Medical judgement analogue studies with applications to spaceflight crew medical officer.

Medical judgement analogue studies with applications to spaceflight crew medical officer.

McCarroll Michele L; Ahmed Rami A; Schwartz Alan; Gothard Michael David; Atkinson Steven Scott; Hughes Patrick; Brito Jose Cepeda; Assad Lori; Myers Jerry; George Richard L

BMJ simulation & technology enhanced learning

2017

2017-10

Background: The National Aeronautics and Space Administration (NASA) developed plans for potential emergency conditions from the Exploration Medical Conditions List. In an effort to mitigate conditions on the Exploration Medical Conditions List, NASA implemented a crew medical officer (CMO) designation for eligible astronauts. This pilot study aims to add knowledge that could be used in the Integrated Medical Model. Methods: An analogue population was recruited for two categories: administrative physicians (AP) representing the physician CMOs and technical professionals (TP) representing the non-physician CMOs. Participants completed four medical simulations focused on abdominal pain: cholecystitis (CH) and renal colic (RC) and chest pain: cardiac ischaemia (STEMI; ST-segment elevation myocardial infarction) and pneumothorax (PX). The Medical Judgment Metric (MJM) was used to evaluate medical decision making. Results: There were no significant differences between the AP and TP groups in age, gender, race, ethnicity, education and baseline heart rate. Significant differences were noted in MJM average rater scores in AP versus TP in CH: 13.0 (+/-2.25), 4.5 (+/-0.48), p=\textless0.001; RC: 12.3 (+/-2.66), 4.8 (+/-0.94); STEMI: 12.1 (+/-3.33), 4.9 (+/-0.56); and PX: 13.5 (+/-2.53), 5.3 (+/-1.01), respectively. Discussion: There could be a positive effect on crew health risk by having a physician CMO. The MJM demonstrated the ability to quantify medical judgement between the two analogue groups of spaceflight CMOs. Future studies should incorporate the MJM in a larger analogue population study to assess the medical risk for spaceflight crewmembers.

Astronaut Health; Clinical Judgement; Decision-making; Medical Judgement; Simulation

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

163–168

4

3