ABSTRACT
Intra-operative decision making is one of the most important non-technical skills for a surgeon. This chapter focuses on intra-operative decision making, which can be described as dynamic decision making: having to decide on a course of action while an event is unfolding, sometimes under time pressure. It introduces a basic model of intra-operative decision making, and describes several different methods that surgeons use to make the decisions. The chapter discusses influencing factors and offers suggestions for training and assessment of these decision-making skills. Intra-operative decision making can be conceptualized as a two-stage cognitive process. The first step is situation assessment, defining the situation and judging risk and time. The second stage of intra-operative decision making is the cognitive process of choosing a course of action to meet the needs of the situation assessment. Rule-based decision making requires more conscious effort than the intuitive method.
