A MEASURE OF QUEBEC EMERGENCY PHYSICIANS' INTENTIONS TO USE WIKI-BASED REMINDERS TO PROMOTE BEST PRACTICES IN TRAUMA CARE

Purpose: The purpose of this project was to measure emergency physicians' intentions to use wiki-based reminders to promote best practices in trauma care and to determine what influences this intention.

Method: Drawing on the Theory of Planned Behavior (TPB), we conducted a quantitative online survey targeting emergency physicians working in 12 Quebec trauma centers (purposively chosen to represent a variety of trauma center levels across Quebec). All emergency physicians working in the Emergency Department of these centers were elligible. Using a previously validated questionnaire (Archambault, 2014), we measured the direct (intention, attitude, perceived behavioral control and subjective norm) and indirect TPB constructs (control beliefs, normative beliefs, behavioral beliefs) using a 7-point Likert scale. After consent, participants viewed a 6-minute video demonstrating an emergency physician using a wiki-based reminder and then answered the questionnaire. We performed univariate descriptive statististics and calculated Cronbach’s alpha to measure the reliability of the questionnaire’s items. 

Result:

We recruited 1 Level I, 5 Level II,and 6 Level III trauma centers. Among the eligible emergency physicians, 66% (151/266) completed the questionnaire. The average age of participants was 37 (SD=8,54) and the average number of years in practice was 9,8 (SD=8,23) ; 62,3% (n=94) were women; 92% (n=139) were family physicians or did not have a specific emergency medicine certification.

Constructs		Chronbach Alpha	Mean (SD)
Direct	Intention	0.87	5.702 (0.923)
	Perceived Behavioral Control	0.95	6.406 (0.976)
	Subjective Norm	0.76	3.646 (0.976)
	Attitude	0.87	5.991 (1.231)
Indirect Beliefs	Normative	0.74	«+»: 6.171 (0.943)
			«-»: 4.36 (1.482)
	Control	Facilitators: 0.88	«+»: 6,793 (0.676)
		Barriers: 0.69	«-»: 2.811 (1.61)
	Behavioral	0.86	«+»: 6.532 (0.644)
			«-»: 5.171 (1.445)

Conclusion: Our results suggest that emergency physicians in Quebec have high intentions to use wiki-based reminders to promote best practices in trauma care. Their perceived behavioral control and attitude are also high compared to lower subjective norm. A multivariate factorial analysis is needed to determine which of the indirect constructs (barriers, facilitators, positive and negative referents, advantages and disadvantages) will influence the most physicians' intention to use a wiki-based reminder to promote best practice in trauma care. These factors will need to be considered in the implementation of a wiki-based reminder system to promote best practice in trauma care in Quebec.