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Digitalization and Physician Learning: Individual Practice, Organizational Context, and Social Norm
University West, School of Business, Economics and IT, Divison of Law, Economics, Statistics and Politics. NU Hospital Group, Trollhättan, Sweden. (LINA)ORCID iD: 0000-0002-0493-8974
Örebro University, University Health Care Research Center, Faculty of Medicine and Health, Sweden.
University West, School of Business, Economics and IT, Divison of Informatics. (LINA)ORCID iD: 0000-0002-0575-4309
2020 (English)In: Journal of Continuing Education in the Health Professions, ISSN 0894-1912, E-ISSN 1554-558X, Vol. 40, no 4, p. 220-227Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: The emerging context of online platforms and digitally engaged patients demands new competencies of health care professionals. Although information and communication technologies (ICTs) can strengthen continuous professional development (CPD) and learning at work, more research is needed on ICT for experiential and collegial learning.

METHODS: The study builds on prior qualitative research to identify issues and comprises a quantitative assessment of ICT usage for learning in health care. A survey was administered to Swedish physicians participating in a CPD program as part of specialist medical training. Conclusions focused specifically on learning dimensions are drawn from correlation analyses complemented with multiple regression.

RESULTS: The findings show that physicians' actual use of ICT is related to perceived performance, social influence, and organizational context. Social norm was the most important variable for measured general usage, whereas performance expectancy (perceived usefulness of ICT) was important for ICT usage for learning. The degree of individual digitalization affects performance and, in turn, actual use.

DISCUSSION: The study highlights the need to incorporate ICT effectively into CPD and clinical work. Besides formal training and support for specific systems, there is a need to understand the usefulness of digitalization integrated into practice. Moving beyond instrumentalist views of technology, the model in this study includes contextualized dimensions of ICT and learning in health care. Findings confirm that medical communities are influencers of use, which suggests that an emphasis on collegial expectations for digital collaboration will enhance practitioner adaptation.

Place, publisher, year, edition, pages
2020. Vol. 40, no 4, p. 220-227
Keywords [en]
CPD, digitalization, health informatics, ICT, information systems, physicians, workplace learning
National Category
Information Systems, Social aspects Pedagogy
Research subject
Work Integrated Learning
Identifiers
URN: urn:nbn:se:hv:diva-15941DOI: 10.1097/CEH.0000000000000303PubMedID: 32969857Scopus ID: 2-s2.0-85097575303OAI: oai:DiVA.org:hv-15941DiVA, id: diva2:1472520
Available from: 2020-10-01 Created: 2020-10-01 Last updated: 2021-02-05Bibliographically approved
In thesis
1. Digital Work: Coping with Contradictions in Changing Healthcare
Open this publication in new window or tab >>Digital Work: Coping with Contradictions in Changing Healthcare
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Digital work is bringing significant change to all professions, as established work settings are replaced by remote work and digital teamwork and collaboration. Contradictions arise when work is no longer bounded in time or space and personal and professional life merge. This raises several issues. The issues include control of time, professional boundaries, and privacy and security. Healthcare is one area where digital technology is a growing influence on professional work, roles, and relationships. The medical profession demands constant learning as it undergoes accelerating advancements in both medicine and technology. This has the effect of a change in patient-physician relationships as patients access medical information on public sites and interact with providers outside the clinical setting.The research documents the effects of professional use of multiple technologies to interact, share knowledge, and coordinate. The research problem therefore addresses the blending of personal and professional technology use in healthcare specifically and the public sector in general, focusing on the impact of digitally engaged patients on practice.The aim of the thesis is to explore dimensions of digital work that arise from the use of digital technologies in daily work and learning, with a focus on the professional role of physicians.

It poses the following research questions: RQ1) What opportunities and challenges do physicians experience from using digital technologies for work and learning and how do they view their role and expertise in relation to informed and digitally engaged patients? And RQ2) What does the analysis reveal about thecharacteristics of digital work, and its implications for professionalism? The topic covers dynamics between information, technology, and people, in the context of work and learning in healthcare. Therefore, the perspectives guiding the research lie at the intersection of multiple disciplines, like Information Systems, workplace learning and health informatics. The thesis adopts a sociotechnical approach wherein the concept of information system is understood broadly to comprise information content, social context, and specific technologies. For the analysis of the research data, it combines workplace learning theories with concepts from the information infrastructure, and infrastructuring literature to identify and analyze characteristics and contradictions of digital work. The thesis comprises five peer-reviewed research papers. The data comes from 15 semi-structured interviews, three focus groups and a survey of 148 Swedish resident physicians. The project is informed by an engaged research approach, including observations from longitudinal collaborative research, and development projects that involved physicians and other public sector professionals. By exploring and describing physicians’ interactions with multiple digital technologies as part of everyday work, the thesis responds to calls for research to capture the sociotechnical dimensions and effects of digital technologies on work beyond traditional standalone systems. It addresses a real-world problem that public sector healthcare faces, by providing contextual details and insights into how digital health technology and public information intervene in the patient-physician relationship. The findings suggest that digital work can be understood as a process of coping with contradictions, where physicians reconfigure professionalism through ongoing efforts to embrace the new forms of work without sacrificing core values. The thesis concludes with guidelines to address the transformation of professional roles and responsibilities, the new qualities and competencies required for digital work, and the need for interdisciplinary research and consideration of diverse perspectives for an appropriate design of sociotechnical medical systems.

Place, publisher, year, edition, pages
Trollhättan: University West, 2021. p. 97
Series
PhD Thesis: University West ; 44
Keywords
Digital work, Information Systems, physicians, professionalism, workplace learning, flipped healthcare.
National Category
Information Systems, Social aspects
Research subject
Work Integrated Learning
Identifiers
urn:nbn:se:hv:diva-16273 (URN)978-91-88847-90-4 (ISBN)978-91-88847-89-8 (ISBN)
Public defence
2021-02-26, 13:00 (English)
Opponent
Supervisors
Available from: 2021-02-05 Created: 2021-02-05 Last updated: 2021-02-05Bibliographically approved

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Vallo Hult, HelenaGellerstedt, Martin

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