Health Care Professional Association Agency in Preparing for Artificial Intelligence: Protocol for a Multi-Case Study
Bibliographic record
Abstract
BACKGROUND: The emergence of artificial intelligence (AI) in health care has impacted health care systems, including employment, training, education, and professional regulation. It is incumbent on health professional associations to assist their membership in defining and preparing for AI-related change. Health professional associations, or the national groups convened to represent the interests of the members of a profession, play a unique role in establishing the sociocultural, normative, and regulative elements of health care professions. OBJECTIVE: The aim of this paper is to present a protocol for a proposed study of how, when faced with AI as a disruptive technology, health professional associations engage in sensemaking and legitimization of change to support their membership in preparing for future practice. METHODS: An exploratory multi-case study approach will be used. This study will be informed by the normalization process theory (NPT), which suggests behavioral constructs required for complex change, providing a novel lens through which to consider the agency of macrolevel actors in practice change. A total of 4 health professional associations will be studied, each representing an instrumental case and related fields selected for their early consideration of AI technologies. Data collection will consist of key informant interviews, observation of relevant meetings, and document review. Individual and collective sensemaking activities and action toward change will be identified using stakeholder network mapping. A hybrid inductive and 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 health professional associations. Of these 17 interviews, 15 (88%) have been transcribed. Document review is underway and complete for one health professional association and nearly complete for another. Observation opportunities have been challenged by competing priorities during COVID-19 and may require revisiting. 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 health professional associations have considered this topic at the time of the study and, hence, what priority it has been assigned within the health professional association and what actions have been taken to consider or prepare for it. The fact that this may differ between health professional associations and practice environments will require consideration throughout the analysis. CONCLUSIONS: Ultimately, this protocol outlines a case study approach to understand how, when faced with AI as a disruptive technology, health professional associations engage in sensemaking and legitimization of change to support their membership in preparing for future practice. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/27340.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.114 | 0.138 |
| Meta-epidemiology (narrow) | 0.003 | 0.003 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.007 | 0.004 |
| Scholarly communication | 0.007 | 0.006 |
| Open science | 0.005 | 0.005 |
| Research integrity | 0.006 | 0.007 |
| Insufficient payload (model declined to judge) | 0.090 | 0.015 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".