How do surgeons make intraoperative decisions?

How do surgeons make intraoperative decisions?
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"Decision making during surgery, particularly during emergency surgery, is a key element in clinical practice that merits better preparation than is currently delivered. Current techniques in surgical training allow little opportunity for reflection, and perhaps there is now place for a more careful scrutiny of surgeons' cognition, using the naturalistic decision research methods. Techniques are being developed to enhance situation awareness and decision‐making skills using low‐fidelity methods,29,38 and these could be easily adapted for surgeons. It appears that post‐event interviewing to extract components of cognitive expertise might be usefully adapted to study surgeons' decision making, and the resulting data could constitute important ingredients of a tuition package. In other professions, where situation awareness and decision making are regarded as safety‐critical skills, they are addressed explicitly in basic training.39,40 Kohls‐Gatzoulis et al41 have demonstrated decision training for surgeons to be both possible and effective. Some of the new courses on surgeons' non‐technical skillsi are beginning to incorporate material on decision making.42 If clinical decision making is to be valued as highly as technical skills, then a better understanding of surgeons' cognitive skills must accrue, so that the processes can be studied, and reconstituted as a skill that can be applied by the practising surgeon. This learning must be applied with a sense of expediency, given the rapidly changing educational environment for future cadres of surgical specialties."
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Qual Saf Health Care. 2007 June; 16(3): 235–239.
doi: 10.1136/qshc.2006.020743.
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