Déconstruction et reconstruction des communautés de pratique dans les organisations de santé professionnelles : le cas des fusions d'hôpitaux universitaires
This study, which draws on the situated action approach, aims to understand the (re)construction of communities of practice (CoPs) in the context of a hospital merger. Combining documentary sources, semi-open ended interviews and observations data, the analysis strategy is twofold. A first method takes into account the merging process itself and the situation of action in time and place. A second method is guided by grounded theory as data are continuously categorized and compared throughout the data collection phase. Within this perspective, where the notion of process is a key figure, we have identified, in link with current literature, interrelated characteristics, such as mutual engagement, a joint enterprise, shared repertoire that intervene in the reconstruction of a community of practice (CoP). Our analysis points to the action domain as the common denominator of community practices, domain where tacit and explicit knowledge tend to converge in time. This shared practice, eminently social in nature, generates knowledge and negotiated rules that are upheld by its members within the framework of their meetings. This perspective has also brought forth how communities of practice take shape within processes of continuous learning that combine phases of intense participation that favor a shared understand of the action domain and the reification of their representations. In this specific study, the participation/reification dialectic reveals a “making sense” process where meaning of action and social regulation are intricately linked. Nevertheless, the resulting social regulation does not de facto, imply the encounter of a shared regulation. Rather, our results reveal an ensemble of regulations, sometimes concurrent, sometimes in equilibrium, in relation of the context within actors are situated. These findings on the dynamics of the reconstruction of communities of practice offer a new way of thinking changes within organizations such as the hospital, not only in respect to strategic dimensions and changes amongst team leaders but also in taking into account the lay actors and their capacities of thinking and acting out change.
Merger Communities of practice Social regulation Changement continu Continuous change Situated learning and knowledge