SE05GENERATING A MODEL TO EXPLORE DECISION MAKING IN AN ACUTE SURGICAL SETTING

There is no current research in surgery that articulates what constitutes good or poor decisions in acute management of a surgical patient. The aim of this study was to define good and poor decision making to facilitate the teaching, learning and assessment of surgical trainees' decision making skills. A qualitative web-based survey was delivered to global experts in Surgery, Medical Education and Cognitive Research. Half the participants were asked to list features of a good decision, characteristics of a good decision maker and essential factors in developing good decision making skills. The rest of the participants were asked to consider the same areas related to poor decision making. The free text responses were collated and grouped into themes. 29 (52%) experts responded. The free text comments for good and poor decisions were predominantly the inverse of each other. However some of the features of a poor decision included qualified statements; e.g. timing was important but some respondents felt a poor decision was characterised by being too slow and others by being too fast. The relationship between themes was considered and a model generated to illustrate acute surgical decision making. The model is composed of three major layers -central is the decision process, surrounded by the decision maker and the decision environment. Each of these three layers is compiled of sub layers. From this model a second model was generated to consider how factors important in decision making might interact in real life. Understanding decision making is vital for training surgeons. These models enable the factors that constitute decision making to be mapped in detail. [PUBLICATION ABSTRACT]