Literature DB >> 33752873

The long game: Evolution of clinical decision making throughout residency and fellowship.

Ingrid A Woelfel1, Brentley Q Smith2, Ritu Salani2, Alan E Harzman3, Amalia L Cochran3, Xiaodong Phoenix Chen3.   

Abstract

BACKGROUND: The purpose of this study was to explore the trajectory of autonomy in clinical decision making.
METHODS: We conducted a qualitative secondary analysis of interviews with 45 residents and fellows from the General Surgery and Obstetrics & Gynecology departments across all clinical postgraduate years (PGY) using convenience sampling. Each interview was recorded, transcribed and iteratively analyzed using a framework method.
RESULTS: A total of 16 junior residents, 22 senior residents and 7 fellows participated in 12 original interviews. Early in training residents take their abstract ideas about disease processes and make them concrete in their applications to patient care. A transitional stage follows in which residents apply concepts to concrete patient care. Chief residents re-abstract their concrete technical and clinical knowledge to prepare for future surgical practice.
CONCLUSIONS: Understanding where each learner is on this pathway will assist development of curriculum that fosters resident readiness for practice at each PGY level.
Copyright © 2021 Elsevier Inc. All rights reserved.

Entities:  

Keywords:  Autonomy; Clinical decision-making

Mesh:

Year:  2021        PMID: 33752873      PMCID: PMC9045150          DOI: 10.1016/j.amjsurg.2021.03.023

Source DB:  PubMed          Journal:  Am J Surg        ISSN: 0002-9610            Impact factor:   3.125


  28 in total

Review 1.  Qualitative research in health care. Analysing qualitative data.

Authors:  C Pope; S Ziebland; N Mays
Journal:  BMJ       Date:  2000-01-08

2.  The role of endoscopy in the management of choledocholithiasis.

Authors:  John T Maple; Steven O Ikenberry; Michelle A Anderson; Vasundhara Appalaneni; G Anton Decker; Dayna Early; John A Evans; Robert D Fanelli; Deborah Fisher; Laurel Fisher; Norio Fukami; Joo Ha Hwang; Rajeev Jain; Terry Jue; Khalid Khan; Mary Lee Krinsky; Phyllis Malpas; Tamir Ben-Menachem; Ravi N Sharaf; Jason A Dominitz
Journal:  Gastrointest Endosc       Date:  2011-10       Impact factor: 9.427

3.  Alignment of Personality Is Associated With Increased Intraoperative Entrustment.

Authors:  Danielle C Sutzko; Anna E Boniakowski; Vahagn C Nikolian; Patrick E Georgoff; Niki Matusko; Juliet A Thompson-Burdine; Hadley I Stoll; Kaustubh A Prabhu; Rebecca M Minter; Gurjit Sandhu
Journal:  Ann Surg       Date:  2019-12       Impact factor: 12.969

4.  Prospective validation of the safety of a laparoscopic cholecystectomy training paradigm featuring incremental autonomy.

Authors:  Tarik D Madni; Evan Barrios; Jonathan B Imran; Luis Taveras; Audra T Clark; Holly B Cunningham; Alana Christie; Stephen Luk; Herb A Phelan; Michael W Cripps
Journal:  Am J Surg       Date:  2018-10-31       Impact factor: 2.565

Review 5.  Clinical decision making: how surgeons do it.

Authors:  Wendy Crebbin; Spencer W Beasley; David A K Watters
Journal:  ANZ J Surg       Date:  2013-05-03       Impact factor: 1.872

6.  Measuring intra-operative decision-making during laparoscopic cholecystectomy: validity evidence for a novel interactive Web-based assessment tool.

Authors:  Amin Madani; Yusuke Watanabe; Elif Bilgic; Philip H Pucher; Melina C Vassiliou; Rajesh Aggarwal; Gerald M Fried; Elliot J Mitmaker; Liane S Feldman
Journal:  Surg Endosc       Date:  2016-07-13       Impact factor: 4.584

7.  Impact of a clinical decision making module on the attitudes and perceptions of surgical trainees.

Authors:  Nikita R Bhatt; Eva M Doherty; Ehab Mansour; Oscar Traynor; Paul F Ridgway
Journal:  ANZ J Surg       Date:  2016-02-28       Impact factor: 1.872

8.  Resident Self-Entrustment and Expectations of Autonomy: OB > GYN?

Authors:  Brentley Q Smith; Ingrid Woelfel; Ritu Salani; Alan Harzman; Xiaodong Chen
Journal:  J Surg Educ       Date:  2020-08-02       Impact factor: 2.891

9.  What factors influence attending surgeon decisions about resident autonomy in the operating room?

Authors:  Reed G Williams; Brian C George; Shari L Meyerson; Jordan D Bohnen; Gary L Dunnington; Mary C Schuller; Laura Torbeck; John T Mullen; Edward Auyang; Jeffrey G Chipman; Jennifer Choi; Michael Choti; Eric Endean; Eugene F Foley; Samuel Mandell; Andreas Meier; Douglas S Smink; Kyla P Terhune; Paul Wise; Debra DaRosa; Nathaniel Soper; Joseph B Zwischenberger; Keith D Lillemoe; Jonathan P Fryer
Journal:  Surgery       Date:  2017-09-23       Impact factor: 3.982

10.  Unravelling the polyphony in clinical reasoning research in medical education.

Authors:  Charilaos Koufidis; Katri Manninen; Juha Nieminen; Martin Wohlin; Charlotte Silén
Journal:  J Eval Clin Pract       Date:  2020-06-22       Impact factor: 2.431

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