Seite - 129 - in Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners

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