Developing a theoretical model of clinician information usage propensity.

Based on qualitative research, we developed the theoretical construct "clinician information usage propensity" as a hypothetical indicator of attitudes and behaviour towards clinical information and systems. We devised a survey to validate the construct and had 146 responses. Principal components analysis extracted four factors accounting for 47.2% of the variance: beliefs about clinical judgement, beliefs about information quality, cultural resistance and cognitive approach. The components were reasonably consistent with the model but two factors (beliefs about information quality, cognitive approach) had low reliability (alpha<0.6). Cultural resistance was the main factor and correlated with gender, grade and age group. Female clinicians showed significantly higher cultural resistance and preference for narrative; hospital doctors generally had higher cultural resistance than general practitioners. As only 47.2% of the variance was explained, further work is needed to refine the instrument to remove redundancy, improve sensitivity on the identified components and allow the construct to be explored as a form of technology adoption model. We posit that beliefs about clinical judgement merit further attention in medical informatics research.