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Evaluation of an online discussion forum for emergency practitioners.

https://arctichealth.org/en/permalink/ahliterature160222
Source
Health Informatics J. 2007 Dec;13(4):255-66
Publication Type
Article
Date
Dec-2007
Author
Janet A Curran
Syed Sibte Raza Abidi
Author Affiliation
IWK Health Centre, CIHR Child Health Clinician Scientist Training Program, 5980 University Ave, Halifax, NS, Canada. janet.curran@iwk.nshealth.ca
Source
Health Informatics J. 2007 Dec;13(4):255-66
Date
Dec-2007
Language
English
Publication Type
Article
Keywords
Communication
Cooperative Behavior
Emergency Service, Hospital - organization & administration
Health Knowledge, Attitudes, Practice
Health Personnel
Hospitals, Rural - organization & administration
Hospitals, Urban - organization & administration
Humans
Internet - utilization
Nova Scotia
Social Support
Abstract
Knowledge is a critical element in the delivery of quality healthcare. In a busy emergency department (ED) clinicians attempting clinically relevant discussion with their peers face multiple interruptions and a lack of sustained meaningful interactions. Information and communication technologies such as online discussion forums enable practitioners to share practice knowledge at times that fit into their daily workflow. We conducted an experiment in which we provided emergency clinicians with access to an asynchronous discussion forum as a medium to support development of an online social network for information exchange. The outcomes were evaluated using a social network perspective to better understand the knowledge seeking and sharing behaviors among rural and urban emergency practitioners participating in the online discussion forum. The online discussion forum created an opportunity for emergency practitioners from multiple ED sites to engage in dialogue around topics that were relevant to their practice learning needs.
PubMed ID
18029403 View in PubMed
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Factors influencing rural and urban emergency clinicians' participation in an online knowledge exchange intervention.

https://arctichealth.org/en/permalink/ahliterature116656
Source
Rural Remote Health. 2013 Jan-Mar;13(1):2175
Publication Type
Article
Author
Janet A Curran
Andrea L Murphy
Douglas Sinclair
Patrick McGrath
Author Affiliation
IWK Health Centre, Halifax, Nova Scotia, Canada.
Source
Rural Remote Health. 2013 Jan-Mar;13(1):2175
Language
English
Publication Type
Article
Keywords
Academic Medical Centers
Adult
Aged
Attitude of Health Personnel
Canada
Clinical Competence
Decision Making
Diffusion of Innovation
Emergency Medicine - education
Female
Humans
Internet
Knowledge Bases
Male
Middle Aged
Pilot Projects
Questionnaires
Rural Health Services - manpower - statistics & numerical data
Social Networking
Urban Health Services - manpower - statistics & numerical data
Abstract
Rural emergency departments (EDs) generally have limited access to continuing education and are typically staffed by clinicians without pediatric emergency specialty training. Emergency care of children is complex and the majority of children receive emergency care in non-pediatric tertiary care centers. In recent decades, there has been a call to action to improve quality and safety in the emergency care of children. Of the one million ED visits by children in Ontario in 2005-2006, one in three visited more than once in a year and one in 15 returned to the ED within 72 hours of the index visit. This study explored factors influencing rural and urban ED clinicians' participation in a Web-based knowledge exchange intervention that focused on best practice knowledge about pediatric emergency care. The following questions guided the study: (i) What are the individual, context of practice or knowledge factors which impact a clinician's decision to participate in a Web-based knowledge exchange intervention?; (ii) What are clinicians' perceptions of organizational expectations regarding knowledge and information sources to be used in practice?; and (iii) What are the preferred knowledge sources of rural and urban emergency clinicians?
A Web-based knowledge exchange intervention, the Pediatric Emergency Care Web Based Knowledge Exchange Project, for rural and urban ED clinicians was developed. The website contained 12 pediatric emergency practice learning modules with linked asynchronous discussion forums. The topics for the modules were determined through a needs assessment and the module content was developed by known experts in the field. A follow-up survey was sent to a convenience sample of 187 clinicians from nine rural and two urban Canadian EDs participating in the pediatric emergency Web-based knowledge exchange intervention study.
The survey response rate was 56% (105/187). Participation in the knowledge exchange intervention was related to individual involvement in research activities (?(2)=5.23, p=0.019), consultation with colleagues from other EDs (?(2)=6.37, p=0.01) and perception of organizational expectations to use research evidence to guide practice (?(2)=5.52, p=0.015). Most clinicians (95/105 or 92%) reported relying on colleagues from their own ED as a primary knowledge source. Urban clinicians were more likely than their rural counterparts to perceive that use of research evidence to guide practice was an expectation. Rural clinicians were more likely to rely on physicians from their own ED as a preferred knowledge source.
The decision made by emergency clinicians to participate in a Web-based knowledge exchange intervention was influenced by a number of individual and contextual factors. Differences in these factors and preferences for knowledge sources require further characterization to enhance engagement of rural ED clinicians in online knowledge exchange interventions.
PubMed ID
23374031 View in PubMed
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Understanding the Canadian adult CT head rule trial: use of the theoretical domains framework for process evaluation.

https://arctichealth.org/en/permalink/ahliterature116121
Source
Implement Sci. 2013;8:25
Publication Type
Article
Date
2013
Author
Janet A Curran
Jamie Brehaut
Andrea M Patey
Martin Osmond
Ian Stiell
Jeremy M Grimshaw
Author Affiliation
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Civic Campus, Ottawa, ON, Canada. janet.curran@iwk.nshealth.ca
Source
Implement Sci. 2013;8:25
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Canada
Craniocerebral Trauma - radiography
Decision Support Systems, Clinical
Emergency Medicine - standards
Emergency Service, Hospital - standards
Evaluation Studies as Topic
Humans
Physician's Practice Patterns - standards
Tomography, X-Ray Computed - utilization
Unnecessary Procedures
Abstract
The Canadian CT Head Rule was prospectively derived and validated to assist clinicians with diagnostic decision-making regarding the use of computed tomography (CT) in adult patients with minor head injury. A recent intervention trial failed to demonstrate a decrease in the rate of head CTs following implementation of the rule in Canadian emergency departments. Yet, the same intervention, which included a one-hour educational session and reminders at the point of requisition, was successful in reducing cervical spine imaging rates in the same emergency departments. The reason for the varied effect of the intervention across these two behaviours is unclear. There is an increasing appreciation for the use of theory to conduct process evaluations to better understand how strategies are linked with outcomes in implementation trials. The Theoretical Domains Framework (TDF) has been used to explore health professional behaviour and to design behaviour change interventions but, to date, has not been used to guide a theory-based process evaluation. In this proof of concept study, we explored whether the TDF could be used to guide a retrospective process evaluation to better understand emergency physicians' responses to the interventions employed in the Canadian CT Head Rule trial.
A semi-structured interview guide, based on the 12 domains from the TDF, was used to conduct telephone interviews with project leads and physician participants from the intervention sites in the Canadian CT Head Rule trial. Two reviewers independently coded the anonymised interview transcripts using the TDF as a coding framework. Relevant domains were identified by: the presence of conflicting beliefs within a domain; the frequency of beliefs; and the likely strength of the impact of a belief on the behaviour.
Eight physicians from four of the intervention sites in the Canadian CT Head Rule trial participated in the interviews. Barriers likely to assist with understanding physicians' responses to the intervention in the trial were identified in six of the theoretical domains: beliefs about consequences; beliefs about capabilities; behavioural regulation; memory, attention and decision processes; environmental context and resources; and social influences. Despite knowledge that the Canadian CT Head Rule was highly sensitive and reliable for identifying clinically important brain injuries and strong beliefs about the benefits for using the rule, a number of barriers were identified that may have prevented physicians from consistently applying the rule.
This proof of concept study demonstrates the use of the TDF as a guiding framework to design a retrospective theory-based process evaluation. There is a need for further development and testing of methods for using the TDF to guide theory-based process evaluations running alongside behaviour change intervention trials.
Notes
Cites: J Gen Intern Med. 2005 Apr;20(4):334-915857490
Cites: Qual Saf Health Care. 2005 Feb;14(1):26-3315692000
Cites: Ann Emerg Med. 1999 Apr;33(4):437-4710092723
Cites: Health Technol Assess. 2004 Feb;8(6):iii-iv, 1-7214960256
Cites: JAMA. 1997 Feb 12;277(6):488-949020274
Cites: Ann Emerg Med. 1997 Jul;30(1):14-229209219
Cites: Ann Emerg Med. 2003 Aug;42(2):173-8012883504
Cites: Ann Emerg Med. 2001 Sep;38(3):317-2211524653
Cites: Ann Emerg Med. 2001 Aug;38(2):160-911468612
Cites: Lancet. 2001 May 5;357(9266):1391-611356436
Cites: Acad Emerg Med. 2000 Nov;7(11):1223-3111073470
Cites: JAMA. 2000 Jul 5;284(1):79-8410872017
Cites: BMJ. 2000 Jan 8;320(7227):114-610625273
Cites: JAMA. 2005 Sep 28;294(12):1511-816189364
Cites: Acad Emerg Med. 2005 Oct;12(10):948-5616166599
Cites: Ann Emerg Med. 2006 Dec;48(6):713-917112935
Cites: Ann Emerg Med. 2006 Dec;48(6):720-217112936
Cites: BMC Public Health. 2007;7:14117615052
Cites: Br J Health Psychol. 2009 Nov;14(Pt 4):625-4619159506
Cites: BMJ. 2009;339:b414619875425
Cites: Med Decis Making. 2010 May-Jun;30(3):398-40820042533
Cites: Arch Dis Child Educ Pract Ed. 2010 Jun;95(3):88-9220501532
Cites: CMAJ. 2010 Oct 5;182(14):1527-3220732978
Cites: Qual Health Res. 2005 Nov;15(9):1277-8816204405
Cites: Implement Sci. 2012;7:3522531601
Cites: Implement Sci. 2012;7:3822531013
Cites: Implement Sci. 2012;7:3722530986
Cites: Psychol Health. 2011 Nov;26(11):1479-9821678185
Cites: Milbank Q. 2011 Jun;89(2):167-20521676020
Cites: Implement Sci. 2011;6:1321320312
Cites: Psychol Health. 2010 Dec;25(10):1229-4520204937
PubMed ID
23433082 View in PubMed
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