Head, heart or checklist? How self-reported decision-making strategies change according to speciality and grade: a cross-sectional survey of doctors.
Oliver PumphreyJack GrenvilleMatthew ColquhounBarry MullinsPatrick EarlsSimon EatonStewart CleevePublished in: Postgraduate medical journal (2019)
Decision-making strategies may evolve with increasing clinical experience from a predominant use of rule-based approaches towards greater use of intuitive or analytical methods depending on the familiarity and acuity of the clinical situation. Rule-based strategies remain important for delivering evidence-based care, particularly for less experienced clinicians, and for physicians more than surgeons, possibly due to the greater availability and applicability of guidelines for medical problems. Anaesthetists and intensivists tend towards more analytical decision-making than physicians; an observation which might be attributable to the greater availability and use of objective data in the care environment. As part of broader training in non-technical skills and human factors, increasing awareness among trainees of medical decision-making models and their potential pitfalls might contribute to reducing the burden of medical error in terms of morbidity, mortality and litigation.
Keyphrases
- decision making
- healthcare
- palliative care
- primary care
- quality improvement
- endothelial cells
- mental health
- pain management
- medical students
- risk factors
- affordable care act
- big data
- electronic health record
- type diabetes
- risk assessment
- coronary artery disease
- chronic pain
- mass spectrometry
- health insurance
- human health
- general practice
- thoracic surgery