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Use of Cognitive Task Analysis to Understand Decision-making for Management of Blunt Abdominal Trauma in Children

Study objective To use cognitive task analysis (CTA) to elicit experts’ knowledge and outline their clinical decision-making process for the management of pediatric blunt abdominal injury. Methods This was a mixed-methods study involving in-depth interviews and a focus group with local experts follo...

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Autores principales: Ahluwalia, Tania, Toy, Serkan, Kennedy, Chris
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6472713/
https://www.ncbi.nlm.nih.gov/pubmed/31032155
http://dx.doi.org/10.7759/cureus.4095
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author Ahluwalia, Tania
Toy, Serkan
Kennedy, Chris
author_facet Ahluwalia, Tania
Toy, Serkan
Kennedy, Chris
author_sort Ahluwalia, Tania
collection PubMed
description Study objective To use cognitive task analysis (CTA) to elicit experts’ knowledge and outline their clinical decision-making process for the management of pediatric blunt abdominal injury. Methods This was a mixed-methods study involving in-depth interviews and a focus group with local experts followed by a review survey with a panel of experts from numerous pediatric trauma centers across the United States. All experts specialized in pediatric emergency medicine and pediatric trauma surgery. Results Common themes that emerged during seven in-depth interviews with local experts included: clinical management, clinical reasoning, situational awareness, potential errors/novice traps, knowledge and skills, communication, and quality indicators. A total of 17 external experts responded to the survey for a response rate of 77%. External experts indicated that the information outlined in the CTA was complete and accurate, and provided valuable insights into the discrepancies that were unresolved during the focus group with local experts. They indicated agreement with potential errors/novice traps reported by local experts. Specifically, they indicated that the failure in coordinating team activities, maintaining the big picture, and performing a thorough physical examination posed serious threats to novices when managing a child with blunt abdominal trauma. Conclusion CTA may be applied to pediatric management of blunt abdominal injury to identify critical steps and potential errors to serve as a framework for education in pediatric emergency medicine and pediatric trauma surgery. Future studies may apply CTA to other types of traumatic injuries and/or involve an interdisciplinary approach.
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spelling pubmed-64727132019-04-26 Use of Cognitive Task Analysis to Understand Decision-making for Management of Blunt Abdominal Trauma in Children Ahluwalia, Tania Toy, Serkan Kennedy, Chris Cureus Emergency Medicine Study objective To use cognitive task analysis (CTA) to elicit experts’ knowledge and outline their clinical decision-making process for the management of pediatric blunt abdominal injury. Methods This was a mixed-methods study involving in-depth interviews and a focus group with local experts followed by a review survey with a panel of experts from numerous pediatric trauma centers across the United States. All experts specialized in pediatric emergency medicine and pediatric trauma surgery. Results Common themes that emerged during seven in-depth interviews with local experts included: clinical management, clinical reasoning, situational awareness, potential errors/novice traps, knowledge and skills, communication, and quality indicators. A total of 17 external experts responded to the survey for a response rate of 77%. External experts indicated that the information outlined in the CTA was complete and accurate, and provided valuable insights into the discrepancies that were unresolved during the focus group with local experts. They indicated agreement with potential errors/novice traps reported by local experts. Specifically, they indicated that the failure in coordinating team activities, maintaining the big picture, and performing a thorough physical examination posed serious threats to novices when managing a child with blunt abdominal trauma. Conclusion CTA may be applied to pediatric management of blunt abdominal injury to identify critical steps and potential errors to serve as a framework for education in pediatric emergency medicine and pediatric trauma surgery. Future studies may apply CTA to other types of traumatic injuries and/or involve an interdisciplinary approach. Cureus 2019-02-19 /pmc/articles/PMC6472713/ /pubmed/31032155 http://dx.doi.org/10.7759/cureus.4095 Text en Copyright © 2019, Ahluwalia et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Ahluwalia, Tania
Toy, Serkan
Kennedy, Chris
Use of Cognitive Task Analysis to Understand Decision-making for Management of Blunt Abdominal Trauma in Children
title Use of Cognitive Task Analysis to Understand Decision-making for Management of Blunt Abdominal Trauma in Children
title_full Use of Cognitive Task Analysis to Understand Decision-making for Management of Blunt Abdominal Trauma in Children
title_fullStr Use of Cognitive Task Analysis to Understand Decision-making for Management of Blunt Abdominal Trauma in Children
title_full_unstemmed Use of Cognitive Task Analysis to Understand Decision-making for Management of Blunt Abdominal Trauma in Children
title_short Use of Cognitive Task Analysis to Understand Decision-making for Management of Blunt Abdominal Trauma in Children
title_sort use of cognitive task analysis to understand decision-making for management of blunt abdominal trauma in children
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6472713/
https://www.ncbi.nlm.nih.gov/pubmed/31032155
http://dx.doi.org/10.7759/cureus.4095
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