Collaborative Knowledge Translation: Application of a Wiki Model for Primary Care Practitioners [4 Cr2 1530 Shachak]


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  • Collaborative Knowledge Translation: Application of a Wiki Model for Primary Care Practitioners [4 Cr2 1530 Shachak]

    1. 1. Shachak, A. et al.: Collaborative Knowledge Translation: Application of a Wiki Model for Primary Care Practitioners <ul><li>This slideshow, presented at Medicine 2.0’08 , Sept 4/5 th , 2008, in Toronto, was uploaded on behalf of the presenter by the Medicine 2.0 team </li></ul><ul><li>Do not miss the next Medicine 2.0 congress on 17/18th Sept 2009 ( ) </li></ul><ul><li>Order Audio Recordings (mp3) of Medicine 2.0’08 presentations at </li></ul>
    2. 2. Collaborative Knowledge Translation: Application of a Wiki Model for Primary Care Practitioners Aviv Shachak, Steve Hockema, Jamie Meuser, Lena Salach, Tupper Bean, Noah Ivers, Mike Evans
    3. 3. Presentation wiki <ul><li> / </li></ul>
    4. 4. Knowledge Translation (KT) From: Lang et al., 2007
    5. 5. The nature of knowledge and criticism of EBM <ul><li>Knowledge is created through interaction </li></ul><ul><li>Knowledge is actionable </li></ul><ul><li>Expertise and tacit knowledge </li></ul><ul><li>The practice to research gap </li></ul><ul><li>Evidence is constantly changing </li></ul><ul><li>Difficult to implement EBM at the point of care </li></ul>
    6. 6. A better model… From: Baumbusch et al., 2008
    7. 7. Another step forward <ul><li>Crossing traditional role boundaries: collaboration in the creation and dissemination of knowledge </li></ul><ul><li>Interprofessional </li></ul><ul><li>Wikis are ideal for this purpose: - online EBM resources are becoming the preferred option for answering clinical questions; - Creating an on-line community; - Multi- (or inter-)professional community, transcends traditional borders; - Constant updating </li></ul>
    8. 8. Centre for Effective Practice <ul><li>Focus: clinical care gaps in primary acre </li></ul><ul><li>NFP: close gaps by developing relevant, evidence-based interventions </li></ul><ul><li>Identify barriers to optimal practice & produce practical solutions </li></ul><ul><li>Relevant regardless of clinical setting, training or background </li></ul>
    9. 9. Family Practice Sourcebook <ul><li>Best selling textbook for primary care </li></ul><ul><li>Reference tool for residents and primary care providers (MDs, nurses, pharms, etc.) </li></ul><ul><li>Covers current approaches and controversies in the prevention and treatment </li></ul><ul><li>Evidence based but short shelf life </li></ul><ul><li>DFCM at U of T lead contributor: + 194 faculty, residents, and medical students contributed </li></ul>
    10. 10. Collaborative Learning Tool (COLT) <ul><li>Apply 2.0 models to facilitate knowledge translation by connecting researchers and health care practitioners (MDs, nurses, pharms) </li></ul><ul><li>Allows practitioners to participate in the synthesis of evidence and engage in an on-going discussion </li></ul><ul><li>Updated continuously, thereby fostering the faster creation and dissemination of knowledge. </li></ul>
    11. 11. COLT <ul><li>Offer the Sourcebook via a modified wiki to primary care practitioners </li></ul><ul><li>Content managed by a University led team (independent) </li></ul><ul><li>Endorsed by professional colleges and bodies </li></ul><ul><li>Provide current, valid, and relevant resources (tools, videos, patient info, etc.) </li></ul>
    12. 12. Key Differences <ul><li>Sustainable financial model (Gov’t and NGO support, CME, publishing, etc.) </li></ul><ul><li>Users are authenticated and must give credentials </li></ul><ul><li>Final decisions for revisions rest with “clinical editors” to ensure balance, evidence, validity, etc. </li></ul><ul><li>Consistent language, style and formatting will be maintained by a professional editor to ensure consistent voice, readability, etc . </li></ul>
    13. 13. To Date…. <ul><li>Development server hosting source wiki software (Mediawiki) </li></ul><ul><li>Beta site/concept pages established </li></ul><ul><li>Finalizing the edit/access/approval framework and work flow </li></ul><ul><li>Focus groups, demonstrations, and qualitative testing have taken place </li></ul><ul><li>Identified a variety of operational and technical issues and will inform the further development </li></ul><ul><li>Establishing appropriate partnerships/funding agreements </li></ul>
    14. 14. Current Version The list of subject areas follows the table of content from the Sourcebook for continuity and quick access.
    15. 15. Current Version A page demonstrating a subject area: Women’s Gynecology – Endometriosis. A detailed table of contents for the subject area appears for the user to quickly see what is available (e.g., physician tools, tips and tricks, patient tools, videos, etc.)
    16. 16. Proposed Version
    17. 17. Benefits <ul><li>Unlike standard textbooks that only are updated with each new edition, this will be constantly updated to reflect new research and local realities for best practice; </li></ul><ul><ul><li>Encourage an active role for professionals in reviewing and sharing information; </li></ul></ul><ul><ul><li>Promote and disseminate proven KT tools to encourage best practices, with rapid feedback and revision aimed at making them better </li></ul></ul><ul><ul><li>Support interaction in different time scales (20 sec/20 min/2 hrs) </li></ul></ul><ul><li>Comprehensive resource for all health practitioners engaged in primary care and will support interprofessional care </li></ul>
    18. 18. Benefits <ul><li>Develop a greater sense of interaction and community among members of the primary care community </li></ul><ul><li>Positive effect on the healthcare system through: </li></ul><ul><ul><li>Fostering collaboration and engaging professionals in reviewing and sharing information </li></ul></ul><ul><ul><li>Improving access to current and relevant information, resources and tools </li></ul></ul><ul><ul><li>Building the concept of interprofessional care into the development of knowledge products (Guidelines, CME delivery etc.) </li></ul></ul>
    19. 19. Potential COLT Partners Founders Potential Content Supporters Infrastructure Quality management
    20. 20. Partnership Involvement <ul><li>Each organization will participate in: </li></ul><ul><ul><li>Input into the design and structure; </li></ul></ul><ul><ul><li>Recruitment of content editors and champions; </li></ul></ul><ul><ul><li>Promotion and endorsement to potential funders, users, etc.; </li></ul></ul><ul><ul><li>Assistance in the recruitment of users; </li></ul></ul><ul><ul><li>Contribution to content and links of resources, applications, functions </li></ul></ul><ul><ul><li>Research and evaluation (surveys, interviews, focus groups, etc.) </li></ul></ul>
    21. 21. Research and Evaluation <ul><li>Research questions: </li></ul><ul><ul><li>How best practice resources are created and evolve collaboratively? </li></ul></ul><ul><ul><li>Contributors’ and users’ perceptions of the wiki’s usefulness, ease of use, Credibility, and impact on behavior; </li></ul></ul><ul><ul><li>Diffusion within the primary care community (e.g. rate of diffusion, barriers and enablers, adoption and post-adoption behavior) </li></ul></ul>
    22. 22. Research and Evaluation <ul><li>Mixed methods research: - Discourse and content analysis, - Logfile analysis, - Key informant interviews - Focus groups, - Social network analysis, - Surveys </li></ul><ul><li>Interdisciplinary team, involving researchers, knowledge creators, users and decision makers </li></ul>
    23. 23. Challenges <ul><li>Difficult to measure impact on clinical behavior and patient outcomes. </li></ul><ul><li>Change is inherent (fluid environment) </li></ul><ul><li>Ethics </li></ul>