Reference number: OPUSeJ 201302011948SIC
Links: published article http://www.americanjournalofsurgery.com/article/S0002-9610(12)00577-6/abstract
Title: When surgeons face intraoperative challenges: a naturalistic model of surgical decision making
Authors: Sayra M. Cristancho 1*, Meredith Vanstone 2, Lorelei Lingard 2, Marie-Eve LeBel 1 and Michael Ott 1.
Abstract: Background:Surgery is an environment in which being an expert requires the ability to manage the unexpected. This feature has necessitated a shift in surgical decision-making research. The present study explores the processes by which surgeons assess and respond to nonroutine challenges in the operating room.
Methods: We used a grounded theory methodology supported on intraoperative observations and postoperative interviews with 7 faculty surgeons from various specialties. A total of 32 cases were purposively sampled to compile a dataset of challenging situations.
Results: Thematic data analysis yielded 3 main themes that were linked in a cyclic model: assessing the situation, the reconciliation cycle, and implementing the planned course of action. These elements were connected through 2 points of transition (ie, active and confirmatory reconciliation), during which time the surgeons continue to act although they may change the course of their action.
Conclusions: The proposed model builds on existing theories of naturalistic decision making from other high-stakes environments. This model elaborates on a theoretic language that accounts for the unique aspects of surgery, making it useful for teaching in the operating room.
Author bio: N/A
Sponsor editor: N/A
1) Department of Surgery, Department of Medical Biophysics, Centre for Education Research & Innovation, Western University, London, ON, Canada
2) Department of Medicine, Centre for Education Research & Innovation, Western University, London, ON, Canada
*Corresponding author. Tel.: +1-519-661-2111 ×89253; fax: +519-661-3797.
The authors declare no conflicts of interest.
Keywords: intraoperative challenges, Decision making, Reconciliation
Subject: Medicine/ intraoperative decision making
Bibliography: see Forum
Citation: Cristancho, S M et al, 2013, “When surgeons face intraoperative challenges: a naturalistic model of surgical decision making”, The American Journal of Surgery 205: 2, 156-162. http://www.americanjournalofsurgery.com/article/S0002-9610(12)00577-6/abstract