1. Unpacked Expertise: Difficult Mask Ventilation, Judgment Cues, and Critical Decision-Making.
- Author
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Davies, Amber N.
- Subjects
- *
MEDICAL education , *JUDGMENT (Psychology) , *PROFESSIONS , *TOUCH , *ACADEMIC medical centers , *RESEARCH methodology , *AUDITORY perception , *INTERVIEWING , *HUMAN anatomical models , *MEDICAL personnel , *ARTIFICIAL respiration , *NURSE anesthetists , *ENTRY level employees , *ABILITY , *TRAINING , *CLINICAL competence , *VISUAL perception , *SMELL , *EXPERIENTIAL learning , *PREOPERATIVE education , *LARYNGEAL masks , *EXPERTISE , *DESCRIPTIVE statistics , *DECISION making in clinical medicine , *METROPOLITAN areas , *JUDGMENT sampling , *TRACHEA intubation , *PROMPTS (Psychology) - Abstract
According to tacit knowledge theory, checklists and textbooks cannot convey important aspects of nonroutine mask ventilation (MV) learned experientially. Our objective was to elicit tacit knowledge underlying experienced MV performance to support novice anesthesia providers' MV execution by identifying targets for clinical coaching. We utilized the Critical Decision Method to elicit experienced anesthesia providers' tacit knowledge during nonroutine MV. Using semistructured interviews guided by a general anesthesia (GA) induction checklist and conducted using equipment utilized in GA induction, we probed participants' experiences. A cognitive map was produced depicting critical MV decisions and associated environmental cues. We validated the map via member check and comparison against GA checklists, textbooks, and novice MV knowledge. Experience is necessary to skillfully interpret environmental cues signaling changing conditions in nonroutine MV. Our cognitive map featured 34 critical decisions and 23 environmental (visual, tactile, auditory, and olfactory) cues. Validation identified 45 (16 preoperative, 29 intraoperative) items not found in the GA induction checklist, 15 not presented in textbooks, and 16 not identified by novices. Identifying tacit knowledge may provide a novel way to guide novice anesthesia learners' experiential learning. Highlighting the environmental cues could guide hands on learning, accelerating time to competency. [ABSTRACT FROM AUTHOR]
- Published
- 2023