Judgement and Decision Making in Clinical and Return-to-Sports Decision Making: A Narrative Review

When deciding if an athlete is ready to return to sports after an injury, clinicians face a complex challenge. This process involves not only assessing the physical healing of the athlete but also considering their mental readiness and social factors. Understanding how decisions are made in these situations is crucial because the health and performance of the athlete—and sometimes even the team—depend on it. Below are some insights from this article into the key aspects of decision-making in sports rehabilitation.

Deciding When an Athlete Can Return to Sports:

• Deciding when an athlete can safely return to sports after an injury is complex. It involves looking at their physical health, mental state, and social factors.
• Clinicians (like doctors and therapists) need to make sense of a lot of information, which can be challenging with the increasing amount of data available.

How Clinicians Make Decisions:

• Making these decisions requires judgment—evaluating all the information and choosing the best option.
• These decisions are crucial because they affect the athlete’s health and the team’s success.
• Despite its importance, training on how to make these decisions isn’t always included in clinicians’ education.

Different Ways to Make Decisions:

• Traditional decision-making assumes people always make the most logical choice with all the information available, but real-life decisions are often made with limited information and time.
• People often make “good enough” decisions rather than perfect ones, especially when time and resources are limited.

Shortcuts and Biases in Decision Making:

• Clinicians often use mental shortcuts to make decisions quickly, but these can lead to biases, or systematic errors.
• Common biases include focusing too much on initial information (anchoring), relying on easily remembered examples (availability), and assuming things that seem similar are the same (representativeness).

Using Simple Strategies:

• Some experts suggest that using simple strategies, like focusing on the most important information first, can be effective in decision making.
• These strategies work well if applied correctly but can lead to mistakes if not used carefully.

Two Types of Thinking:

• There are two main ways clinicians make decisions: quick, instinctive thinking (System 1) and slower, more deliberate thinking (System 2).
• Quick thinking is useful in urgent situations, while deliberate thinking is better for complex decisions.

Balancing Quick and Careful Thinking:

• Experienced clinicians often start with quick thinking and switch to more careful thinking when needed.
• Knowing when to use each type of thinking can help make better decisions.

Improving Decision Making:

• Clinicians should be aware of their own biases and consider taking a step back to think more carefully in tough situations.
• Techniques like taking a moment before deciding, managing emotions, and using decision aids (like checklists) can improve decision quality.