Health care professionals' beliefs about using wiki-based reminders to promote best practices in trauma care

Background: wikis are knowledge translation tools that could help health professionals implement best practices in acute care. little is known about the factors influencing professionals' use of wikis. objectives: to identify and compare the beliefs of emergency physicians (eps) and allied health professionals (ahps) about using a wiki-based reminder that promotes evidence-based care for traumatic brain injuries. methods: drawing on the theory of planned behavior,we conducted semistructured interviews to elicit eps' and ahps' beliefs about using a wiki-based reminder. previous studies suggested a sample of 25 eps and 25 ahps. we purposefully selected participants from three trauma centers in quebec,canada,to obtain a representative sample. using univariate analyses,we assessed whether our participants' gender,age,and level of experience were similar to those of all eligible individuals. participants viewed a video showing a clinician using a wiki-based reminder,and we interviewed participants about their behavioral,control,and normative beliefs-that is,what they saw as advantages,disadvantages,barriers,and facilitators to their use of a reminder,and how they felt important referents would perceive their use of a reminder. two reviewers independently analyzed the content of the interview transcripts. we considered the 75% most frequently mentioned beliefs as salient. we retained some less frequently mentioned beliefs as well. results: of 66 eligible eps and 444 eligible ahps,we invited 55 eps and 39 ahps to participate,and 25 eps and 25 ahps (15 nurses,7 respiratory therapists,and 3 pharmacists) accepted. participating ahps had more experience than eligible ahps (mean 14 vs 11 years; p =.04). we noted no other significant differences. among eps,the most frequently reported advantage of using a wiki-based reminder was that it refreshes the memory (n = 14); among ahps,it was that it provides rapid access to protocols (n = 16). only 2 eps mentioned a disadvantage (the wiki added stress). the most frequently reported favorable referent was nurses for eps (n = 16) and eps for ahps (n = 19). the most frequently reported unfavorable referents were people resistant to standardized care for eps (n = 8) and people less comfortable with computers for ahps (n = 11). the most frequent facilitator for eps was ease of use (n = 19); for ahps,it was having a bedside computer (n = 20). eps' most frequently reported barrier was irregularly updated wiki-based reminders (n = 18); ahps'was undetermined legal responsibility (n = 10). conclusions: we identified eps' and ahps' salient beliefs about using a wiki-based reminder. we will draw on these beliefs to construct a questionnaire to measure the importance of these determinants to eps' and ahps' intention to use a wiki-based reminder promoting evidence-based care for traumatic brain injuries.