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 Artificial Intelligence and Human Trust in Healthcare: Focus on Clinicians (Preprint)

2019 ◽  
Author(s):  
Onur Asan ◽  
Alparslan Emrah Bayrak ◽  
Avishek Choudhury
Keyword(s):  
Artificial Intelligence ◽  
Health Care ◽  
Decision Making ◽  
Clinical Use ◽  
Primary Users ◽  
Health Care Practices ◽  
Decision Making Processes ◽  
Psychological Mechanism ◽  
Care Practices ◽  
The One

UNSTRUCTURED Artificial intelligence (AI) can transform health care practices with its increasing ability to translate the uncertainty and complexity in data into actionable—though imperfect—clinical decisions or suggestions. In the evolving relationship between humans and AI, trust is the one mechanism that shapes clinicians’ use and adoption of AI. Trust is a psychological mechanism to deal with the uncertainty between what is known and unknown. Several research studies have highlighted the need for improving AI-based systems and enhancing their capabilities to help clinicians. However, assessing the magnitude and impact of human trust on AI technology demands substantial attention. Will a clinician trust an AI-based system? What are the factors that influence human trust in AI? Can trust in AI be optimized to improve decision-making processes? In this paper, we focus on clinicians as the primary users of AI systems in health care and present factors shaping trust between clinicians and AI. We highlight critical challenges related to trust that should be considered during the development of any AI system for clinical use.

scholarly journals Artificial Intelligence and Human Trust in Healthcare: Focus on Clinicians

10.2196/15154 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e15154 ◽  
Author(s):  
Onur Asan ◽  
Alparslan Emrah Bayrak ◽  
Avishek Choudhury
Keyword(s):  
Artificial Intelligence ◽  
Health Care ◽  
Decision Making ◽  
Clinical Use ◽  
Primary Users ◽  
Health Care Practices ◽  
Decision Making Processes ◽  
Psychological Mechanism ◽  
Care Practices ◽  
The One

Artificial intelligence (AI) can transform health care practices with its increasing ability to translate the uncertainty and complexity in data into actionable—though imperfect—clinical decisions or suggestions. In the evolving relationship between humans and AI, trust is the one mechanism that shapes clinicians’ use and adoption of AI. Trust is a psychological mechanism to deal with the uncertainty between what is known and unknown. Several research studies have highlighted the need for improving AI-based systems and enhancing their capabilities to help clinicians. However, assessing the magnitude and impact of human trust on AI technology demands substantial attention. Will a clinician trust an AI-based system? What are the factors that influence human trust in AI? Can trust in AI be optimized to improve decision-making processes? In this paper, we focus on clinicians as the primary users of AI systems in health care and present factors shaping trust between clinicians and AI. We highlight critical challenges related to trust that should be considered during the development of any AI system for clinical use.

An investigation into the experiences of school counsellors working with adolescents

2021 ◽  
pp. 1-15
Author(s):  
Cathy G. Bettman ◽  
Alexander Digiacomo
Keyword(s):  
Thematic Analysis ◽  
Lived Experiences ◽  
School Context ◽  
Phenomenological Approach ◽  
Health Needs ◽  
School Staff ◽  
Mental Health Needs ◽  
School Counsellors ◽  
Semistructured Interviews ◽  
Insight Into

Abstract Currently, Australia’s school counsellors are increasingly being called upon to respond to adolescent mental health needs. Through semistructured interviews with seven school counsellors working with adolescents, this qualitative study aimed to capture the lived experiences of this group of practitioners. By adopting a phenomenological approach and using thematic analysis, this study provides insight into their profession: the current ambiguity surrounding their role; the opportunities and obstacles they face; as well as the often-present tension between stakeholders including parents, other school staff and external agencies. The findings of this study indicate that school counsellors are challenged by the need to be advocates not only for their students but also for themselves and their roles within the school context.

scholarly journals Under Familiar Fire: Making Decisions during the “Kivu Crisis” 2008 in Goma, DR Congo

2010 ◽  
Vol 45 (2) ◽  
pp. 61-80 ◽  
Author(s):  
Silke Oldenburg
Keyword(s):  
Decision Making ◽  
Lived Experiences ◽  
Violent Conflict ◽  
State Of Exception ◽  
Short History ◽  
Dr Congo ◽  
The People ◽  
History Of ◽  
Decision Making Processes

This paper explores the decision-making processes used by the inhabitants of Goma during the Kivu Crisis in October 2008. The paper's aim is twofold: After providing a short history of the October 2008 events, it seeks in the empirical part to distinguish and clarify the role of rumours and narratives in the setting of violent conflict as well as to analyse their impact on decision-making processes. As the epistemological interest lies more on the people who stay rather than those who flee, in the second part the paper argues that the practice of routinization indicates a conscious tactic whose purpose is to counter the non-declared state of exception in Goma. Routinization is defined as a means of establishing order in everyday life by referring to narratives based on lived experiences.

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 Environmental Justice in India: The National Green Tribunal and Expert Members

2015 ◽  
Vol 5 (1) ◽  
pp. 175-205 ◽  
Author(s):  
Gitanjali Nain Gill
Keyword(s):  
Decision Making ◽  
Environmental Justice ◽  
Decision Makers ◽  
Decision Making Process ◽  
Environmental Disputes ◽  
Scientific Experts ◽  
Decision Making Processes ◽  
Technical Expert ◽  
Insight Into

AbstractThis article argues that the involvement of technical experts in decision making promotes better environmental results while simultaneously recognizing the uncertainty in science. India’s record as a progressive jurisdiction in environmental matters through its proactive judiciary is internationally recognized. The neoteric National Green Tribunal of India (NGT) – officially described as a ‘specialised body equipped with necessary expertise to handle environmental disputes involving multi-disciplinary issues’ – is a forum which offers greater plurality for environmental justice. The NGT, in exercising wide powers, is staffed by judicial and technical expert members who decide cases in an open forum. The experts are ‘central’, rather than ‘marginal’, to the NGT’s decision-making process.This article draws on theoretical insights developed by Lorna Schrefler and Peter Haas to analyze the role of scientific experts as decision makers within the NGT. Unprecedented interview access provides data that grants an insight into the internal decision-making processes of the five benches of the NGT. Reported cases, supported by additional comments of bench members, illustrate the wider policy impact of scientific knowledge and its contribution to the NGT’s decision-making process.

scholarly journals Adapting to Constraints - A Study of Green Star New Zealand's Effects on Decision Making using Classic Grounded Theory

2021 ◽  
Author(s):  
◽  
Hendrik Prins
Keyword(s):  
Decision Making ◽  
Grounded Theory ◽  
New Zealand ◽  
Construction Industry ◽  
Rating System ◽  
Rating Systems ◽  
Classic Grounded Theory ◽  
Decision Making Processes ◽  
Insight Into ◽  
Core Variable

<p>Over the last 25 years building rating systems have been developed to quantify and promote sustainable development in the construction industry. Many countries have now developed their own rating system and some systems have been adapted for international use. The different outcomes and results from their use have been under much scrutiny from developers, clients, industry, and academics. Concerns such as increased cost, points buying, and discrepancies between the rated design and completed projects have been identified.   In order to better understand why these concerns occur, the Green Star New Zealand rating system – adapted from Green Star Australia – was studied to quantify its effects on rated projects. The overall aim of this thesis was to investigate the effects of Green Star New Zealand on the decision making process. Specifically, the way in which this system affects the decision making processes during the design of a rated building was investigated to provide insight into reasons why these different outcomes may occur.   This was undertaken through a classic grounded theory study during which professionals experienced in the use of Green Star were interviewed, and the data collected from the interviews was inductively analysed to generate conceptual theory and concepts. The interview data and discussion with the participants identified that decision making is affected largely through the different constraints and conditions encountered when using Green Star and how they are adapted to. These are applied to decision making through a number of different ways, being directly or indirectly related to Green Star, something decided on with or without prior experience, or internal or external to the design team.  The analysis identified several categories which explained processes and behaviours resulting from the use of Green Star. These are ‘managing Green Star requirements’, ‘credit targeting’, ‘working with unknowns’, ‘disconnection of knowledge’, and ‘balancing project requirements’. It is these categories that caused adaptation to emerge as the primary process of resolving constraints, with ‘adapting to constraints’ emerging as the core variable.</p>

scholarly journals How do healthcare professionals make decisions concerning low-value care practices? Study protocol of a factorial survey experiment on de-implementation

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Marta Roczniewska ◽  
Ulrica von Thiele Schwarz ◽  
Hanna Augustsson ◽  
Per Nilsen ◽  
Sara Ingvarsson ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Factorial Survey ◽  
Survey Experiment ◽  
Factors Affecting ◽  
Vignette Study ◽  
Decision Making Processes ◽  
Care Practices

Abstract Background A large number of practices used in health care lack evidence of effectiveness and may be unnecessary or even cause harm. As such, they should be de-implemented. While there are multiple actors involved in de-implementation of such low-value care (LVC) practices, ultimately, the decision to abandon a practice is often made by each health care professional. A recent scoping review identified 6 types of factors affecting the utilization vs. abandonment of LVC practices. These factors concern health care professionals, patients, outer context, inner context, processes, and the characteristics of LVC practice itself. However, it is unclear how professionals weigh these different factors in and how these determinants influence their decisions about abandoning LVC practices. This project aims to investigate how health care professionals account for various factors as they make decisions regarding de-implementation of LVC practices. Methods This project will be carried out in two main steps. First, a factorial survey experiment (a vignette study) will be applied to empirically test the relevance of factors previously identified in the literature for health care professionals’ decision-making about de-implementation. Second, interactive workshops with relevant stakeholders will be carried out to develop a framework for professionals’ decision-making and to offer suggestions for interventions to support de-implementation of LVC practices. Discussion The project has the potential to contribute to improved understanding of the decision-making involved in de-implementation of LVC practices. We will identify which factors are more important when they make judgments about utilizing versus abandoning LVC practices. The results will provide the basis for recommendations concerning appropriate interventions to support de-implementation decision-making processes.

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