JMIR Publications

ABSTRACT

Background:

The emergence of artificial intelligence (AI) in healthcare impacts on most aspects of our healthcare systems including consideration of employment, training, education, and professional regulation for healthcare professions. It is incumbent on healthcare professional associations (HPAs) to assist their membership in defining and preparing for AI-related change. HPAs, or the national groups convened to represent the interests of the members of a profession, hold a unique role in establishing and maintaining the socio-cultural, normative, and regulative elements of healthcare professions.

Objective:

The objective of this study is to examine how, when faced with AI as a disruptive technology, HPAs engage in sense-making and legitimization of change in order to support their membership in preparing for future practice.

Methods:

An exploratory multi-case study approach will be employed. This study will be informed by normalization process theory (NPT), which suggests behavioural constructs required for complex change, providing a novel lens through which to consider the agency of macro-level actors in practice change. Four HPAs will be studied, with each representing an instrumental case and related fields, selected for their early consideration and adoption of AI technologies. Data collection will consist of key-informant interviews, observation of relevant meetings, and document review. Individual and collective sense-making activities and action toward change will be identified and characterized using stakeholder network mapping. A hybrid inductive/deductive model will be used for a concurrent thematic analysis, mapping emergent themes against the NPT framework to assess fit and identify areas of discordance.

Results:

As of January 2021, we have conducted 17 interviews with representation across the 4 HPAs. Fifteen of these (88.2%) of these have been transcribed. Document review is underway and complete for one HPA and nearly complete for one other HPA. Observation opportunities have been challenged by competing priorities during COVID and may require revisiting.

Conclusions:

A linear cross-case analytic approach will be taken to present the data, highlighting both guidance for the implementation of AI and implications for the application of NPT at the macro level. The ability to inform consideration of AI will depend on the degree to which the engaged HPAs have considered this topic at the time of the study, and hence what priority it has been assigned within the HPA and what actions have been taken to consider or prepare for it. The fact that this may differ between HPAs and associated professions and practice environments will require consideration throughout the analysis. Ultimately, this protocol outlines a case study approach to understanding how, when faced with AI as a disruptive technology, HPAs engage in sense-making and legitimization of the change in order to support their membership in preparing for future practice.