NCM 119 - LECTURE REQUISITES x FOR x

SUCCESFUL x
Decision Making, Problem
Solving, Clinical Reasoning LEADERSHIP x & x
MANAGEMENT

R E Q UI S I T ES - Reflective thinking , related to evaluation

and has a broader scope
DECISION MAKING
- More complex, involves higher order of
- Synonymous with management
reasoning and evaluation both cognitive
- Necessary for safe patient care
(insights, intuitions) and affective
- A complex, cognitive process of choosing
(empathy, and willingness to take action)
a particular course of action; the thought
component
process of selecting a logical choice from
- SKILLS:
available options
o Analyzing – breaking whole into
- Successful Decision Makers:
parts (piece by piece)
o Self-aware
o Applying standard – judging
o Courageous – involves willingness
according to rules
to take risks
o Discriminating – recognizing
o Sensitivity
differences and similarities (group
o Energetic – energy and desire to
things together)
make things happen
o Info seeking – seeks evidence,
o Creative – develop new ways to
facts, and knowledge
solve problems
o Logical reasoning – drawing
- Types of Decision Making
inferences and conclusions
o Recurrent and routine problem
o Predicting – envisions a plan and
solving
its consequences
o Satisficing (both parties are
o Transforming knowledge –
considered)
changing the condition, nature,
o Maximizing or optimal mode (best
form of functions of concepts
decision)
among contexts
PROBLEM SOLVING
- CHARACTERISTICS OF A CRITICAL
- Part of decision making
THINKER
- A systematic process focusing on
o Insight
analyzing a difficult situation involving
o Intuition
higher order reasoning and evaluation
o Empathy
CRITICAL THINKING
o Willingness to take action
- The mental process of actively and
CLINICAL REASONING
skillfully conceptualizing, applying,
- Integrating and applying different types
analyzing, synthesizing, and evaluating
of knowledge to weigh evidence, critically
information to reach an answer or
think about arguments, and reflect on the
conclusion
process used to arrive at diagnosis

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 NCM 119 - LECTURE REQUISITES x FOR x
SUCCESFUL x
Decision Making, Problem
Solving, Clinical Reasoning LEADERSHIP x & x
MANAGEMENT

EXPERIENTIAL LEARNING The Marquis-Huston Model for Teaching Critical

- Provide mock life experiences to learn Thinking
from - It assists in achieving desired learning
- Allows learning to apply leadership and outcomes
management theory - Can be accomplished through writing
- Promotes whole brain thinking and exercises, personal exploration, and
improved problem-solving skills values clarification, along with risk
- Ex: Case studies taking, as case study are examined
VICARIOUS LEARNING TO INCREASE PROBLEM-
SOLVING AND DECISION-MAKING SKILLS
- Decision making, one step in problem
solving process, is an important task that
relies heavily on critical thinking skills
LEARNING EXERCISES
- Case Studies
o Learning how to diagnosed and
select appropriate health
outcomes
o Develops habits of thought as they
learn from experience THEORETICAL APPROACHED TO PROBLEM

- Simulations SOLVING AND DECISION MAKING

o Apply knowledge and gain skill
mastery before working w clients
- Problem-based Learning
o Opportunities to address and learn
from authentic problems
o Active and self-directed nature,
encourages students ability to
think critically, be tolerant of the
ideas of others, and evaluate
conflicting information before
reaching a conclusion
HEURISTICS
a. Allows the person to solve problems more
quickly and to build upon experiences
they have gained in their lives
b. Trial and Error – rather than rules
c. May work most of the time but will not be
the best all the time
- A structured approach to problem solving
and decision making increases clinical
reasoning and is the best way to learn
how to make quality decisions because it
eliminates trial and error and focuses the
learning on a proven process.
o Increases clinical reasoning

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 NCM 119 - LECTURE REQUISITES x FOR x
SUCCESFUL x
Decision Making, Problem
Solving, Clinical Reasoning LEADERSHIP x & x
MANAGEMENT

TRADITIONAL PROBLEM-SOLVING PROCESS - Can easily be adapted as a theoretical

1. Identify the problem model for solving leadership and
2. Gather data to analyze the causes and management problems
consequences of the problem - Weakness
3. Explore alternative solutions o Not requiring clearly stated
4. Evaluate the alternatives objectives
5. Select the appropriate solution o Goals are frequently omitted or
6. Implement the solution obscured
7. Evaluate the results THE IDEALS MODEL
MANAGERIAL DECISION-MAKING MODELS - identify the problem
1. Determine the decision and the desired - define the context
outcomes (set objectives) - enumerate choices
o Helps the problem solver - Analyze options
determine which criteria should be - List reasons explicitly
weighted most heavily in making - Self-correct
their decision CRITICAL ELEMENTS IN PROBLEM SOLVING
2. Research and identify options AND DECISION MAKING
3. Compare and contrast these options and 1. Define Objectives Clearly
their consequences 2. Gather data carefully
4. Make a decision o What is the setting
5. Implement an action plan o What is the problem?
6. Evaluate results o Where is it a problem?
NURSING PROCESS: A PROBLEM-SOLVING AND o When is it a problem?
DECISION-MAKING MODEL o Who is affected by the problem?
NURSING PROCESS DECISION MAKING o What is happening?
1. Assess Identify the decision o Why is it happening? What are the
Collect data causes of the problem? Can I
2. Diagnose
prioritize the causes?
3. Plan Identify criteria for decision o What are the basic underlying
Identify alternatives issues? Areas of conflict?
4. Implement Choose alternative o What are the consequences of the
Implement alternative problem? Which of these are most
5. Evaluation Evaluate steps in decision serious?
- Ida Jean Orlando, 1950s 3. Take the time necessary
- Greatest strength: multiple venues for 4. Generate many alternatives
feedback 5. Think logically
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 NCM 119 - LECTURE REQUISITES x FOR x
SUCCESFUL x
Decision Making, Problem
Solving, Clinical Reasoning LEADERSHIP x & x
MANAGEMENT

6. Choose and act decisively 7. Lack of self-awareness

INDIVIDUAL VARIATIONS IN DECISION 8. Too much time spent identifying the

MAKING problem

- Gender 9. Refusal to act

- Values 10. Using outcome only for evaluation

- Life experiences 11. It is not enough to gather adequate

- Individual preference information, think logically, select from

- Brain hemisphere dominance among many alternatives, and be aware

of the influence of one’s values. (in the
OVERCOMING INDIVIDUAL
final analysis, one must act)
VULNERABILITY IN DECISION MAKING
DECISION-MAKING VARIABLES
- Values – being confused and unclear
- Q: If we all use the same decision-making
about one’s values
or problem-solving model and are given
- Life experience – use available resources,
the same information, will we reach the
research, literature, involve experienced
same decision? Why or why not?
people, evaluate decisions to learn from
mistakes
- Individual Preference
Innovation and Creativity: Critical Aspects
o Self-awareness, honesty and risk
taking of Problem Solving and Decision Making

- Individual Ways of thinking - New research suggests that gender also

o Group process, talking plays a role in how individuals make

management problems over with decisions

others
o Developing whole-brain thinking
o Heterogenous rather than STRATEGIES TO PROMOTE EVIDENCE-
homogenous groups BASED BEST PRACTICE
FREQUENT ERRORS MADE IN DECISION - Implement and evaluate nationally
MAKING sanctioned clinical practice guidelines

1. No clear objective or goal for decision - Question and challenge nursing traditions

2. Faulty data gathering and promote a spirit of risk taking

3. Failure to use science, logic, and - Dispel myths and traditions not supported

empirical evidence by evidence

4. Not considering enough alternatives - Collaborate with other nurses locally and

5. Faulty logic or “crooked” thinking globally

6. Not assessing or ignoring the quality of - Interact with other disciplines to bring

the decision making that is required nursing evidence to the table

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