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Personal career decisions during medical training are not complicated, they are complex.

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Title: Personal career decisions during medical training are not complicated, they are complex.
Authors: Harper, Lea Lea, Desy, Janeve, Davis, Melinda, Weeks, Sarah, McLaughlin, Kevin
Source: Medical Education. Sep2024, Vol. 58 Issue 9, p1042-1048. 7p.
Subjects: Medical education, Satisfaction, Work-life balance, Decision making, Mentoring, Hospital medical staff, Conceptual structures, Happiness, Vocational guidance
Abstract: Background: For medical training to be deemed successful, in addition to gaining the skills required to make appropriate clinical decisions, trainees must learn how to make good personal decisions. These decisions may affect satisfaction with career choice, work–life balance, and their ability to maintain/improve clinical performance over time—outcomes that can impact future wellness. Here, the authors introduce a decision‐making framework with the goal of improving our understanding of personal decisions. Methods: Stemming from the business world, the Cynefin framework describes five decision‐making domains: clear, complicated, complex, chaotic, and confusion, and a key inference of this framework is that decision‐making can be improved by first identifying the decision‐making domain. Personal decisions are largely complex—so applying linear decision‐making strategies is unlikely to help in this domain. Results: The available data suggest that the outcomes of personal decisions are suboptimal, and the authors propose three mechanisms to explain these findings: (1) Complex decision is susceptible to attribute substitution where we subconsciously trade these decisions for easier decisions; (2) predictions are prone to cognitive biases, such as assuming our situation will remain constant (linear projection fallacy), believing that accomplishing a goal will deliver lasting happiness (arrival bias), or overestimating benefits and underestimating costs of future tasks (planning fallacy); and (3) complex decisions have an inherently higher failure rate than complicated decisions because they are the result of an ongoing, dynamic person‐by‐situation interaction and, as such, have more time to fail and more ways to do so. Discussion: Based upon their view that personal decisions are complex, the authors propose strategies to improve satisfaction with personal decisions, including increasing awareness of biases that may impact personal decisions. Recognising that the outcome of personal decisions can change over time, they also suggest additional interventions to manage these decisions, such as different forms of mentoring. Harper et al. explore how outcomes of complex personal decisions can be suboptimal by virtue of cognitive biases and ongoing, dynamic person‐by‐situation interactions. [ABSTRACT FROM AUTHOR]
Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Personal career decisions during medical training are not complicated, they are complex.
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  Data: Background: For medical training to be deemed successful, in addition to gaining the skills required to make appropriate clinical decisions, trainees must learn how to make good personal decisions. These decisions may affect satisfaction with career choice, work–life balance, and their ability to maintain/improve clinical performance over time—outcomes that can impact future wellness. Here, the authors introduce a decision‐making framework with the goal of improving our understanding of personal decisions. Methods: Stemming from the business world, the Cynefin framework describes five decision‐making domains: clear, complicated, complex, chaotic, and confusion, and a key inference of this framework is that decision‐making can be improved by first identifying the decision‐making domain. Personal decisions are largely complex—so applying linear decision‐making strategies is unlikely to help in this domain. Results: The available data suggest that the outcomes of personal decisions are suboptimal, and the authors propose three mechanisms to explain these findings: (1) Complex decision is susceptible to attribute substitution where we subconsciously trade these decisions for easier decisions; (2) predictions are prone to cognitive biases, such as assuming our situation will remain constant (linear projection fallacy), believing that accomplishing a goal will deliver lasting happiness (arrival bias), or overestimating benefits and underestimating costs of future tasks (planning fallacy); and (3) complex decisions have an inherently higher failure rate than complicated decisions because they are the result of an ongoing, dynamic person‐by‐situation interaction and, as such, have more time to fail and more ways to do so. Discussion: Based upon their view that personal decisions are complex, the authors propose strategies to improve satisfaction with personal decisions, including increasing awareness of biases that may impact personal decisions. Recognising that the outcome of personal decisions can change over time, they also suggest additional interventions to manage these decisions, such as different forms of mentoring. Harper et al. explore how outcomes of complex personal decisions can be suboptimal by virtue of cognitive biases and ongoing, dynamic person‐by‐situation interactions. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/medu.15466
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        Text: English
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        Type: general
      – SubjectFull: Satisfaction
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      – SubjectFull: Work-life balance
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      – SubjectFull: Decision making
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      – SubjectFull: Mentoring
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      – SubjectFull: Hospital medical staff
        Type: general
      – SubjectFull: Conceptual structures
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      – SubjectFull: Happiness
        Type: general
      – SubjectFull: Vocational guidance
        Type: general
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      – TitleFull: Personal career decisions during medical training are not complicated, they are complex.
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              M: 09
              Text: Sep2024
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              Y: 2024
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