From Context Comes Expertise: How Do Expert Emergency Physicians Use Their Know-Who to Make Decisions? - 21/05/16
, Jacques Tardif, PhD d, Emmanuel Triby, PhD b, Christine Ammirati, MD, PhD e, Catherine Bertrand, MD, MSc f, Valérie Dory, MD, PhD g, Bernard Charlin, MD, PhD hAbstract |
Study objective |
Decisionmaking is influenced by the environment in which it takes place. The objective of our study was to explore the influence of the specific features of the emergency department (ED) environment on decisionmaking. In this paper, we specifically report on the way emergency physicians use their knowledge of their collaborators to make their decisions.
Methods |
We conducted a qualitative study on emergency physicians recruited in 3 French hospitals. Physicians were equipped with a microcamera to record their clinical activity from their “own-point-of-view perspective.” Semistructured interviews, based on viewing the video, were held with each physician after an actual clinical encounter with a patient. They were then analyzed thematically, using constant comparison and matrices, to identify the central themes.
Results |
Fifteen expert emergency physicians were interviewed. Almost all of them reported using their knowledge of other health care professionals to assess the seriousness of the patient’s overall condition (sometimes even before his or her arrival in the ED) to optimize the patient's treatment and to anticipate future care.
Conclusion |
Emergency physicians interact with many other health care workers during the different stages of the patient’s management. The many ways in which experts use their knowledge of other health care professionals to make decisions puts traditional conceptions of expert knowledge into perspective and opens avenues for future research.
Le texte complet de cet article est disponible en PDF.Plan
| Please see page 748 for the Editor’s Capsule Summary of this article. |
|
| Supervising editor: David L. Schriger, MD, MPH |
|
| Author contributions: TP, JT, ET, and BC conceived the study. TP, CA, and CB obtained research funding and coded data. TP supervised the conduct of the study, conducted the interviews, and drafted the article. All authors contributed substantially to article revision and were involved in interpreting the study findings. TP takes responsibility for the paper as a whole. |
|
| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist and provided the following detail: This study was supported by a grant from the French Society for Emergency Medicine. |
|
| The study sponsor had no role in the study design, data collection, analysis and interpretation, or decision to write and submit this article. The researchers are independent from the sponsor. |
|
| A podcast for this article is available at www.annemergmed.com. |
Vol 67 - N° 6
P. 747-751 - juin 2016 Retour au numéro
Article précédent
- Emergency Physician Task Switching Increases With the Introduction of a Commercial Electronic Health Record
- Natalie C. Benda, Margaret L. Meadors, A. Zachary Hettinger, Raj M. Ratwani
- Visualizing Expertise in Context
- Robert L. Wears, Christiane C. Schubert
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?