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
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Networked intelligence in EDs across Canada CAEP 2016
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
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
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
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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)
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
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
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
Notes de l'éditeur
1800 knowledge tools in wiki
1- Cochrane reviews will become more interoperable with other projects, products, datasets, and systems
2- is releasing datasets from the US Dept. of Health and Human Services to allow researchers/innovators create linked data applications that will help patients