Critical decision method interviews were conducted with 24 consultant surgeons who recalled cases and selected important decisions during the operations. These decision were then discussed in detail in relation to decision-making style and risk management.
The key decision in each case was made using either a rapid, intuitive mode (46%) or a more deliberate comparison of alternative courses of action (50%). Decision strategy was not related to surgical approach (endoscopic vs open), context (elective vs emergency), perceived time pressure, or situational threats. Risk management involved perceiving threats and assessing impact but also indicated the role of personal risk tolerance.
Surgeons described making key intraoperative decisions using either an intuitive or an analytic mode of thinking. Surgeons' risk assessment, risk tolerance, and decision strategies appear to be influenced by their personalities.