Use of Cognitive Task Analysis to Understand Decision-making for Management of Blunt Abdominal Trauma in Children.
Document Type
Article
Publication Date
2-19-2019
Identifier
DOI: 10.7759/cureus.4095; PMCID: PMC6472713
Abstract
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.
Journal Title
Cureus
Volume
11
Issue
2
First Page
4095
Last Page
4095
Keywords
abdominal trauma; cognitive task analysis; decision-making
Recommended Citation
Ahluwalia T, Toy S, Kennedy C. Use of Cognitive Task Analysis to Understand Decision-making for Management of Blunt Abdominal Trauma in Children. Cureus. 2019;11(2):e4095. Published 2019 Feb 19. doi:10.7759/cureus.4095
COinS
Comments
Grant support
Funded by Children’s Mercy Pediatric Emergency Medicine Department. The authors have no financial relationships relevant to this article to disclose.