TY - JOUR T1 - Uptake of an innovation in surgery: observations from the cluster-randomized Quality Initiative in Rectal Cancer trial JF - Canadian Journal of Surgery JO - CAN J SURG SP - 415 LP - 421 DO - 10.1503/cjs.019112 VL - 56 IS - 6 AU - Marko Simunovic AU - Angela Coates AU - Andrew Smith AU - Lehana Thabane AU - Charles H. Goldsmith AU - Mark N. Levine Y1 - 2013/12/01 UR - http://canjsurg.ca/content/56/6/415.abstract N2 - Background: Theory suggests the uptake of a medical innovation is influenced by how potential adopters perceive innovation characteristics and by characteristics of potential adopters. Innovation adoption is slow among the first 20% of individuals in a target group and then accelerates. The Quality Initiative in Rectal Cancer (QIRC) trial assessed if rectal cancer surgery outcomes could be improved through surgeon participation in the QIRC strategy. We tested if traditional uptake of innovation concepts applied to surgeons in the experimental arm of the trial.Methods: The QIRC strategy included workshops, access to opinion leaders, intra-operative demonstrations, postoperative questionnaires, and audit and feedback. For intraoperative demonstrations, a participating surgeon invited an outside surgeon to demonstrate optimal rectal surgery techniques. We used surgeon timing in a demonstration to differentiate early and late adopters of the QIRC strategy. Surgeons completed surveys on perceptions of the strategy and personal characteristics.Results: Nineteen of 56 surgeons (34%) requested an operative demonstration on their first case of rectal surgery. Early and late adopters had similar perceptions of the QIRC strategy and similar characteristics. Late adopters were less likely than early adopters to perceive an advantage for the surgical techniques promoted by the trial (p = 0.023).Conclusion: Most traditional diffusion of innovation concepts did not apply to surgeons in the QIRC trial, with the exception of the importance of perceptions of comparative advantage. ER -