The anatomy of the surgeon’s decision-making

Abstract

Some of the most important elements of any surgical procedure are the decisions that the surgeon makes before, during, and after the surgery itself. Yet, the process of how surgeons make these decisions has not been studied adequately. Despite its enormous significance and regardless of the implications that this decision-making process has on surgical outcomes, the subject has received minimal attention in the literature. Subsequently, there are only a few studies that investigate how these decisions are made, although these decision-making processes are of great importance both for training and patient safety purposes. Often, surgeons have difficulty in describing exactly how they came to specific decision during surgery. Some describe these decisions as “intuition” or “gut-level” responses. Additionally, many factors affect decision-making abilities of surgeons during operations. These factors are the physiologic state of the surgeon, teamwork, external pressures at work, and the surgeon’s ability to adapt quickly to a changing environment, to name only a few. Yet, the question remains, how to perform an evaluation of the surgical decision and gaining a better understanding of a seemingly gut-level process, which helps surgeons combat the external factors experienced before and during surgery? This chapter will attempt to dissect further multiple factors that may explain further how surgeons make decisions.