title: Attitudes of pediatric intensive care unit physicians towards the use of cognitive aids: a qualitative study.
abstract: Cognitive aids are increasingly recommended in clinical practice, yet little is known about the attitudes of physicians towards these tools.
  
  
  
  We employed a qualitative, descriptive design to explore physician attitudes towards cognitive aids in pediatric intensive care units (PICUs). Semi-structured interviews elicited the opinions of a convenience sample of practicing PICU physicians towards the use of cognitive aids. We analyzed interview data for thematic content to examine the three factors of intention to use cognitive aids as defined by the Theory of Planned Behavior (TPB), attitudes, social norms, and perceived control.
  
  
  
  Analysis of 14 interviews suggested that in the PICU setting, cognitive aids are widely used. Discovered themes related to their use touched on all three TPB factors of intention and included: aids are perceived to improve team communication; aids may improve patient safety; aids may hinder clinician judgment; physicians may resist implementation if it occurs prior to demonstration of benefit; effective adoption requires cognitive aids to be integrated into local workplace culture; and implementation should take physician concerns into account.
  
  
  
  Our sample of PICU physicians were open to cognitive aids in their practice, as long as such aids preserve the primacy of clinical judgment, focus on team communication, demonstrate effectiveness through preliminary testing, and are designed and implemented with the local culture and work environment in mind. Future knowledge translation efforts to implement cognitive aids would benefit from consideration of these issues.
authors.affiliation: Division of Pediatric Critical Care, Centre Mère-Enfant Soleil du Centre Hospitalier Universitaire de Québec, 2705 boul Laurier Local R1735, Québec, QC, G1V 4G2, Canada. matthew-john.weiss@mail.chudequebec.ca.|Department of Pediatrics, Université Laval, Faculty of Medicine, Québec, Canada. matthew-john.weiss@mail.chudequebec.ca.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Weiss
authors.affiliation: School of Psychology, Université Laval, Faculty of Social Sciences, Pavillon Félix-Antoine-Savard, 2325, rue des Bibliothèques, Québec, G1V 0A6, Canada.
authors.forename: Chelsea
authors.initials: C
authors.lastname: Kramer
authors.affiliation: School of Psychology, Université Laval, Faculty of Social Sciences, Pavillon Félix-Antoine-Savard, 2325, rue des Bibliothèques, Québec, G1V 0A6, Canada.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Tremblay
authors.affiliation: Department of Family and Emergency Medicine, Université Laval, Faculty of Medicine, Pavillon Ferdinand-Vandry, 1050, avenue de la Médecine Local 2207A, Québec, G1V 0A6, Canada.
authors.forename: Luc
authors.initials: L
authors.lastname: Côté
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D057189:Checklist / Q000706:statistics & numerical data*; D000066491:Clinical Decision-Making; D005260:Female; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D008297:Male; D008491:Medical Informatics Applications; D008875:Middle Aged; D000072143:Pediatricians / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D036301:Qualitative Research
keywords: Cognitive aids; Implementation; Pediatric intensive care; Physician attitudes; Qualitative research; Theory of planned behavior