The IT Identity Threat: A Conceptual Definition and Operational Measure

Exploring the role of professional identity in the implementation of clinical decision support systems-a narrative review

BACKGROUND

Clinical decision support systems (CDSSs) have the potential to improve quality of care, patient safety, and efficiency because of their ability to perform medical tasks in a more data-driven, evidence-based, and semi-autonomous way. However, CDSSs may also affect the professional identity of health professionals. Some professionals might experience these systems as a threat to their professional identity, as CDSSs could partially substitute clinical competencies, autonomy, or control over the care process. Other professionals may experience an empowerment of the role in the medical system. The purpose of this study is to uncover the role of professional identity in CDSS implementation and to identify core human, technological, and organizational factors that may determine the effect of CDSSs on professional identity.

METHODS

We conducted a systematic literature review and included peer-reviewed empirical studies from two electronic databases (PubMed, Web of Science) that reported on key factors to CDSS implementation and were published between 2010 and 2023. Our explorative, inductive thematic analysis assessed the antecedents of professional identity-related mechanisms from the perspective of different health care professionals (i.e., physicians, residents, nurse practitioners, pharmacists).

RESULTS

One hundred thirty-one qualitative, quantitative, or mixed-method studies from over 60 journals were included in this review. The thematic analysis found three dimensions of professional identity-related mechanisms that influence CDSS implementation success: perceived threat or enhancement of professional control and autonomy, perceived threat or enhancement of professional skills and expertise, and perceived loss or gain of control over patient relationships. At the technological level, the most common issues were the system's ability to fit into existing clinical workflows and organizational structures, and its ability to meet user needs. At the organizational level, time pressure and tension, as well as internal communication and involvement of end users were most frequently reported. At the human level, individual attitudes and emotional responses, as well as familiarity with the system, most often influenced the CDSS implementation. Our results show that professional identity-related mechanisms are driven by these factors and influence CDSS implementation success. The perception of the change of professional identity is influenced by the user's professional status and expertise and is improved over the course of implementation.

CONCLUSION

This review highlights the need for health care managers to evaluate perceived professional identity threats to health care professionals across all implementation phases when introducing a CDSS and to consider their varying manifestations among different health care professionals. Moreover, it highlights the importance of innovation and change management approaches, such as involving health professionals in the design and implementation process to mitigate threat perceptions. We provide future areas of research for the evaluation of the professional identity construct within health care.

Evaluating the impact of employees’ perception of identity threat on knowledge sharing behavior during COVID-19: The mediation and moderation effect of social capital and reward system

Quarantine policies introduced in the context of COVID-19 are affecting business operations and slowing down the flow rate of the overall economy. Different degrees and types of threats occur in both the living environment and the working environment during the epidemic prevention, which causes many additional uncertainties. The impact on employees is the identity threat from environment and organizations. This is different from the related research on the identification and impact of the threat before the occurrence of COVID-19. However, in the post-pandemic period, companies continue to strengthen important factors that can increase innovation and recovery, including the role of employee knowledge sharing. The organizational inequity and lack of organizational justice bring about the threat of internal identification in organizations. In order to ensure their own interests in organizations, employees may think twice when sharing knowledge. Therefore, this study explores the relationship among employees’ identity threat, social capital and knowledge sharing behavior from the perspective of organizational behavior. In this study, a sample of high-tech employees was conducted, and a total of 434 questionnaires were obtained. The research results show that employees’ perception of identity threat has a negative impact on knowledge sharing behavior and positively affects social capital; employees’ social capital positively affects their knowledge sharing behaviors; and organizational reward system moderates the relationship between identity threat and knowledge sharing behavior. Based on the comprehensive research findings, this research proposes corresponding theoretical and practical implications.

Connecting perceived effectiveness of app evolution to app engagement: a technology identity perspective

Purpose

This paper extends the current literature on app engagement to identify dynamic factors that affect app engagement and the value-creation pathway that connect these factors with app engagement.

Design/methodology/approach

Survey data were collected from 299 app users to test the proposed research model.

Findings

The study found that the perceived effectiveness of evolution content and that of evolution speed impose both individual and joint positive effects on app identity, which serves as the mediation mechanism that connects these dynamic factors with app engagement.

Originality/value

This study takes the user perspective to explore how user perceptions of the effectiveness of app evolution content and speed, which represent unique user experiences in the app context, cultivate app engagement by enhancing app identity. Specifically, this study reveals the intertwined relationship among perceived effectiveness of app evolution, app identity, and app engagement.

Artificial Intelligence and the Future of Work: A Functional-Identity Perspective

The impact of the implementation of artificial intelligence (AI) on workers’ experiences remains underexamined. Although AI-enhanced processes can benefit workers (e.g., by assisting with exhausting or dangerous tasks), they can also elicit psychological harm (e.g., by causing job loss or degrading work quality). Given AI’s uniqueness among other technologies, resulting from its expanding capabilities and capacity for autonomous learning, we propose a functional-identity framework to examine AI’s effects on people’s work-related self-understandings and the social environment at work. We argue that the conditions for AI to either enhance or threaten workers’ sense of identity derived from their work depends on how the technology is functionally deployed (by complementing tasks, replacing tasks, and/or generating new tasks) and how it affects the social fabric of work. Also, how AI is implemented and the broader social-validation context play a role. We conclude by outlining future research directions and potential application of the proposed framework to organizational practice.

Identity Threats as a Reason for Resistance to Artificial Intelligence: Survey Study With Medical Students and Professionals

Background

Information systems based on artificial intelligence (AI) have increasingly spurred controversies among medical professionals as they start to outperform medical experts in tasks that previously required complex human reasoning. Prior research in other contexts has shown that such a technological disruption can result in professional identity threats and provoke negative attitudes and resistance to using technology. However, little is known about how AI systems evoke professional identity threats in medical professionals and under which conditions they actually provoke negative attitudes and resistance.

Objective

The aim of this study is to investigate how medical professionals’ resistance to AI can be understood because of professional identity threats and temporal perceptions of AI systems. It examines the following two dimensions of medical professional identity threat: threats to physicians’ expert status (professional recognition) and threats to physicians’ role as an autonomous care provider (professional capabilities). This paper assesses whether these professional identity threats predict resistance to AI systems and change in importance under the conditions of varying professional experience and varying perceived temporal relevance of AI systems.

Methods

We conducted 2 web-based surveys with 164 medical students and 42 experienced physicians across different specialties. The participants were provided with a vignette of a general medical AI system. We measured the experienced identity threats, resistance attitudes, and perceived temporal distance of AI. In a subsample, we collected additional data on the perceived identity enhancement to gain a better understanding of how the participants perceived the upcoming technological change as beyond a mere threat. Qualitative data were coded in a content analysis. Quantitative data were analyzed in regression analyses.

Results

Both threats to professional recognition and threats to professional capabilities contributed to perceived self-threat and resistance to AI. Self-threat was negatively associated with resistance. Threats to professional capabilities directly affected resistance to AI, whereas the effect of threats to professional recognition was fully mediated through self-threat. Medical students experienced stronger identity threats and resistance to AI than medical professionals. The temporal distance of AI changed the importance of professional identity threats. If AI systems were perceived as relevant only in the distant future, the effect of threats to professional capabilities was weaker, whereas the effect of threats to professional recognition was stronger. The effect of threats remained robust after including perceived identity enhancement. The results show that the distinct dimensions of medical professional identity are affected by the upcoming technological change through AI.

Conclusions

Our findings demonstrate that AI systems can be perceived as a threat to medical professional identity. Both threats to professional recognition and threats to professional capabilities contribute to resistance attitudes toward AI and need to be considered in the implementation of AI systems in clinical practice.

Technology renewal, user resistance, user adoption: status quo bias theory revisited

Purpose

The article provides a conceptual replication and enrichment of the status quo bias theory in the specific context of understanding IT department user resistance and user adoption. The findings can assist technology renewals and associated change management professionals to assess and plan the adoption and active usage of human resource systems.

Design/methodology/approach

The authors used survey method to gather data. All items were based on prior literature. They administrated the survey to employees of GOODTECH (name changed), information systems (IS) department members, situated in France. They obtained 103 valid responses along with usage data from the system to run their path model, in order to validate the proposed research model.

Findings

The study offers an enriched user resistance model (URM) to understand why IT-savvy employees would resist or adopt new human resource tools. Apart from providing partial validity to status quo bias theory in the French context, the enriched model uses behavioral intention to use as an intermediate variable to explain the influence of two key constructs of the original theory: switching cost and switching benefits. This research provides a better explanatory power to understand the cause of user resistance and new IT use.

Research limitations/implications

The sample size used in the study can be considered as a limitation, although power analysis reveals that the results are significant and valid. The context of the study is also limited to one country and to a specific type of IS implementation scenario. Since the purpose of the paper was to offer contextual theory enhancement, the findings are valid for this purpose.

Practical implications

Digital project managers are offered a framework to increase technology adoption of new human resource tools and evaluate how to reduce user resistance at times of technology renewals. Self-efficacy for change and colleagues’ opinion can indirectly impact behavioral intention to use via switching cost and switching benefit perceptions and thus reducing resistance perceptions as well as increasing adoption of new IT tools in post-implementation phases.

Originality/value

The paper enriches the well-established user resistance theory in IS domain in a context of human resource post-implementation phase by studying IT-savvy end user's perceptions. The paper demonstrates the need to integrate user adoption and user resistance variables in one parsimonious framework and extends support to emerging research on dual focus perspective.