In this session, I will review the literature on virtual communities of practice and wikis in emergency medicine. I will propose a new model for knowledge translation to link emergency physicians from across Canada in the creation of a novel open-source and free database of shared resources that can be reused and adapted to local contexts. Finally, I will provide a glimpse of a new era in knowledge translation in the era of the Semantic Web. Learning Objectives 1- Learn how communities of practice and wikis can support clinical practice in emergency medicine 2- Learn how a database of open-source and free knowledge tools could support your ED 3- Learn about the evolution of knowledge translation in the era of the of the Semantic Web

1. Networked
intelligence in
EDs across
Canada
Patrick Archambault, MD, MSc, FRCPC
Clinician-scientist FRQS Junior 2 (CISSS-CA, Hôtel-Dieu de Lévis)
Assistant professeur, DMFMU and Anesthesia, Université Laval
@patarchambault

2. Financial disclosures
None
Research projects funded by CIHR, FRQS, CMPA, KT
Canada
Partners

3. Plan
1. What are social networks ?
2. What are communities of practice ?
3. What communication tools are used?
4. Why would we want to use wikis?
5. Research program on wikis
6. Future: Semantic web

4. Recent history in information sharing 4

5. Knowledge sharing
Web 1.0: Single
knowledge hubs
Web 2.0: distributed
networked knowledge
sharing
5

6. Social networks are growing
• ER docs are
increasingly
connected
• Social networks
allow us to share
knowledge more
openly and faster Infographic created by Ivor Kovic @ivorkovic

7. Social networks
• Social network = set of social actors
(individuals/organizations) with interactions
• Diffusion of innovations theory focuses on
the spread and use of ideas from one actor
to another
7

8. John Stuart Mill
“ Placing humans in
contact with persons
dissimilar to
themselves is one of
the primary sources of
progress (1909) ”
8

9. Communities of practice
• Lave and Wenger coined the term while
studying apprenticeship as a learning model
• “Informal group of peers/practionners that
have a common sense of purpose, a
common need to resolve an issue, and/or a
common need develop expertise, knowledge
or innovation”
9

10. Elements of a CoP
• Community-Domain-Place to meet
• Shared domain of knowledge
• Explicit knowledge (know what to do)
• Tacit knowledge (know-how; experience)
• There is no knowledge outside of people, only
information.
10

11. Web and CoPs
• Web has extended the reach beyond local
CoP
• Expands the possibilities for community
11

12. Virtual EM communities of practice
• CanadiEM
• SGEM
• ALiEM
• #FOAMed
• The Rounds
• Sermo
12

13. Honeycomb
model
Each social media
have different
functions
13
Kietzmann et al 2012

14. Build a collaborative environment
• Find and connect with experts
• Find and connect with peers
• Identify the needs of your community
• Social media can support your needs
• Identity (Facebook)
• Conversation (Blog)
• Sharing (wikis)
14

15. What is a wiki?
• Webpage content
• User-generated
• Edited by whoever
has access
• Synthesis of
information
• Open wiki
(Wikipedia)
• Closed wiki
(WikEM)

16. Why use a wiki?
16
Archambault et al http://www.jmir.org/2013/10/e210/

17. A wiki for KT ?
KTools support
evidence based
decision making:
• Care protocols
• Order sets
• Decision aids
Archambault et al http://www.researchprotocols.org/2015/1/e21/
Archambault et al http://medinform.jmir.org/2016/2/e18/
Plaisance et al http://www.researchprotocols.org/2016/1/e24/

18. WikiTrauma research program
Project A Wikis and Collaborative Writing Applications in Health Care: A Scoping Review: positive
potential but strong evidence is lacking
(scoping review JMIR, 2013) + (protocole Cochrane, 2014)
Project B Healthcare professionals' intentions to use wiki-based reminders to promote best practices in
trauma care (mixed methods survey): strong intention among health professionals to
use a wiki, but there is a need for training about how to use a wiki.
(manuscrit JMIR 2012) + (pre/post case study, Medicine 2.0) + (Quebec provincial
survey)
Project C Development of a theory based intervention to increase use of wiki-based reminders
promoting best practices in trauma care: created an online training course (Wiki101)
(CIHR planning meeting May 2014)
Project D Implementation and Evaluation of a Wiki Involving Multiple Stakeholders Including Patients in the
Promotion of Best Practices in Trauma Care (currently ongoing)
(Funded by CMPA 2014)

19. WikiTrauma: ongoing experiment
To edit a page
Archambault et al 2015 http://www.researchprotocols.org/2015/1/e21/

20. Protocol published JMIR ResProtoc, 2015
http://www.researchprotocols.org/2015/1/e21/

21. Wikis for KT: summary
• Wikis have interesting potential for KT
• Savings by reducing duplication?
• Continuous quality improvement?
• Improved interprofessional collaboration?
• Improved collaboration between hospitals?
• More research is needed

22. Future of the Web
• Semantic Web
technology will
allow human-
readable web
pages to become
machine-readable
by adding metadata
22

23. Examples of Semantic Web
• Cochrane’s Linked Data project
• HealthData.gov
23

24. Semantic wiki database
• Semantic wiki database could allow sharing
and reuse of information on larger scale
• Linked knowledge tools would facilitate
distributed intelligence and continuous
system learning
24

25. Semantic Web
• Automation
• Data fusion
• Continual learning
• Compounding (as data accumulates)
• Contextualisation (linking content to context)
25http://nofilmschool.com/2010/05/web-3-0-now-were-just-talking-semantics

26. The future?
26
Tim Berners-Lee:
“If we end up developing
all the things I can
image, we will have
failed.”

27. Questions or comments?
Merci! Thank you!
Patrick.m.archambault@gmail.com
@patarchambault

28. More about wikis in healthcare
http://medinform.jmir.org/2016/2/e18/
http://www.researchprotocols.org/2016/1/e24/
http://journals.cambridge.org/action/displayAbstract?fr
omPage=online&aid=9821394&fileId=S148180351400
0499
http://www.researchprotocols.org/2015/1/e21/
http://www.jmir.org/2013/10/e210/
http://www.jmir.org/2011/4/e114/
http://www.ncbi.nlm.nih.gov/pubmed/22515985
http://www.jmir.org/2015/2/e48/
http://www.jmir.org/2011/1/e14/
28