Clinical decision-making by the emergency department resident physicians for critically ill patients

Tengda Xu, Jun Xu, Xuezhong Yu, Sui Ma, Zhong Wang

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PDF(89 KB)
Front. Med. ›› 2012, Vol. 6 ›› Issue (1) : 89-93. DOI: 10.1007/s11684-012-0183-9
RESEARCH ARTICLE

Clinical decision-making by the emergency department resident physicians for critically ill patients

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Abstract

The application of main methodologies for clinical decision-making by residents in emergency medical practice was assessed, and issues in this area were investigated. The treatments provided to 2 611 critical patients by the Peking Union Medical College Hospital of were analyzed by independent investigators who evaluated the main clinical decision-making processes applied by the hospital residents. The application of decision-making strategies by PG1 and PG3 groups, which means the residents in first year and the third year, were compared. The patients were treated according to pattern recognition (43.0%), hypothetico-deductive reasoning (23.4%), event-driven models (19.3%), and rule-using algorithms (5.9%). A significant difference was found between PG1 and PG3 groups (χ2=498.01, P<0.001). Pattern recognition and hypothetic-deductive methods were the most common techniques applied by emergency physicians in evaluating critically ill patients. The decision-making processes applied by junior and senior residents were significantly different, although neither group adequately applied rule-using algorithms. Inclusion of clinical decision-making in medical curricula is needed to improve decision-making in critical care.

Keywords

clinical decision-making / emergency medicine / critically ill patient / resident / methodology

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Tengda Xu, Jun Xu, Xuezhong Yu, Sui Ma, Zhong Wang. Clinical decision-making by the emergency department resident physicians for critically ill patients. Front Med, 2012, 6(1): 89‒93 https://doi.org/10.1007/s11684-012-0183-9

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