NIGERIA  

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