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Risk tolerance among veterinary anaesthesia specialists and residents: a cross-sectional survey study
Aurora Zoff1, Luisa Viterbo2, Karla Borland3
1North Downs Specialist Referrals, Bletchingley, Surrey, UK.
Objective:
To establish veterinary anaesthetists' risk tolerance to different hypothetical clinical scenarios and explore the need for specific guidelines related to those scenarios.
Study Design:
Cross-sectional, anonymous, voluntary online questionnaire.
Population &/Or Animals:
Diplomates and residents of the American College of Veterinary Anesthesia and Analgesia (ACVAA) and European College of Veterinary Anaesthesia and Analgesia (ECVAA) currently performing small animal anaesthesia.
Methods:
An electronic survey with 10 hypothetical clinical scenarios was sent to residents and Diplomates of the ACVAA and ECVAA. A 4-point Likert scale (1-yes, 2-probably, 3-unlikely, 4-no) was used to identify how likely respondents would be to proceed with anaesthesia when faced with each scenario. Descriptive statistics were calculated to summarise data. Differences and agreement between Diplomates and residents of the ACVAA and ECVAA colleges for the different scenarios were analysed with a Mann-Whitney U test. Quantitative content analysis was performed on the data entered in the free-text box. Codes with more than 10 entries in either group were analysed using the chi-square test.
Results:
No statistically significant differences were found between the two groups, except for one question showing Diplomates were more likely than residents to go ahead without offering the owner an echocardiography in a 2-year-old dog with an undiagnosed heart murmur (p = 0.016). The most frequent justifications emerging from the free text included the desire for owner involvement in the decision-making process. The survey revealed that 60.6% of the participants believed that guidelines would be helpful when faced with the decision-making dilemmas presented in this study.
Conclusions And Clinical Relevance:
These results indicate that training level does not appear to influence risk tolerance in veterinary anaesthetists. Decision-making in veterinary anaesthesia is likely multifactorial and may be aided by guidelines, although further studies are needed to clarify which type of guidelines would be most helpful.
