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Record W2991923043 · doi:10.1136/bmjstel-2019-000515

Risk orientation predicts hypoxic time during difficult airway simulation: a mixed-methods pilot study

2019· article· en· W2991923043 on OpenAlexaffabout
Jake Hayward, Niresha Velmurugiah, Jonathan P. Duff

Bibliographic record

VenueBMJ Simulation & Technology Enhanced Learning · 2019
Typearticle
Languageen
FieldMedicine
TopicClinical Reasoning and Diagnostic Skills
Canadian institutionsUniversity of Alberta
Fundersnot available
KeywordsDebriefingThematic analysisAirwayMedicinePersonalityIntervention (counseling)Airway managementPsychologyClinical psychologyNursingQualitative researchSocial psychologyAnesthesiaMedical education

Abstract

fetched live from OpenAlex

Personality factors may explain some of the practice variation observed in medicine. In this pilot study, we used simulation to investigate the relationship between risk orientation and airway management. We hypothesised that higher risk tolerance would predict earlier intervention. Ten emergency medicine residents from the University of Alberta participated in a standardised difficult airway simulation. There was a constant rate of oxygen desaturation necessitating eventual airway intervention. A debriefing interview and a risk orientation questionnaire followed. Time of hypoxia prior to intervention was the outcome measure. Audio interview transcripts underwent thematic analysis. Nine participants were included; one did not complete the simulation as instructed. Higher risk tolerance predicted longer hypoxic time prior to intubation (r=0.72, p=0.03). Theme analysis revealed consistent fears regarding patient instability and chances of a failed airway intervention. Patient instability was emphasised more so by those who intervened earlier. We show that personality characteristics influence resuscitation decision-making at an early stage of training. Trainees may therefore be susceptible to certain types of medical error based on their risk aversion. Implications for resident training, care quality and patient safety are discussed.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.006
metaresearch head score (Gemma)0.010
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Simulation or modeling · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.007
Threshold uncertainty score0.030

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0060.010
Meta-epidemiology (narrow)0.0000.001
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0010.001
Science and technology studies0.0010.001
Scholarly communication0.0010.001
Open science0.0010.001
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0020.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.016
GPT teacher head0.378
Teacher spread0.363 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designSimulation or modeling
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations5
Published2019
Admission routes2
Has abstractyes

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