A Simulation-based, cognitive assessment of resident decision making during complex urinary catheterization scenarios
| Autor: | Rebeca D. Ray, Jay N. Nathwani, Katherine E. Law, Shannon M. DiMarco, Carla M. Pugh, Anna Witt |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Urethral injury medicine.medical_specialty medicine.medical_treatment Clinical Decision-Making 030232 urology & nephrology Decision tree Article Urinary catheterization 03 medical and health sciences Cognition 0302 clinical medicine Humans Medicine Intensive care medicine Simulation based Urinary catheter business.industry Decision Trees Internship and Residency Diagnostic test General Medicine medicine.disease Education Medical Graduate 030220 oncology & carcinogenesis Female Surgery Surgical education Cognitive Assessment System Medical emergency Urinary Catheterization business |
| Zdroj: | The American Journal of Surgery. 213:622-626 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2017.01.007 |
| Popis: | Background This study explores general surgery residents' decision making skills in uncommon, complex urinary catheter scenarios. Methods 40 residents were presented with two scenarios. Scenario A was a male with traumatic urethral injury and scenario B was a male with complete urinary blockage. Residents verbalized whether they would catheterize the patient and described the workup and management of suspected pathologies. Residents' decision paths were documented and analyzed. Results In scenario A, 45% of participants chose to immediately consult Urology. 47.5% named five diagnostic tests to decide if catheterization was safe. In scenario B, 27% chose to catheterize with a 16 French Coude. When faced with catheterization failure, participants randomly upsized or downsized catheters. Chi-square analysis revealed no measurable consensus amongst participants. Conclusions Residents need more training in complex decision making for urinary catheterization. The decision trees generated in this study provide a useful blueprint of residents' learning needs. Summary Exploration of general surgery residents' decision making skills in uncommon, complex urinary catheter scenarios revealed major deficiencies. The resulting decision trees reveal residents' learning needs. |
| Databáze: | OpenAIRE |
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