Intra-operative decision making by ophthalmic surgeons

Keryn Pauley, Rhona Flin, Augusto Azuara-Blanco

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Purpose
Research on surgical decision making and risk management usually focuses on peri-operative care, despite the magnitude and frequency of intra-operative risks. The aim of this study was to examine ophthalmic surgeons’ intra-operative decisions and risk management strategies in order to explore differences in cognitive processes.

Method
Critical decision method interviews were conducted with 12 consultant ophthalmologists who recalled cases and selected important decisions during the operations. These decisions were then discussed in detail in relation to decision making style and risk management. Transcripts were coded according to decision making strategy (analytical, recognition primed decision, creative and rule-based) and risk management (threats, risk assessment and risk tolerance).

Results
The key decision in each case was made using either a rapid, intuitive mode of thinking (n=6, 50%) or a more deliberate comparison of alternative courses of action (n=6, 50%). Rule-based or creative decision making was not used. Risk management involved the perception of threats and assessment of threat impact but was also influenced by personal risk tolerance. Risk tolerance seemed to play a major role during situations requiring a stopping rule. Risk management did not appear to be influenced by time pressure.

Conclusions
Surgeons described making key intra-operative decisions using either an intuitive or an analytical mode of thinking. Ophthalmic surgeons’ risk assessment, risk tolerance and decision strategies appear to be influenced by personality.
Original languageEnglish
Pages (from-to)1303-1307
JournalBritish Journal of Ophthalmology
Volume97
Issue number10
Early online date18 Sep 2013
DOIs
Publication statusPublished - 01 Oct 2013

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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