Risk, probability and decisions in emergency medicine‪.‬

Thanks for downloading and reading our first St.Emlyn’s e-book. In it, we focus on decision making, arguably one of the most important core skills of medicine. In the acute specialities such as Emergency Medicine, Acute Medicine, Critical Care and Prehospital Care the complexities of clinical decisions are amplified by the time critical nature of our practice. We are often required to make decisions quickly, and also at a point in the patients journey when there may be significant uncertainty as to what the underlying cause of the patient’s injury or illness is. 

Those of us who operate in the time critical, information light world of the resuscitationist know that we are judged by the quality of these complex decisions. This is both an immense challenge, but also a huge privilege as those decisions can transform a patient’s clinical course. If you follow the St.Emlyn’s blog and podcast then you will already know this, but I would challenge you to stop and consider how much of your formal  time in training has been spent on understanding risk, uncertainty, decisions and dilemmas? I suspect relatively little, which is arguably surprising, considering its importance. How do we learn these skills, and how did other develop them? A useful exercise is to stop and think about a colleague or teacher who exhibits that elusive quality of ‘great clinical judgement’. How do you think they developed those skills? It’s likely a combination of practice, reflection, feedback, review and time, but undoubtably, it did not come without effort or study. At St.Emlyn’s we’ve always believed, that by thinking about thinking (meta-cognition), we can improve our understanding of clinical practice and thus become better clinicians. This book is an introduction into how we do this.

We hope to inspire you to think more deeply about the risks, uncertainties and complexities that underpin decision making in acute specialities. 

Vive la #FOAMed

Simon Carley

Professor of Emergency Medicine