Moreover, CoPs develop their practice through improving the diffusion of innovation within their active networks; the benefits of such interactions are countless especially in the field of healthcare. One can assume that specialty doctors' communities would present the perfect example for CoPs because they share the same practice, interest and professionalism. It would be interesting to study if those CoP networks exist in United Arab Emirates, whether they are active or not and whether leaders can be identified. Collecting such data will enable this project to measure if the rate of diffusion of new innovation can be improved and hence be used by pharmaceutical companies in UAE to improve their resource allocation; all within healthcares' ethical framework.

Overview of Study

This dissertation used a five-chapter format to achieve the above-stated research purpose. To this end, chapter one introduced the topic under consideration, a statement of the problem, the purpose and importance of the study, as well as its scope and rationale. Chapter two below provides a review of the relevant peer-reviewed and scholarly literature concerning the current healthcare context of the UAE, an overview of communities of practice in general and how these communities tend to mature over time. Chapter three is used to describe more fully the dissertation's methodology, including a description of the study approach, the data-gathering method and the database of study consulted. Chapter four of the dissertation consists of an analysis of the data developed during the research process and chapter five presents relevant conclusions, recommendations and personal reflections.

Chapter Two:

Literature Review

Context of Setting

The UAE currently has 40 public hospitals, a number that represents a major increase from just seven which was the case in 1970 (UAE country profile, 7). Moreover, the UAE Ministry of Health has launched a multimillion-dollar program in order to enlarge the country's existing health facilities and hospitals, medical centers to serve all of the seven emirates (UAE country profile, 7). An ultra-modern general hospital has been constructed in Abu Dhabi with a projected bed capacity of 143, including a trauma unit, and will serve as the framework for the development of a home health care program in the UAE. In addition, in an effort to attract affluent UAE nationals and expatriates who traditionally have traveled abroad for their health care services, Dubai is also developing Dubai Healthcare City; this facility will offer state-of -- the art evidence-based private healthcare services to UAE healthcare consumers as well as serving as an advanced academic medical training center, with the completion of these facilities scheduled for later this year (UAE country profile, 7).

There is also a growing need for heart specialists in the UAE with the current principal cause of death being cardiovascular disease, accounting for fully 28% of all deaths in the country (UAE country profile, 7). The primary causes of these casualties include accidents and injuries, malignancies, and congenital anomalies (UAE country profile, 7). In addition, the UAE launched a national initiative designed to prevent transmission of acquired immune deficiency syndrome (AIDS) and to control its entry into the country in 1985, an initiative that has been effective. For instance, according to World Health Organization estimates, in 2002?3, there were less than 1,000 people in the UAE who had been infected with the human immunodeficiency / AIDS virus (UAE country profile, 7).

A brief overview of healthcare metrics for the UAE is provided in Table 1 below.

Table 1

Healthcare overview of UAE

Healthcare Category

Statistics

World Rank

Birth rate, crude > per 1,000 people

15.59 per 1,000 people [121st of 195]

Children Underweight Rate

3%

[61st of 95]

Contraception

28%

[63rd of 89]

Dependency ratio per 100

36

[167th of 166]

Drug access

95%

[50th of 163]

HIV AIDS > Adult prevalence rate

0.18%

[104th of 136]

Hospital beds > per 1,000 people

2.2 per 1,000 people [43rd of 149]

Life expectancy at birth > Female

78.56 years [74th of 226]

Life expectancy at birth > Male

73.35 years [69th of 226]

Life expectancy at birth > Total population

75.89 years [71st of 225]

Life expectancy at birth, total > years

79.18 years [23rd of 194]

Maternal mortality

3 per 100,000

[135th of 136]

Physicians > per 1,000 people

2.02 per 1,000 people [50th of 148]

Plastic surgery procedures [32nd of 34]

Probability of not reaching 40

5.4%

[97th of 111]

Probability of reaching 65 > Male

75.8%

[35th of 159]

Smoking prevalence, males > % of adults

17.3%

[36th of 42]

Spending > Per person

1,428

[21st of 133]

According to U.S. government analysts, in 2005 the UAE had more than 4.5 million mobile cellular telephone subscribers, as compared with 1.2 million landlines in use (representing a penetration rate of 101 and 28 lines per 100 residents, respectively). The technology that is used for domestic lines includes microwave radio relay and fiber optic and coaxial cable (UAE country profile, 19). Furthermore, as of 2009, the UAE had almost 400,000 Internet hosts and almost three million Internet users (UAE, 2010), clearly indicating the country's ability to facilitate the communication requirements for traditional as well as virtual communities of practice, and these issues are discussed further below.
Communities of Practice

One of the most developed and widely practiced models across many types of organizations today is the community of practice (Brown & Duguid, 2000). This is particularly true in such process-intensive operations as healthcare (Hemmasi & Csanda, 2009). According to Bounfour (2003), "The installation of 'communities of practice' has as its ultimate goal the organisation of a dynamic dialogue between the tacit knowledge of individuals and the formalised knowledge of the firm" (p. 164). The research to date suggests that communities of practice appear to be an evolution, continuation and amplification of the team concept (Wenger et al., 2002).

Although conventional teams have been highly successful over the years, communities of practice appear to be particularly well suited to provide additional benefits by being more responsive in dealing with the opportunities and challenges of today's rapidly changing environment, growing global competition, and the ever advancing information technology. Moreover, communities of practice can provide organizations with the framework they need to ensure that the tacit or implicit knowledge that is present in an organization is not lost by forging connections between individuals who share comparable interests in ways that help diffuse the information to all community members (Hemmasi & Csanda, 2009). Furthermore, as Droege and Hoobler (2003) point out, CoPs are structures that can effectively prevent loss of tacit knowledge associated with employee turnover by providing the connections necessary for transfer and retention of knowledge.

One of the original groups that has been consistently cited as being among the pioneers in the formation of communities of practices concerned machine repairman for Xerox (Brown & Duguid, 2000). The results of a study of these community members showed that working in knowledge-sharing groups can help to transform companies into learning organizations. In this regard, a more recent study by Anand, Gardner and Morris (2007) of consulting firms documented the efficacy of communities of practice as being effective knowledge-based frameworks that were able to help fuel innovation. Likewise, a review of communities of practice adoption by the government of the Netherlands conducted by Kranendonk and Kersten (2007) concluded that these groups represent viable ways to help draw on the "wisdom of the crowd" to identify solutions to problems that could not be solved by single individuals. In this regard, McDermott (1999) suggests that there are three basic considerations an organization should take when designing a CoP; in this regard, organizations should determine:

1. The kinds of knowledge that will be shared in the group -- i.e., explicit or tactic knowledge;

2. The group's sense of identity; and,

3. The extent to which the knowledge shared is integrated into actual work (26).

There have been some conflicting reviews concerning how communities of practice are created and sustained, with some authorities (Wenger, McDermott & Snyder, 2002) suggesting that the majority of such groups are created voluntarily and informally and that this is a prerequisite for success; by contrast, other authorities (Perry & Zender, 2004) have found that it is possible for professional communities of practice to be formed in purposeful ways that contribute to their sustainability (Hammasi & Csanda, 2009).

Lave and Wenger (1991) are credited with introducing the term, "communities of practice," in an attempt to better define the need for forging more cohesive communities and to help legitimize the practices of individuals. By and large, communities of practice concern a group of people who hold in common certain defined beliefs, practices, and understandings that extend over time in an effort to achieve a common goal (Wenger, 1998). Based on his review of recent trends, Roth (1998) believed that these emerging communities "are identified by the common tasks members engage in and the…