Quantitative assessment of expert and novice surgeons' thinking processes: an application to hernia repair

TY - JOUR

T1 - Quantitative assessment of expert and novice surgeons' thinking processes

T2 - an application to hernia repair

AU - Agha, Hayder

AU - Arora, Sonal

AU - Sevdalis, Nick

PY - 2011/7

Y1 - 2011/7

N2 - BACKGROUND: The aim of this study was to capture quantitatively surgeons' decision making when faced with a choice of open or laparoscopic inguinal hernia repair.METHODS: Twenty-one general surgeons (10 consultants or attending surgeons, 11 registrars or residents) were presented with 46 clinical vignettes differing in clinical and patient factors. Surgeons' choices of open or laparoscopic repair were submitted to multiple regression. Beta coefficients were computed for each factor and compared across expert and novice participants.RESULTS: Consultants and attending surgeons considered the nature of the hernia (primary or recurrent; beta = .40), the site of the hernia (unilateral or bilateral; beta = .27), American Society of Anesthesiologists score (beta = -.25), and previous abdominal surgery (beta = .20). Trainees weighted most the site of the hernia (beta = 30), previous abdominal surgery (beta = .23), the nature of the hernia (beta = .20), and American Society of Anesthesiologists score (beta = -.10).CONCLUSIONS: This study offers an objective assessment of surgeons' decision making, with specific application to hernia repair. Further research into quantitative methods that capture surgeons' thinking processes could distill factors that expert surgeons consider important in a number of key situations and assist in trainees' decision making.

AB - BACKGROUND: The aim of this study was to capture quantitatively surgeons' decision making when faced with a choice of open or laparoscopic inguinal hernia repair.METHODS: Twenty-one general surgeons (10 consultants or attending surgeons, 11 registrars or residents) were presented with 46 clinical vignettes differing in clinical and patient factors. Surgeons' choices of open or laparoscopic repair were submitted to multiple regression. Beta coefficients were computed for each factor and compared across expert and novice participants.RESULTS: Consultants and attending surgeons considered the nature of the hernia (primary or recurrent; beta = .40), the site of the hernia (unilateral or bilateral; beta = .27), American Society of Anesthesiologists score (beta = -.25), and previous abdominal surgery (beta = .20). Trainees weighted most the site of the hernia (beta = 30), previous abdominal surgery (beta = .23), the nature of the hernia (beta = .20), and American Society of Anesthesiologists score (beta = -.10).CONCLUSIONS: This study offers an objective assessment of surgeons' decision making, with specific application to hernia repair. Further research into quantitative methods that capture surgeons' thinking processes could distill factors that expert surgeons consider important in a number of key situations and assist in trainees' decision making.

KW - Surgical education

KW - Surgical skill

KW - Decision making

KW - Hernia

KW - CLINICAL JUDGMENT ANALYSIS

KW - EVIDENCE-BASED MEDICINE

KW - DECISION-MAKING

KW - INGUINAL-HERNIA

KW - SURGICAL PRACTICE

KW - PROSTATE-CANCER

KW - GENERAL-SURGERY

KW - MANAGEMENT

U2 - 10.1016/j.amjsurg.2010.03.010

DO - 10.1016/j.amjsurg.2010.03.010

M3 - Article

SN - 0002-9610

VL - 202

SP - 110

EP - 115

JO - American Journal of Surgery

JF - American Journal of Surgery

IS - 1

ER -