Problem-Solving Skills in Anesthesia

Abstract

The development of human resources and especially the training of problem-solving skills and teamwork are essential in high-risk environments. Personnel must be able to cope with rarely occurring yet dangerous incidents. Training should be domain-specific and based on the analysis of required skills. Our analysis will address "general problem-solving skills" of the anesthetist. Anesthetists work in complex environments under stressful conditions: intransparency, dynamic decision-making and uncertainty. Problem-solving in the operating rooms also demands cognitive and interpersonal skills in addition to the technical skills. This paper inquires into exactly which skills are seen as important for effective incident management by expert anesthetists. Data for our multi-method analysis were collected through observations done in the operating room, expert interviews (n=3), questionnaire (n=38), and expert hearing (n=5 anesthesia instructors). Results show that vital skills required in incident management during anesthesia involve appropriate organization in the course of action (goal-setting, planning, decision-making and an ongoing evaluation), team interaction, and the use of heuristics. Subjects refer to skills that enable them to maintain an overview of the situation, to concoct simple linear plans, and to work together as a team. Of the data sources used, qualitative and narrative approaches (interviews, open items in questionnaires) yielded the most substantial insights regarding skills needed for problem-solving. URN: urn:nbn:de:0114-fqs0303115