To call or not to call: a judgement of risk by pre‐registration house officers
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Objectives This study set out to answer the following questions. What influences a junior doctor’s response to a judgement call within a clinical setting? What, if any, are the relationships between these influences? Methods This paper describes an interpretivist study based on a grounded theory approach to data analysis. This involved a phased approach to data collection using semi‐structured interviews. Analysis was facilitated by observations and group presentations. Participants were doctors in their first year of postgraduate practice who were purposively selected from a range of hospitals in the Northern Deanery. Results The data demonstrated a number of influences on whether junior doctors chose to seek senior assistance. These included the upholding and balancing of tenets that were necessary for ensuring safe practice, and estimating the chance and severity of potential negative consequences to patients, themselves and their teams. In order to make these judgements, junior doctors drew on different forms of knowledge, especially knowledge gained from previous clinical experiences. In judging whether or not to contact a senior, pre‐registration house officers (PRHOs) were practising essential clinical attributes, that of independent yet co‐operative and discerning practitioners who are able to balance multiple considerations while ensuring patient care. Conclusions This particular judgement of risk, as it was described by those interviewed, was a dynamic process exemplified by the need to create counterbalances between multiple consequences. As a result, no prescriptive action could have allowed PRHOs to deal with the numerous configurations they faced and took into account.
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Any feedback that is delivered will be interpreted through the filters with which the receiver views the world of practice, the feedback provider, and his/her own abilities.
“any feedback that is delivered will be interpreted through the filters with which the receiver views the world of practice, the feedback provider, and his/her own abilities.”
From Factors influencing responsiveness to feedback: On the interplay between fear, confidence, and reasoning processes. (2012) · cites this paper as Stewart 2008
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- Authors
- Stewart, J.
- Affiliations
- Newcastle University (GB)
- Corresponding author
- Stewart, Jane
- Venue
- Medical Education
- Publisher
- Wiley
- Published
- 2008-08-12
- Volume
- 42
- Issue
- 9
- Pages
- 938-944
- ISSN
- 0308-0110 (ISSN-L)
- 1365-2923
- OpenAlex
- W2058347044
- Cited by
- 51
- References
- 27
- Citations by year
- 2024: 2 · 2023: 2 · 2022: 3 · 2021: 1 · 2020: 1 · 2019: 4 · 2018: 6 · 2017: 3 · 2016: 2 · 2015: 4 · 2014: 2 · 2013: 5 · 2012: 6
- FWCI
- 2.39
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Medical Education (publishedVersion)
- PubMed (publishedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Topics
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Keywords
- pre-registration house officers, medical residents, clinical judgment, risk assessment, clinical decision-making, clinical experience, patient safety, clinical features
- MeSH terms
- Attitude of Health Personnel, Clinical Competence, Education, Medical, Graduate, England, Humans, Judgment, Medical Staff, Hospital, Risk Factors, Risk Assessment
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