Does it apply to me: Using Relational Frame Theory to examine anaesthetists' approach to safety behaviour and human factors

Healthcare must provide safe and effective treatment while being cost-effective and ethical in its delivery. Anaesthesia is particularly prone to production pressure, which can lead to compromises in patient safety through risky decision-making. Australian anaesthetists (N=192), trainees, and specialists were asked to complete an electronic survey asking whether they would proceed with surgery in 11 clinical elective scenarios involving a violation of a standard or practice guideline. They were also asked how confident they were in their decisions and provided an opportunity to explain. Across all scenarios, anaesthetists would have proceeded ranging from 8.3% to 89.6. The likelihood to proceed and confidence in the decision in some scenarios was influenced by the decision made, gender, age, and level of expertise. Although not originally designed to investigate rule-governed behaviour using Relational Framework Theory, we found evidence of the influence of plys, tracks and augments, in the explanations which participants provided. Relational Framework Theory may provide insights into individual beliefs, values, motivators, and the influence of culture-behavioural systems in anaesthetists attitudes towards safety practices and human factors.