Group phenomena in medical decisions--an analysis among residents of a department of otolaryngology

Abstract

Group phenomena concern the behaviour of particular groups which differs from that of individuals. One relevant phenomenon is the 'risky shift', which describes the observation of groups making riskier decisions than individuals. These phenomena have not been investigated for German physicians as yet. In a prospective study, participating ENT residents received a questionnaire with a description of 12 clinical borderline cases. The participants were asked to answer these individually using a 10-point analogous scale from 1 (no indication for surgery/treatment) to 10 (indication for surgery/treatment). In the afternoon, the questions were again -provided and discussed within the group. For the morning round, the median of the answers had values between 3 and 9 (average: 6.25). After group discussion in the afternoon, the medians averaged 4 with values between the minimum '1' and the maximum '10'. Regarding statistics, these changes in response behaviour were partially significant (p<0.05). Furthermore, a trend towards more extreme -decisions was observed. This study shows, that group discussions influence the outcome of the decision-making process in medical residents. Therefore, one should always be aware of this kind of phenomenon when making medical decisions within a group. However, group discussions must still be encouraged and remain fundamental for clinical routine.