When surgeons face intraoperative challenges: a naturalistic model of surgical decision making – Cover

Date: 2013-02-01

Reference number: OPUSeJ 201302011948SIC

Links: published article http://www.americanjournalofsurgery.com/article/S0002-9610(12)00577-6/abstract

Forum: http://www.opusej.org/library/when-surgeons-face-intraoperative-challenges-a-naturalistic-model-of-surgical-decision-making-forum/

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

Affiliations/disclaimers/funding/acknowledgements:

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

Language: English

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

References: see Forum http://www.opusej.org/library/when-surgeons-face-intraoperative-challenges-a-naturalistic-model-of-surgical-decision-making-forum/

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