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3. Usage of DCMT in relation to present theories regarding junior doctor
communication
Grounded theory (GT) and action research (AR) were the methodologies used in the
research behind DCMT [18]. There are general advantages to using GT in healthcare
organisation research. In addition, there were specific reasons why GT was used in
combination with AR to develop DCMT. These issues and a discussion of GT version
selection in DCMT research are below.
GT is commonly used in healthcare research. Its advantages include its innate
pragmatism, adaptability to study resources and where there are few pre-existing theories
[40]. This is especially beneficial in complex organisations with unpredictable
phenomena. Other researchers of junior doctor communication for the purposes of
requesting assistance [11, 12] have also used GT. GT can also be used together with
action research (AR), such that the two methodologies complement each other [41]. GT
enhances the rigour of AR theory building and chain of evidence creation [42], whilst
AR helps address power differences between researcher and researched [18]. GT was
also particularly useful in DCMT research in that theory generated should be modifiable
as new data arises. This is so that its concepts are modified as necessary and the theory
continues to be relevant [43]. This is particularly important as hospital organisations and
ICT systems evolve with time.
Classical GT (CGT) is one of three common versions of GT, the other two being
Straussian GT and constructivist GT. The versions differ in their underlying philosophy,
coding techniques and approach to research of previous literature [44]. An example of
GT version selection according to research question is Tallentire et al’s [11] usage of
constructivist GT to understand junior doctor behaviour in acute patient care. Liang [18]
used CGT to explain junior doctor communicative behaviour in response to messages.
This is consistent with differences between these GT versions, in that constructivist GT
aims to understand multiple perspectives in a social process, whilst CGT focuses on one
main concern [43]. CGT offers other advantages in both healthcare [43] and information
systems [40] research. CGT is flexible in accommodating many types and sources of
data. This is advantageous in hospital ICT research given the variety of ICT physical
devices and modes used [22]. CGT can accommodate different theoretical perspectives.
Patient safety research, of which DCMT is an example, has classically favoured
positivistic and quantitative approaches. These do not reflect complexity or explain
underlying factors well [45]. Whilst CGT as a GT version has seldom been used in
information systems research [46], its philosophical pragmatism is advantageous in
bridging these two worlds. CGT generated theories also have theoretical concepts
transferrable to different settings [47], meaning that DCMT is potentially applicable to
other organisational situations where individuals communicate about risk.
4. Explanation of success or failure in communication about the deteriorating
patient
Since DCMT has not been used in ICT development as yet, its potential usage will be
demonstrated with an example of a junior doctor ICT system. Patel et al [34] studied
information transfer and clinician satisfaction with locators compared to Hark, a mobile
phone-based task management system. Nurses sent pre-arranged messages or locator
pages to junior doctors during usual hospital business days. Recipient reply was defined
J.Liangetal. / JuniorDoctorCommunicationSystemsand theDCMT 129
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book Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners"
Applied Interdisciplinary Theory in Health Informatics
Knowledge Base for Practitioners
- Title
- Applied Interdisciplinary Theory in Health Informatics
- Subtitle
- Knowledge Base for Practitioners
- Authors
- Philip Scott
- Nicolette de Keizer
- Andrew Georgiou
- Publisher
- IOS Press BV
- Location
- Amsterdam
- Date
- 2019
- Language
- English
- License
- CC BY-NC 4.0
- ISBN
- 978-1-61499-991-1
- Size
- 16.0 x 24.0 cm
- Pages
- 242
- Category
- Informatik