Riley Brian, Brandon Cowan, Jacquelyn A Knox, Patricia S O'Sullivan, David Bayne, Traci Ito, Jeannette Lager, Hueylan Chern
Comparing Peer and Faculty Feedback for Asynchronous Laparoscopic Skill Acquisition
Journal of surgical education
wide variation endoflife eol intensive care unit icu use among academic medical centers amcs objective develop hypotheses regarding medical decisionmaking factors underlying variation highfidelity simulation experiment involving critically terminally ill elder followed survey debriefing cognitive interview evaluated using triangulated quantitativequalitative comparative analysis study conducted 2 amcs state health care system disparate eol icu use subjects hospitalbased physicians responsible icu admission decisions measurements included treatment plan prognosis diagnosis qualitative case perceptions clinical reasoning sixtyseven 111 60 eligible physicians agreed participate 48 72 could scheduled significant betweenamc differences 3month prognosis treatment plan systematic differences perceptions case case perceptions lowintensity amc seemed influenced absence donotresuscitate order context norms universal code status discussion documentation upon admission whereas case perceptions highintensity amc seemed influenced patients known metastatic gastric cancer context norms oncologists avoiding code status discussions simulation study 2 amcs hospitalbased physicians different perceptions identical case hypothesize different advance care planning norms may influenced decisionmaking heuristics