Introduction
Moira Stewart, Judith Belle Brown, W Wayne Weston, Ian R McWhinney, Carol L McWilliam, Thomas R Freeman in Patient-Centered Medicine, 2013
The early writings describing evidence-based medicine make clear that it is not intended to replace clinical judgment. Clinical decision making is described as taking into account three elements: the evidence, patient particulars, and patient preference (Haynes et al., 2002; Sackett et al., 2000). Evidence-based medicine has made tremendous strides in describing and putting into practice a method for acquiring the best available evidence about an issue in health care. The concurrent improvements in electronic databases and retrieval systems make it possible to access this information at the site of care and to integrate with the EMR. Evidence-based medicine is, in essence, a robust and extremely useful method for framing questions and evaluating evidence. It is not itself a clinical method, although it does inform the clinician.
Collaboration
Judith Belle Brown, Moira Stewart, W Wayne Weston in Challenges and Solutions in Patient-Centered Care, 2018
Deference to professional authority is not unusual, especially for older people, who place high value upon their doctor’s recommendations (McWilliam et al, 1994). Patients, often overwhelmed by the severity of their problems, depend on their physicians to direct the decision-making process (Ende et al, 1989). Such behavior presents challenges for professionals, as it raises questions about how to involve patients in decision making about their care. Who will be involved in the decision-making process? How will it be communicated? In what ways can the patient be supported and encouraged to participate in decisions about his or her care? Is there a shared understanding of both the doctor’s and the patient’s roles in the decision-making process? Does the therapeutic outcome appear consistent with the patient’s long-term goals and interests? The challenge does not end once the decision is taken. Understanding and dealing with the consequences of interventions are also a part of the shared decision-making responsibilities. For example, Mr Williams clearly needed support and guidance in dealing with his post-surgical complications, not chastisement.
Guidelines for the Practice of Interventional Techniques
Mark V. Boswell, B. Eliot Cole in Weiner's Pain Management, 2005
Medical decision making refers to the complexity of establishing a diagnosis and/or selecting a management option as measured by three components: Diagnosis/management options with a number of possible diagnoses and/or the number of management optionsReview of records/investigations, with number and/or complexity of medical records, diagnostic tests, and other information that must be obtained, reviewed, and analyzedRisk(s) of significant complications, morbidity, and mortality, as well as comorbidities associated with the patient’s presenting problem(s), the diagnostic procedure(s), and/or the possible management options
Perception of Biostatistics by Lebanese Medical Students: A Cross-Sectional Study
Published in Alexandria Journal of Medicine, 2021
Nivine Abou Dargham, Youssef Sultan, Omar Mourad, Mariam Baidoun, Omar Aboul Hosn, Azza Abou El Naga, Hisham F Bahmad, Bilal Azakir
In medicine, decision making includes interpreting clinical evidence, comparing results, and linking patient information to medical literature in order to achieve the best quality of patient care. Henceforth, early exposure of medical students and physicians-in-training to research tools including Biostatistics is of utmost importance [3]. Physicians’ understanding of basic biostatistics knowledge is necessary not only to be able to critically appraise literature and identify the flow in the information, but also to judge the authenticity of the literature and to reduce diagnostic errors [4–7]. Unfortunately, despite curricular integration of EBM, studies have demonstrated that clerkship-level medical students were only able to execute half of the steps of EBM with difficulties especially pertaining to critical appraisal [8,9].
Ward round simulation in final year medical students: Does it promote students learning?
Published in Medical Teacher, 2018
Claudia Behrens, Diana H. J. M. Dolmans, Jimmie Leppink, Gerard J. Gormley, Erik W. Driessen
Our quantitative and qualitative data revealed sub-optimal ward round skills, mainly related to the management of acutely ill patients, prioritization, documentation and clinical decision-making skills. This is consistent with literature, in which other researchers in WRS have reported deficiencies in doctors’ teamwork skills, decision-making skills and clinical skills; such as difficulties in reaching a diagnosis in critically ill patients and prioritizing effectively (Norgaad et al. 2004; Nikendei et al. 2007, 2008). Although the students have clinical placements on real emergency wards, their role during emergencies is often as passive observers. For example, observing a “cardiac arrest team” treating a patient. This could explain the deficiencies reported in this study. Clinical decision-making was perceived as a difficult task. We can infer that a lack of opportunities to practice decision-making skills during the medical curriculum could have influenced these perceived difficulties. McGregor et al. (2012) reported similar data using WRS in an undergraduate setting.
Institutional distrust among gay, bisexual, and other men who have sex with men as a barrier to accessing pre-exposure prophylaxis (PrEP)
Published in AIDS Care, 2019
Meghan Peterson, Kathryn Nowotny, Emily Dauria, Trisha Arnold, Lauren Brinkley-Rubinstein
Another participant questioned when he would receive his psychiatric medications despite feeling that they were important to his well-being: They ordered them and they’ve been telling me that they’ve been ordered and that they should be […] they should have it today, and I still have not been exposed to my psychiatric meds and those are very important to me because that’s what keeps me at a level playing field. It’s like I have really bad anxiety, and I have really bad like PTSD […]The participant felt disempowered in accessing his medications. He noted that he did not trust medical staff to obtain them based on being told conflicting information on when his medications would arrive. Many participants similarly explained how while they received medical care, they had little autonomy over decision-making. The lack of autonomy fostered feelings of distrust toward the system and providers at the RIDOC.
Related Knowledge Centers
- Cognition
- Irrationality
- Problem Solving
- Psychological Research
- Tacit Knowledge
- Psychology
- Value
- Choice
- Knowledge
- Medical Diagnosis