Defining Decision Making: A Qualitative Study of International Experts’ Views on Surgical Trainee Decision Making

Abstract

This study provides criteria described by experts when considering surgical decisions, decision makers, and development of decision-making skills. It proposes a working definition of a good decision maker. Understanding these criteria will enable clinical teachers to better recognize and encourage good decision-making skills and identify poor decision-making skills for remediation.

Post‐mortem general surgeon reflection on decision‐making: a mixed‐methods study of mortality audit data

“…The present study is unique in utilizing large‐scale mortality audit data to gain an insight into the reflective opinions of surgeons. Our results support existing literature in finding the decision to operate, or not, is difficult . This is particularly the case in situations where no dominant treatment option exists or in the context of diagnostic uncertainty, pressure from patients and families, limited hospital resources and sometimes pressures from colleagues …”

“…Research into surgical decision‐making typically involves observing or analysing specific decisions . The present study is unique in utilizing large‐scale mortality audit data to gain an insight into the reflective opinions of surgeons.…”

Surgical Decision Making for the Elderly Patients in Severe Head Injuries

“…Although the mean IPM and mean IPU of the group A were higher than those of the group B, the outcome was favorable in only 2 patients in the group B. A good decision may be more likely to lead to a better patient outcome, but outcome alone cannot measure the quality of a decision20).…”

“…Ethical training for neurosurgeons is to be encouraged21). To develop decision-making skills, there should be a supportive environment, with good supervision, mentoring, and role modeling20). Most medical problems can be treated in multiple different ways.…”

“…Rather, a treatment choice should be made based on an individual's preferences and willingness to accept risk. The most consistent features about a surgical decision were that it was well informed and well considered20). A mathematical model22), while limited, does provide an accurate index of injury severity and may be useful in providing cause to pause and consider the long-term implications of life-saving but non-restorative surgical intervention8).…”