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VERSION:2.0
PRODID:Linklings LLC
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TZID:America/Phoenix
X-LIC-LOCATION:America/Phoenix
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TZOFFSETFROM:-0700
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DTSTART:19700101T000000
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BEGIN:VEVENT
DTSTAMP:20241014T203103Z
LOCATION:FLW Salon B
DTSTART;TZID=America/Phoenix:20240913T095500
DTEND;TZID=America/Phoenix:20240913T100500
UID:HFESAM_ASPIRE - Presented by HFES_sess279_LBR135@linklings.com
SUMMARY:Approaches to decision making vary across types of emergent patien
 t scenarios
DESCRIPTION:Late Breaking Results\n\nShilo Anders and Megan Salwei (Vander
 bilt University Medical Center); Duran (Tram) Huang (University of Pittsbu
 rgh); Carrie Reale (Vanderbilt University Medical Center); Laura Militello
  and Christen Sushereba (Applied Decision Science, LLC); Janelle Faiman an
 d Meredith Kingeter (Vanderbilt University Medical Center); Elizabeth Sinz
  (West Virginia University); Jeffery Cooper (Harvard Medical School); Aman
 da Burden (Cooper Medical School of Rowan University); Michael Andreae (Un
 iversity of Utah School of Medicine); John Rask (University of New Mexico)
 ; Laurence C Torsher (Mayo Clinic); Arna Banerjee (Vanderbilt University M
 edical Center); Adam I Levine (Mt Sinai School of Medicine); David Gaba (S
 tanford University); and Jason Slagle and Matthew B Weinger (Vanderbilt Un
 iversity Medical Center)\n\nBackground/Objective: Acute management of crit
 ical events is needed to save lives. We used high-fidelity simulation to e
 xplore clinician decision-making during crisis events. Explore how diverse
  challenges within dynamic high-risk simulated scenarios affect anesthesio
 logists’ decision making.\n\nMethod: We designed four high-fidelity simula
 tion scenarios involving complex challenging situations in perioperative c
 are (e.g., acute decompensation requiring life-saving interventions). Anes
 thesiologists volunteered to perform in all four scenarios in one day. Aft
 er each simulation, participants were interviewed using applied cognitive 
 task analysis methods. Cognitive probes targeted 3-5 participant-identifie
 d ‘key events’, focusing on important cues, assessments, and actions. Tran
 scribed interviews were coded in Dedoose™.\n\nResults: We identified diffe
 rent aspects of decision-making based on the challenges presented in each 
 scenario (e.g., clinical vs. behavioral) between participants. For example
 , in a scenario with a complicated paraplegic patient who becomes more hem
 odynamically unstable and unresponsive, participants described treatment g
 oals (e.g., decrease the heart rate) and mental simulation (e.g., what the
 y would need for intubation) more frequently than in the other scenarios. 
 Conversely, in a scenario requiring management of a fixated colleague (an 
 actor) whose interventions caused further patient deterioration, participa
 nts more often described temporizing (e.g., treating seizure empirically w
 ithout knowing cause) and rule-based (e.g. following established but somet
 imes inappropriate) protocols. \n\nTakeaways: This study suggests cognitiv
 e interviews could be useful in providing insights into cognitive processe
 s used to manage different clinical challenges. Findings have implications
  for training and decision aid design to support acute high-risk decision-
 making.\n\nSession Chairs: Krystyna Gielo-Perczak (University of Connectic
 ut) and Vickie Nguyen (UX Consultant)
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