REQUISITES FOR SUCCESSFUL LEADERSHIP & MANAGEMENT|NCM 119|TOPIC 1

CHAPTER 1 Leadership Roles & Management Functions in Nursing 9TH edition

DECISION MAKING, PROBLEM SOLVING, CHARACTERISTICS OF A CRITICAL THINKER

CRITICAL THINKING, & CLINICAL REASONING v Insight
v Decision making v Intuition
• A complex, cognitive process of choosing a particular v Empathy
course of action v Willingness to take action
• The thought process of selecting a logical choice from
SUCESSFUL DECISION MAKER
available options v Self-aware
• Doubt exists and a choice is made in uncertainty • Increases EQ and understand internal factors that drive
v Problem solving your decision-making process
• Part of decision making; a systematic process focusing on v Courageous
analyzing a difficult situation involving higher order • Requires the ability to face our fears and take action
reasoning and evaluation despite them
• Difference between problem solving & decision making: • Fear is natural and necessary in decision making
decision making may occur without the full analysis v Sensitive
required in problem solving. • We process sensory information more carefully
• Problem solving attempts to identify the root of the v Energetic
problem • Cognitive effects of decision making fatigue can vary that
v Critical thinking (Reflective thinking) may lead to avoidance behavior
• The mental process of actively and skillfully • Burnt our brains make more reckless decisions
conceptualizing, applying, analyzing, synthesizing, and v Creative
evaluating information to reach an answer or conclusion • To make novel solutions
• Reflecting, examining, reasoning, and forming judgment TYPES OF DECISION MAKING
about facts RECURRENT AND ROUTINE PROBLEM SOLVING
• Involves higher order reasoning; more complicated than v Repetitive in nature & require relatively little consideration
decision making & problem solving v Routine decisions are related to the tactical aspects of an org

v Clinical reasoning SATISFICING

• Integrating and applying different types of knowledge to
v Decision making strategy that aims for a satisfactory or
adequate result rather than the optimal solution
weigh evidence, critically think about arguments, and
reflect on the process used to arrive at diagnosis v Instead of putting on maximum exertion on attaining the ideal
outcome, it focuses on pragmatic effort when confronted with
• Collaborative and reflective process that involves
task
knowledge and experience
• Think for a minute about the last major decision you made MAXIMIZING OR OPTIMAL MODE
v Characterized by seeking the best option through an exhaustive
• Was it made by trial and error?
search through alternatives
EXPERIENTIAL LEARNING
v Provides mock life experiences to learn from v Contrasted with satisficing in which individual evaluate options

v Allows learners to apply leadership and management theory until the reach on that is good enough

v Promotes whole brain thinking and improved problem- solving v Ideal outcome
Act / practice skill
Simulation
FREQUENT ERRORS MADE IN DECISION
→

skills
PBL Analyze real life problems
MAKING
→

v Learning exercise
1. No clear objective or goal for decision
• Case studies, writing exercises, specific management or
2. Faulty data gathering
fictional / <

leadership problems etc

real cases Questions that should be asked in data gathering
• Require some degree of critical thinking, problem solving,
• What is the setting?
decision making or clinical reasoning
• What is the problem?
MARQUIS-HUSTON CRITICAL THINKING MODEL
• Where is it a problem?
- Assist in achieving desired learner
• When is it a problem?
outcomes
• Who is affected by the problem?
- Personalized learning helps learner to
• What is happening
internalize learning
Didactic theory > Material Presented • What are the consequences of the problem? Which of
Personalized leaving to internalize learning
> Needed
these are the most serious
Group process
Problem solving • What are the basic underlying issue? Areas of
conflict?

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Requisites for successful leadership and management NCM 119
• Why is happening? What are the causes of the v Instead, they rely on discrete, often unconscious processes
problem? Can I prioritize the causes? known as heuristics.
• Was this poor decision made because necessary v Heuristics refers to using a “trial-and-error” or “rule-of- thumb”
information was intentionally or unintentionally approach to problem solving.
withheld from you?
COMPARISON OF LEFT VS RIGHT BRAIN
3. Failure to use science, logic, and empirical evidence in making
decisions LEFT BRAIN RIGHT BRAIN
• Overgeneralizing: stereotypical statements are used to
- Analytical and linear - Creative and intuitive
justify arguments and decisions - Language, logic and - Nonverbal ideation and
numbers creativity
• Affirming the consequences: assuming something is
- Upper left à factual - Upper right à big picture
bad because a something replaced it. data and numbers thinkers & futuristic
- Lower left à highly - Lower right à emotional;
• Arguing from analogy: a component that is present in
organized and detail sympathetic, kinesthetic and
two separate components and then states that those oriented empathetic & interpersonal
components are alike in ALL aspects
Mostly used by management
4. Not considering enough alternatives
COMPARISON OF ECONOCMIC &
5. Faulty logic or “crooked thinking”
ADMINISTRATIVE MAN
6. Not assessing or ignoring the quality of the decision making
that is required ECONOMIC MAN ADMINISTRATIVE MAN

7. Lack of self-awareness - Makes decisions in - Knowledge is fragmented

8. Too much time spent identifying the problem rational manner - Is impossible to
- Has complete knowledge accurately predict future
9. Refusal to act of problem or situation consequences
10. Using outcome only for evaluation - Considers all alternatives - Considers multiple
- Has systematic ordering alternatives but not all
11. It is not enough to gather adequate information, think logically, of alternatives - Makes decisions that are
select from among many alternatives, and be aware of the - Selects maximizing choice good enough
- - Final choice is satisficing
influence of one’s values. In the final analysis, one must act.

DECISION-MAKING VARIABLES
v If we all use the same decision-making or problem-solving TO MAKE BETTER DECISIONS:
v Use a systematic decision- making process whenever possible.
model and are given the same information, will we all reach the
v Decision making process:
same decision? Why or why not?
• Series of steps taken by an individual to determine the
v Is an unknown in decision-making problem
best course of action to meet their needs
v It has a domain, which is compact representation of the set of
• Business context à steps taken by mangers to determine
possible values variables
planned path for business initiative and set specific actions
v Decision making variables types are references to object whose
in motion
exact nature depends on the underlying optimizer of a model
STEPS IN DECISION MAKING
CRITICAL ASPECTS OF PROBLEM 1. Identify goals
SOLVING AND DECISION MAKING 2. Gather information for weighing options
v New research suggests that gender also plays a role in how
3. Consider consequences
individuals make decisions
4. Make your decision
v Creativity doesn’t lead to company invention and growth,
5. Evaluate your decision
innovation does
v Innovation does not happen without creative people
TRADITIONAL PROBLEM-SOLVING PROCESS
1. Identify the problem.
GENDER 2. Gather data to identify the causes and consequences of the
v New research suggests that gender also plays a role in how
problem.
individuals make decisions Disadvantage :
3. Explore alternative solutions. Lengthy process
v Women
-

lesseffective at time constraints

-

4. Evaluate each alternative.

• Frontal lobe (problems solving) & limbic cortex
5. Select appropriate solution.
(emotions) are larger in women
6. Implement the solution.
• Think more with white matter à work faster
7. Evaluate the results.
v 6.5 times more grey matter in men (think more w/ grey
matter)

RIGHT BRAIN VS LEFT BRAIN DOMINNACE

v Some people fail to use any type of systematic examination of
the problem or its alternatives for solution.

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Requisites for successful leadership and management NCM 119
NURSING PROCESS BY IDA JEAN ORLANDO
(1950S) Managerial Decision Making Models
1.) ASSESS 1.) Nursing process ( Adpie )
2.) DIAGNOSE 2.)
3.) PLAN
4.) IMPLEMENT
5.) EVALUATE > Analyze Alternatives
using SWOT

3.) Integrated Ethical

STRATEGIES TO PROMOTE EVIDENCE BASED problem solving Model

BEST PRACTICE
v Implement and evaluate nationally sanctioned clinical practice
guidelines.
v Question and challenge nursing traditions and promote a spirit
of risk taking. 4.) Intuitive decision Making Model
Intuition should
v Dispel myths and traditions not supported by evidence.
•
be use in
conjunction nl empericae 7 rational decision
making
•
Intuition is rapid automatic
process recognizing familiar
v Collaborate with other nurses locally and globally. 7 using experience to
find solution
of problems instantly

v Interact with other disciplines to bring nursing evidence to the •

Recognition Primed Decision CRPD) model by Klein (2008 )

table

DECISION-MAKING TOOLS
v Decision grids
• Allows one to visually examine the alternatives and
compare each against the same criteria
• Maybe useful when changing method of managing care on
> prevent confirmation Bias
a unit
v Payoff tables
• Cost-profit-volume relationship
• Very helpful when some quantitative information is
available such as items cost or predicted used
v Decision trees
• Decisions are often tied to the outcomes of other events
v Consequence tables
• Demonstrate how various alternatives create different
consequences
• Lists objectives for solving problem down one side of a
table and rate how each alternative would meet the
desired objective
v Logic models
• Schematics or pictures of how programs are intended to
operate
v Program evaluation and review technique (PERT)
• Determine timing of decisions
• Booz-Allen-Hamilton
•
Flowchart that
predicts when events crew

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