Factors Affecting Clinician Decision-Making in In Vitro Fertilization

Date of Conferral

2015

Degree

Ph.D.

School

Public Health

Advisor

Dr. Amany Refaat

Abstract

This study focused on factors that influenced clinician embryo disposition decision-making in in vitro fertilization (IVF). Evidence-based medicine (EBM) should be built on the premise of shared decision-making. This paradigm is often skewed, resulting in clinician stress, a higher probability of errors, reduced productivity, or ineffective decisions. Guided by the theory of planned behavior and the self-perception theory, this study assessed the independent variables' religiosity, ethnicity, level of burnout, gender, age, years of experience, and clinical role in relationship to the dependent variable "decision-making" as measured by the Lyerly Frozen Embryo Survey, Maslach Burnout Inventory, and the Areas of Worklife Survey. IVF clinicians throughout the United States and Europe (n = 151) completed an online survey via a nonrandom, cross-sectional methodology. Study results indicated the factors were not significant. A vast majority of participants identified as: White, (84%), and female (75%), and that religion was very important (73%). The bulk of participants had a moderate level of burnout (85%), which showed that the multitude of participants were not experiencing overly high levels of emotional exhaustion, were not emotionally detached from their patients' needs, and felt a high degree of personal accomplishment. Recommendations included using a larger sample size, different variables, or developing a new survey as the decision making process may have been more multifaceted than anticipated. There are more areas to be studied around factors and decision making to fully understand these concepts. The positive social change implications include an increased awareness of factors that have the potential for impacting clinician decision-making as a reminder of the importance to be cognizant and sensitive of the needs of patients.

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