Using a VCoP to Facilitate
Knowledge Sharing
Among Dental Hygienists with
Community Practices:
A Case Study
Thesis Defense
Robin Roderick, RDH, BSDH
Chair -- Ann O’Kelley Wetmore, RDH, BS, MSDH
Second Member -- Rebecca Stolberg, RDH, BS, MSDH
Third Member --Ben Meredith, EdD
Welcome and
Thank You!
Communities of Practice (CoP)
“Groups of people who share a concern or a passion for something
they do and learn how to do it better as they interact regularly.”
Wenger, 1998, p. 4
Structural characteristics
The Domain – a field or scope of knowledge
The Community – member engagement in the domain
The Practice – shared knowledge among practitioners
Virtual Communities of Practice (VCoP)
“Online personal relationships motivated by
common interest or domain.”
Chin & Chignell, 2007
This Study Seeks to Answer
the following:
• Will the implementation of an Online
Discussion Board facilitate Knowledge
Sharing within a VCoP of Dental
Hygienists with Community Practices?
• What is the perceived value of membership
in this VCoP?
Background of the Study
The aim of this study was to
• Gather general information about Dental Hygienists with
Community Practices
• Identify the perceived value of membership in the Alliance of
Dental Hygiene Practitioners’ (ADHP) Virtual Community
• Explore if an online Discussion Board (DB) would facilitate
knowledge sharing among ADHP members
• Provide a framework for development of a VCoP with DB
Introduction
A minority (2.4%) of Washington State dental hygienists are
direct providers of oral hygiene services
• Mobile Dental Hygiene Services
• Practice in multiple community settings
• Variety of patient populations
• Possible Consequences or Complications:
 Professional isolation
 Limited opportunities to consult with peers
Rhea & Bettles, 2011; Barnett, Jones, Bennett, Iverson, & Bonney, 2012; Larkin, Griffith, Pitler, Donahue,
& Sbrolla, 2012; Curran, Murphy, Abidi, Sinclair & McGarth 2009; Dawes & Sampson, 2003;
Parboosingh, 2002.
Virtual Communities of Practice
(VCoPs)
Recognized in medical healthcare as a means to
• Share information
• Contribute to best practices
• Promote professional development
• Reduce professional isolation
• Develop Identity
• Unprecedented in the Dental Hygiene Profession
Rhea & Bettles, 2011; Barnett, Jones, Bennett, Iverson, & Bonney, 2012; Larkin, Griffith, Pitler, Donahue,
& Sbrolla, 2012; Curran, Murphy, Abidi, Sinclair & McGarth 2009; Dawes & Sampson, 2003;
Parboosingh, 2002.
Design
• Single in-depth ethnographic-type case study with mixed
methods
• Purposive sampling technique
o Homogenous sample of dental hygienists with
community practices
• Data Collection
o Quantitative data – online questionnaire and
informants
o Qualitative data – online questionnaire and
observations
Procedure
Approval for research was granted February 15, 2014
• Sample source - Approached by existing CoP Alliance of
Dental Hygiene Practitioners (ADHP) on development of a
VCoP for networking and public awareness
• Sample Size - ADHP Listserv (members and support
members)
• Plan - Implementation and 12 week observation of the PI
created VCoP (alliance-rdhpractitioners.org) with linked
online Discussion Board (rdhforum.alliancerdhpractitioners.org) until saturation
• Description of Setting –VCoP (alliancerdhpractitioners.org) with linked online Discussion Board
(rdhforum.alliance-rdhpractitioners.org)
ADHP Website
ADHP Discussion Board
Data Collection Tree
Figure 4. Statistical
Analysis Data Collection
Tree.
Introductory Background Questionnaire
The sample for the IBQ consisted of eight females
and one male, ranging in age from 39 to 67
(M=55). One has a Certificate in Dental Hygiene,
six have Associate of Science in Dental Hygiene
degrees; four have Bachelor of Science degrees,
three have additional Associate of Applied
Science degrees, and one has a Master of Science
degree in Oral Biology. Years practicing in dental
hygiene ranged from 15 years to 30+ (M=23.4).
Combined hours spent practicing under RCW
18.29.056 monthly were 509 with 253 hours in
senior centers or nursing homes; 200 hours in
community-based sealant programs, and 55
hours serving homebound patients. Hours spent
outside of RCW 18.29.056 range from zero to 30
hours (M=14.5), divided equally between private
practice, community clinics, and education.
Income practicing as a direct provider ranged
from less than $20,000 to over $60,000
(M=$38,750) with less than $20,000 (n=3), $20,000
to $29,000 (n=1), $40,000 to $49,000 (n=1), $60,000
or greater (n=3), and one chose not to answer.
Geographic locations served are urban (n=1),
suburban (n=1), rural/suburban (n=2),
Suburban/urban (n=1), with the majority serving
all three (n=3).
English is the primary language (n=8, 89%), and
one chose not to say (n=1, 11%). Primary means
of communication was divided between email
(n=5) and professional meetings/conferences
(n=5), with internet (n=1) and phone (n=1) last.
Nearly all subjects (n=8, 89%) were members of
ADHA, and 20% (n=2) reported membership in
other associations.
Introductory Background Questionnaire continued
Introductory Background Questionnaire continued
Online Discussion Board User Characteristics
Membership in the ADHP is open to all dental
hygienists. The sample for the online DB
consisted of 13 females, five of whom were on
the ADHP Board of Directors. All were
registered dental hygienists, three had
Associate of Science in Dental Hygiene degrees;
six had Bachelor of Science degrees, and four
had Master degrees. In addition, one dental
hygienist was a Certified Dental Assistant.
Four participants were located in King County,
two in Pierce County, and one each in Clallum,
Clark, Island, Kitsap, and Thurston Counties.
Clark, Kitsap, King, Pierce, Skagit, and
Thurston counties are considered urban core
and sub-urban (n=8), Island is sub-urban and
large rural, and Clallum is considered large
rural and isolated rural. Providers worked in
multiple locations, and provided services to
different populations. Nine participants
worked with seniors, in centers or programs
(n=9), two in adult homes (n=2), two in
children’s programs (n=2), one with the
developmental disabled (n=1), one in long term
care (n=1), one worked in a hospital (n=1), one
was an independent provider (n=1), and one
was retired from working in school based
programs (n=1). Six participants had
administrative privileges for the DB with seven
as moderators. Analysis of all online discussion
posts generated in this study found three
participants were the most active in the DB
with P-3 having 23 posts; P-4, 19; and P-1, 10.
Less active participants were P-2 with 5 posts;
P-11 and P-6, 3; P-7 and P-10, 2; P-13and P-9, 1;
and P-5 with zero. One participant registered
on the DB in June (n=1), four in July (n=4),
seven in September (n=7), and one in October
(n=1).
To Assess Research Question 1
Will the implementation of a DB facilitate Knowledge Sharing within a
Virtual Community of Practice?
To Assess Research Question 1
Will the implementation of a DB facilitate Knowledge Sharing within a
Virtual Community of Practice?
To Assess Research Question 1
Will the implementation of a DB facilitate Knowledge Sharing within a
Virtual Community of Practice?
To Assess Research Question 1
Will the implementation of a DB facilitate Knowledge Sharing within a
Virtual Community of Practice?
Statewide Providers (Members and Non-members)
ADHP founders supplied additional data
affording a snapshot of members and nonmembers practicing in Washington State. The
sample pool consisted of 111 dental hygienists
with community practices, services provided
and areas served. The Rural-Urban Commuting
Area Codes (RUCAs), a census tract-based
classification scheme was used to distinguish
areas of service by direct providers. Analysis
found King (n=26), Pierce (n=15), Spokane
(n=8), and Whatcom (n=7) counties had the
most providers, followed by Yakima, Clark,
Thurston, Snohomish (n=5), Kitsap, and Benton
(n=4) with Callam, Grant, Mason (n=3), Grays
Harbor (n=2), Island, Douglas, Lewis, and
Chelan (n=1) having the least providers.
Nineteen counties (n=19) did not have
providers.
Statewide 111 known dental hygienists provide
oral hygiene services as a direct provider. The
most common population served was seniors,
treated in Senior Centers and Senior Programs
(n=55), followed by children, treated in school
sealant programs and other types of programs
(n=22). Subsequently, developmental
disabilities/mental illness (n=15), long-term
care (n=13), independent provider services
(n=7), public/community health (n=7), nursing
homes (n=6), and adult family (n=6). The
populations and facilities least served were
group homes (n=2), homebound (n=2),
rehabilitation (n=1), and prisons (n=1).
Statewide Providers (Members and Non-members)
Statewide 111 known dental hygienists provide
oral hygiene services as a direct provider. The
most common population served was seniors,
treated in Senior Centers and Senior Programs
(n=55), followed by children, treated in school
sealant programs and other types of programs
(n=22). Subsequently, developmental
disabilities/mental illness (n=15), long-term
care (n=13), independent provider services
(n=7), public/community health (n=7), nursing
homes (n=6), and adult family (n=6). The
populations and facilities least served were
group homes (n=2), homebound (n=2),
rehabilitation (n=1), and prisons (n=1).
Tools to Gather Data in DB
Sense of Community Index 2 (SCI-2)
• SCI is the most commonly used measurement of
sense of community.
• The SCI-2 explores member’s feelings regarding
reinforcement of needs with 24 Likert like
questions.
According to Community Science (http://www.communityscience.com),
Tools to Gather Data in DB
UCINET: a software package for Windows
• Designed to represent and analyze social networks
• Measures connectivity of community
• Size, degree centrality and density
NetDraw: a feature of UCINET software
• Visual representation of network relationship
• Displays connections
• Interactions
• Information flow
Significance
VCoP to Facilitate KS Among
Dental Hygienists with
Community Practices
Most studies in this literature review focus mainly
on CoP for medical healthcare professionals.
• Dental hygienists with community practices
are direct providers of oral health services that
practice in Washington State under RCW
18.29.056.
• Establishment of the Alliance of Dental
Hygiene Practitioners (ADHP) in 2000.
Curran et al. 2009; Larkin 2012: Washington State Legislation, 2013.
Methodology
A single in-depth ethnographic -type case
study will use a mixed method approach to
explore the use of a DB for dental hygienists
with community practices to form a CoP.
Rhea & Bettles, 2011.
Quantitative/Descriptive Data
Descriptive data collected from participants
will
• Identify the demographics and
characteristics of dental hygienists with
community practices.
• Population served and service area.
Qualitative Data
Qualitative data will
• Determine development of community
among members .
• Collected by means of questionnaires and
observation of participation in the DB.
Sample
• Participants will be a convenience sample of
dental hygienists with community practices in
Washington State.
• The PI will recruit dental hygiene community
practitioners who are members of the ADHP
via alliance-rdhpractitioners.org DB.
Inclusion / Exclusion Criteria
• Inclusion to this study is licensed Washington
State Dental Hygienists practicing under RCW
18.29.056.
• Licensed Washington State Dental Hygienists
not practicing under RCW 18.29.056 will be
excluded from the study.
Sampling plan
The PI will use a current email listserv, provided
by the founder of the ADHP to invite dental
hygienists with community practices to join
alliance-rdhpractitioners.org DB.
To assure secure discussions
• Members will create a password upon entry
into the DB.
• Must use the password to log into the site.
Sample size
• There are currently 60 dental hygienists with
community practices on the listserv used by
the ADHP.
• The population represented is small in
comparison to dental hygienists practicing in
other settings.
Description of Setting
• This study will be implemented in the state of
Washington because dental hygienists are allowed
by their scope of practice to have community
practices in Washington State.
• A DB is proposed as a suitable research site for
investigating KS
• Ease of use
• Flexibility
• Accessibility to geographically dispersed dental
hygienists with community practices.
Hearn & White, 2009; Wenger, McDermott & Snyder, 2002; Wenger, White & Smith, 2009; Barnett, Jones,
Bennett, Iverson, & Bonney, 2012; Hearn & White, 2009; Larkin, Griffith, Pitler, Donahue, & Sbrolla, 2012;
Li, Grimshaw, Nielsen, Judd, Coyte, & Graham, 2009; Wenger, White, & Smith, 2009; Wilson & Fairchild,
2011
Study Variables
To answer the research questions:
 Has a CoP formed among the dental hygienists
with community practices?
 If so, does this VCoP facilitate knowledge
sharing among dental hygienists with
community practices?
Investigate the cause and effect relationship in
this case study and determine independent,
dependent, and intervening variables.
Study Variables
Independent Variable:
• Implementation of the VCoP
Dependent Variables:
• Knowledge Sharing (KS)
• Sense of Community
Within-subject-variables such as age, gender,
practice setting and location, education level, and
years in practice will be identified as intervening
variables.
Instruments
Website
Introductory Background Questionnaire (IBQ)
Sense of Community Index-1 (SCI-2)
Social Networking Analysis (SNA).
Observation of DB board threads will determine if
knowledge is being shared among members.
ADHP Website
The alliance-rdhpractitioners.org website will
mainly consist of three components
• The Participant Directory
• The DB to facilitate practitioners in sharing
tactic knowledge
• Resources provided by members to support
sharing explicit knowledge
The ADHP participants’ directory and
membership enrollment will support the domain
aspect of a CoP.
ADHP Website
• Activity by participants into this web-based
community imply commitment.
• The website and discussion board (DB) will be
developed under guidance from Centers for
Disease Control (CDC) and Prevention CoP
Approach.
• Established CoP conceptual framework from a
resource kit titled Communities of Practice
Program.
Introductory Background
Questionnaire (IBQ)
The purpose of the questionnaire is to gather
initial data on each participant and to answer any
questions the participants might have about the
study.
Consent to participate in the study will be
considered if the community dental hygienist
completes this background questionnaire.
Statistical
Analysis
Data
Collection
Tree
Summary
• Ethnographic-type case study
• Mixed methods approach
• Convenience sample of Dental Hygienists in
Community Practices
• Internet DB will serve as the setting and platform for
data gathering
• IBQ and the SCI-2 to provide descriptive
demographic data on sense of community
Summary
Overall, this study provides general information
about dental hygienists with community practices
in Washington State and demonstrates how an
online DB can facilitate knowledge sharing among
this unique CoP. Results suggest value in
membership and community. Implementation of a
DB may encourage community and knowledge
sharing as a VCoP among geographically dispersed
community practitioners.
Thank You.
I look forward to your comments and
questions
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