title: Decision making in urological surgery.
abstract: BACKGROUND
  Non-technical skills are important behavioural aspects that a urologist must be fully competent at to minimise harm to patients. The majority of surgical errors are now known to be due to errors in judgment and decision making as opposed to the technical aspects of the craft.
  
  
  METHODS
  The authors reviewed the published literature regarding decision-making theory and in practice related to urology as well as the current tools available to assess decision-making skills. Limitations include limited number of studies, and the available studies are of low quality.
  
  
  RESULTS
  Decision making is the psychological process of choosing between alternative courses of action. In the surgical environment, this can often be a complex balance of benefit and risk within a variable time frame and dynamic setting. In recent years, the emphasis of new surgical curriculums has shifted towards non-technical surgical skills; however, the assessment tools in place are far from objective, reliable and valid. Surgical simulators and video-assisted questionnaires are useful methods for appraisal of trainees.
  
  
  CONCLUSIONS
  Well-designed, robust and validated tools need to be implemented in training and assessment of decision-making skills in urology. Patient safety can only be ensured when safe and effective decisions are made.
authors.affiliation: MRC Centre for Transplantation, NIHR Biomedical Research Centre, King's Health Partners, King's College London, London, UK.
authors.forename: Hamid
authors.initials: H
authors.lastname: Abboudi
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahmed
authors.forename: Pasha
authors.initials: P
authors.lastname: Normahani
authors.forename: May
authors.initials: M
authors.lastname: Abboudi
authors.forename: Roger
authors.initials: R
authors.lastname: Kirby
authors.forename: Ben
authors.initials: B
authors.lastname: Challacombe
authors.forename: Mohammed Shamim
authors.initials: MS
authors.lastname: Khan
authors.forename: Prokar
authors.initials: P
authors.lastname: Dasgupta
mesh_terms: D002983:Clinical Competence; D003657:Decision Making; D006801:Humans; D013043:Specialties, Surgical; D014572:Urology