scholarly journals OSCE Rater Cognition – An International Multi-centre Qualitative Study.

2021 ◽  
Author(s):  
Sarah Hyde ◽  
Christine Fessey ◽  
Katherine Boursicot ◽  
Rhoda McKenzie ◽  
Deirdre McGrath
Keyword(s):  
Decision Making ◽  
Data Analysis ◽  
Qualitative Study ◽  
Medical Examination ◽  
Thinking Aloud ◽  
Objective Structured Clinical Examinations ◽  
Decision Making Processes ◽  
Recruiting Strategy ◽  
Tacit Assumptions ◽  
Insight Into

Abstract Introduction This study aimed to explore the decision-making processes of raters during objective structured clinical examinations (OSCEs), in particular to explore the tacit assumptions and beliefs of raters as well as rater idiosyncrasies.MethodsThinking aloud protocol interviews were used to gather data on the thoughts of examiners during their decision-making, while watching trigger OSCE videos and rating candidates. A purposeful recruiting strategy was taken, with a view to interviewing both examiners with many years of experience and those with less experience examining at final medical examination level.ResultsThirty-one interviews were conducted in three centres in three different countries. Three themes were identified during data analysis, entitled ‘OSCEs are inauthentic’, ‘looking for glimpses of truth’ and ‘evolution with experience’. ConclusionThis study gives an insight into how raters approach OSCEs, and how the perceived shortcomings of OSCEs affect how examiners consider candidate behaviours. Some examiners, more likely the more experienced group, may deviate from an organisation’s instructions due to perceived shortcomings of the assessment.

scholarly journals OSCE rater cognition – an international multi-centre qualitative study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Sarah Hyde ◽  
Christine Fessey ◽  
Katharine Boursicot ◽  
Rhoda MacKenzie ◽  
Deirdre McGrath
Keyword(s):  
Decision Making ◽  
Data Analysis ◽  
Student Performance ◽  
Student Perception ◽  
Thinking Aloud ◽  
Objective Structured Clinical Examinations ◽  
Decision Making Processes ◽  
Method Of Assessment ◽  
Recruiting Strategy ◽  
Tacit Assumptions

Abstract Introduction This study aimed to explore the decision-making processes of raters during objective structured clinical examinations (OSCEs), in particular to explore the tacit assumptions and beliefs of raters as well as rater idiosyncrasies. Methods Thinking aloud protocol interviews were used to gather data on the thoughts of examiners during their decision-making, while watching trigger OSCE videos and rating candidates. A purposeful recruiting strategy was taken, with a view to interviewing both examiners with many years of experience (greater than six years) and those with less experience examining at final medical examination level. Results Thirty-one interviews were conducted in three centres in three different countries. Three themes were identified during data analysis, entitled ‘OSCEs are inauthentic’, ‘looking for glimpses of truth’ and ‘evolution with experience’. Conclusion Raters perceive that the shortcomings of OSCEs can have unwanted effects on student behaviour. Some examiners, more likely the more experienced group, may deviate from an organisations directions due to perceived shortcomings of the assessment. No method of assessment is without flaw, and it is important to be aware of the limitations and shortcomings of assessment methods on student performance and examiner perception. Further study of assessor and student perception of OSCE performance would be helpful.

Conquery: an Open Source Application to analyze High Content Healthcare Data (Preprint)

2021 ◽  
Author(s):  
Fabian Kovacs ◽  
Max Thonagel ◽  
Marion Ludwig ◽  
Alexander Albrecht ◽  
Manuel Hegner ◽  
...  
Keyword(s):  
Decision Making ◽  
Big Data ◽  
Data Analysis ◽  
Open Source ◽  
Open Source Software ◽  
Medical Records ◽  
Healthcare Sector ◽  
Study Cohort ◽  
Decision Making Processes ◽  
Analytical Approaches

BACKGROUND Big data in healthcare must be exploited to achieve a substantial increase in efficiency and competitiveness. Especially the analysis of patient-related data possesses huge potential to improve decision-making processes. However, most analytical approaches used today are highly time- and resource-consuming. OBJECTIVE The presented software solution Conquery is an open-source software tool providing advanced, but intuitive data analysis without the need for specialized statistical training. Conquery aims to simplify big data analysis for novice database users in the medical sector. METHODS Conquery is a document-oriented distributed timeseries database and analysis platform. Its main application is the analysis of per-person medical records by non-technical medical professionals. Complex analyses are realized in the Conquery frontend by dragging tree nodes into the query editor. Queries are evaluated by a bespoke distributed query-engine for medical records in a column-oriented fashion. We present a custom compression scheme to facilitate low response times that uses online calculated as well as precomputed metadata and data statistics. RESULTS Conquery allows for easy navigation through the hierarchy and enables complex study cohort construction whilst reducing the demand on time and resources. The UI of Conquery and a query output is exemplified by the construction of a relevant clinical cohort. CONCLUSIONS Conquery is an efficient and intuitive open-source software for performant and secure data analysis and aims at supporting decision-making processes in the healthcare sector.

scholarly journals Decision-making dilemmas of paediatricians: a qualitative study in Japan

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e026579
Author(s):  
Momoko Sasazuki ◽  
Yasunari Sakai ◽  
Ryutaro Kira ◽  
Naoko Toda ◽  
Yuko Ichimiya ◽  
...  
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Professional Education ◽  
Best Interests ◽  
Complex Structures ◽  
Social Consensus ◽  
Face To Face ◽  
Life Threatening ◽  
Decision Making Processes ◽  
Five Elements

ObjectiveTo delineate the critical decision-making processes that paediatricians apply when treating children with life-threatening conditions and the psychosocial experience of paediatricians involved in such care.DesignWe conducted semistructured, individual face-to-face interviews for each participant from 2014 to 2015. The content of each interview was subjected to a comprehensive qualitative analysis. The categories of dilemma were extracted from a second-round content analysis.ParticipantsParticipants were board-certified paediatricians with sufficient experience in making decisions in relation to children with severe illnesses or disabilities. We repeated purposive sampling and analyses until we reached saturation of the category data.ResultsWe performed interviews with 15 paediatricians. They each reported both unique and overlapping categories of dilemmas that they encountered when making critical decisions. The dilemmas included five types of causal elements: (1) paediatricians’ convictions; (2) the quest for the best interests of patients; (3) the quest for medically appropriate plans; (4) confronting parents and families and (5) socioenvironmental issues. Dilemmas occurred and developed as conflicting interactions among these five elements. We further categorised these five elements into three principal domains: the decision-maker (decider); consensus making among families, colleagues and society (process) and the consequential output of the decision (consequence).ConclusionsThis is the first qualitative study to demonstrate the framework of paediatricians’ decision-making processes and the complex structures of dilemmas they face. Our data indicate the necessity of establishing and implementing an effective support system for paediatricians, such as structured professional education and arguments for creating social consensus that assist them to reach the best plan for the management of severely ill children.

Diagnostic conversations: Clinical Decision Making in surgery – Part 2

Diagnosis ◽  
2014 ◽  
Vol 1 (2) ◽  
pp. 189-193 ◽  
Author(s):  
David Allan Watters ◽  
Spencer Wynyard Beasley ◽  
Wendy Crebbin
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Learning Opportunities ◽  
Clinical Decisions ◽  
Decision Making Processes ◽  
Royal Australasian College ◽  
Insight Into ◽  
Made In

AbstractProceduralists who fail to review their decision making are unlikely to learn from their experiences, irrespective of whether the operative outcome is successful or not. Teaching junior surgeons to develop ‘insight’ into their own decision making has long been a challenge. Surgeons and staff of the Royal Australasian College of Surgeons worked together to develop a model to help explain the processes around clinical decision making and incorporated this model into a Clinical Decision Making (CDM) training course. In this course, faculty apply the model to specific surgical cases, within the model’s framework of how clinical decisions are made; thus providing an opportunity to identify specific decision making processes as they occur and to highlight some of the learning opportunities they provide. The conversation in this paper illustrates the kinds of case-based interactions which typically occur in the development and teaching of the CDM course.The focus in this, the second of two papers, is on reviewing post-operative clinical decisions made in relation to one case, to improve the quality of subsequent decision making.

scholarly journals Analyzing How Discursive Practices Affect Physicians’ Decision-Making Processes: A Phenomenological-Based Qualitative Study in Critical Care Contexts

2017 ◽  
Vol 54 ◽  
pp. 004695801773196
Author(s):  
Luigina Mortari ◽  
Roberta Silva
Keyword(s):  
Decision Making ◽  
Lived Experiences ◽  
Phenomenological Approach ◽  
Discursive Practices ◽  
Health Care Practices ◽  
Common Framework ◽  
Decision Making Processes ◽  
Care Practices ◽  
Icu Physicians ◽  
Insight Into

An intensive care unit (ICU) is a demanding environment, defined by significant complexity, in which physicians must make decisions in situations characterized by high levels of uncertainty. This study used a phenomenological approach to investigate the decision-making (DM) processes among ICU physicians’ team with the aim of understanding what happens when ICU physicians must reach a decision about the infectious status of a patient. The focus was put on the identification of how the discursive practices influence physicians’ DM processes and on how different ICU environments make different discursive profiles emerge, particularly when a key issue is at the center of the physicians’ discussion. A naturalistic approach used in this study is particularly suitable for investigating health care practices because it can best illuminate the essential meaning of the “lived experiences” of the participants. The findings revealed a common framework of elements that provide insight into DM processes in ICUs and how these are affected by discursive practices.

scholarly journals GPs’ decisions about prescribing anticipatory medicines at the end of life: a qualitative study

2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X702809
Author(s):  
Ben Bowers ◽  
Kristian Pollock ◽  
Sam Barclay ◽  
Stephen Barclay
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
End Of Life ◽  
Thematic Analysis ◽  
Symptom Management ◽  
Symptom Relief ◽  
Structured Interviews ◽  
Family Experiences ◽  
Decision Making Processes ◽  
Purposive Sample

BackgroundGPs have a central role in decisions about prescribing anticipatory medications (AMs) to help control symptoms at the end of life. Little is known about GPs’ decision-making processes in prescribing AMs and the subsequent use of prescribed drugs.AimTo explore GPs’ decision-making processes in the prescribing and use of AMs for patients at the end of life.MethodA qualitative interpretive descriptive enquiry with a purposive sample of 13 GPs working across one English county. Data was collected in 2017 via semi-structured interviews and analysed inductively using Braun and Clarke’s thematic analysis.ResultsThree themes were constructed from the data: 1) ‘Something we can do’: AMs were a tangible intervention GPs felt they could offer to provide symptom relief for patients approaching death. 2) ‘Getting the timing right’: the prescribing of AMs was recognised as a harbinger of death for patients and families. GPs preferred to prescribe drugs weeks before death was expected, while recognising this meant that many prescribed AMs were never used. 3) ‘Delegating care while retaining accountability’: GPs relied on nurse to assess when to administer drugs and keep them updated about their use.ConclusionGPs view AMs as key to symptom management for dying people. AMs are routinely prescribed even though they are often not used. In order to feel comfortable delegating care, GPs need regular access to nurses and trust in their skills to administer drugs appropriately. Patient and family experiences of AMs, and their preference for involvement in decision-making about their use warrant urgent investigation.

Sign in / Sign up

Export Citation Format

Share Document