Cognitive evaluation of the predictors of use of computerized protocols by clinicians.

We describe a cognitive approach to evaluating the factors that motivate clinicians to use computerized protocols. Using Value-Expectancy theories we developed an open-ended interview to assess clinicians' beliefs and experiences about the use of computerized protocols. Using a qualitative methodology, 3 reviewers independently identified key concepts raised by 13 interviewees. These concepts were aggregated and independently sorted into 39 categories. Then final categories were chosen by consensus. Analysis of the concepts showed consistency across clinician specialties of physicians, nurses and respiratory therapists. Inter-rater reliability calculated using Cohen's Kappa was 0.474. Identified constructs from Value-Expectancy and Intrinsic Motivation theories were: Work Importance, Perception of Situation, Role Relevance, Beliefs regarding Control, Beliefs regarding Normative Expectations, Beliefs regarding Self-Efficacy, Attitude, Habit, Environmental Support and Pre-Behavior. This model will form the basis for an instrument to assess the beliefs and expectations of clinical use regarding the use of computerized protocols.