Next Article in Journal
Factors Affecting Self-Care Behavior Levels among Elderly Patients with Type 2 Diabetes: A Quantile Regression Approach
Previous Article in Journal
Association between Circle of Willis Configuration and Rupture of Cerebral Aneurysms
Article Menu

Export Article

Open AccessArticle

Development of an Adapted Model for Decision-Making to Improve Reasoning and Risk Assessment in an Emergency Team: A Prospective Simulation Study

1
German Red Cross, Emergency Medical Service, 72764 Reutlingen, Germany
2
University Hospital, Eberhard Karls University Tübingen, 72076 Tübingen, Germany
3
Department of Anesthesiology, Intensive Care Medicine, Emergency and Pain Medicine, Klinikum am Steinenberg, 72764 Reutlingen, Germany
4
Department of Internal Medicine, Cardiology, Angiology and Intensive Care Medicine, Klinikum am Steinenberg, 72764 Reutlingen, Germany
*
Author to whom correspondence should be addressed.
Medicina 2019, 55(7), 339; https://doi.org/10.3390/medicina55070339
Received: 12 June 2019 / Revised: 2 July 2019 / Accepted: 3 July 2019 / Published: 4 July 2019
(This article belongs to the Section Emergency Medicine)
  |  
PDF [566 KB, uploaded 5 July 2019]
  |  

Abstract

Background and Objectives: Medical staff is rarely trained in structured decision-making, relying instead on intuition without due consideration for the associated pros and cons. Materials and Methods: We adopted a model for decision-making to improve reasoning and risk assessment and carried out a prospective simulation study using paramedic students in a three-year training program. We conducted a training session in which participants were lectured on decision-making using the FAR-BEK model (German abbreviation for facts, alternatives, risks, competence, decision, control), physiological processes in decision-making under stress, as well as medico-legal aspects for the comprehension and justification of medical decisions. We analyzed pre- and post-training scenarios to elucidate the influence of training on decision-making. Results: Twenty paramedic students, with a mean age of 22.0 ± 1.7 years, took part in the study. The question of whether decision aids can be applied, initially affirmed by 40% of participants, rose to 71.4% (p = 0.011) following our training. Confidence in decision-making increased on a 7-point Likert scale from 4.5 to 4.8 points (p < 0.394). The reasoning behind the decisions rose from 5.3 to 5.6 points (p < 0.081). Indication, options, and risks rose significantly, from 5.4 to 6.1 points (p = 0.045). Overall, our simulation training significantly increased the points of decision support taken into account (57.8% vs. 88.9%, p < 0.001). Viewed individually, the largest increase of 180% was seen in risk assessment (33.3% vs. 93.3%, p < 0.002). The second largest increase of 150% was seen in the question of one’s own permissions (26.7% vs. 66.7%, p < 0.066). Also, the control increased (40.0% vs. 86.7%, p < 0.021). Conclusions: With a brief training course, both the awareness and the implementation of a structured decision-making model in paramedic students can be significantly increased. Nevertheless, no definitive conclusions can be made with respect to the implementation of real patient care. The application of structured, standardized decision-making tools may need to be further consolidated in routine medical use. View Full-Text
Keywords: decision-making; risk assessment; simulation training; paramedic; medical education decision-making; risk assessment; simulation training; paramedic; medical education
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Häske, D.; Dorau, W.; Heinemann, N.; Stock, J.-P.; Schempf, B. Development of an Adapted Model for Decision-Making to Improve Reasoning and Risk Assessment in an Emergency Team: A Prospective Simulation Study. Medicina 2019, 55, 339.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Medicina EISSN 1010-660X Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top