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Surgeons' intraoperative decision making and risk management.
Keryn Pauley1, Rhona Flin, Steven Yule
1School of Psychology, University of Aberdeen, UK. k.pauley@abdn.ac.uk
American Journal of Surgery
|April 12, 2011
Summary
Surgeons utilize intuitive or deliberate thinking for critical intraoperative decisions. Personal risk tolerance and personality traits influence surgeons' decision-making and risk management strategies during surgery.
Area of Science:
- Surgery
- Cognitive Psychology
- Decision Science
Background:
- Intraoperative risks are significant yet understudied compared to perioperative risks.
- Surgical decision-making and risk management research often overlooks the intraoperative phase.
Purpose of the Study:
- To investigate surgeons' intraoperative decision-making processes.
- To explore surgeons' risk management strategies during operations.
- To identify differences in cognitive processes influencing surgical decisions.
Main Methods:
- Critical Decision Method interviews were used.
- 24 consultant surgeons participated, recalling and discussing key intraoperative decisions.
- Interviews focused on decision-making styles and risk management.
Main Results:
- Key intraoperative decisions were made intuitively (46%) or analytically (50%).
- Decision strategies were independent of surgical approach, context, time pressure, or situational threats.
- Risk management involved threat perception, impact assessment, and personal risk tolerance.
Conclusions:
- Surgeons employ intuitive or analytic thinking for critical intraoperative decisions.
- Personality appears to influence surgeons' risk assessment, tolerance, and decision strategies.
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