HP5: CRITICAL THINKING AND PROBLEM-SOLVING AND SCIENTIFIC APPROACH
Decision Making, Problem Solving, Critical Thinking ...
Transcript of Decision Making, Problem Solving, Critical Thinking ...
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Decision Making, Problem Solving, Critical Thinking & Clinical
Reasoning
Definitions
Decision making is a complex, cognitive process often defined as choosing a particular course of action
Problem solving is part of decision making. A systematic process that focuses on analyzing a difficult situation. Problem solving always includes a decision-making step
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Critical Thinking (reflective thinking): is a mental process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and evaluating information to reach an answer or conclusion. It involves both cognitive and affective components
Clinical Reasoning: Integrating and applying different types of knowledge to weigh evidence, critically think about arguments and reflect upon the process used to arrive at a diagnosis. It uses both knowledge and experience to make decisions at the point of service.
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Vicarious learning to increase PS and DM skills
Case studies
Simulation
Problem-based learning
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Theoretical Approaches to PS &DM
Most individuals rely on discrete, often unconscious processes known as heuristics: (use trial and error or rule-of- thumb) quick PS
A structured approach The best way to make quality decisions: prevents trial and error, focus on alternatives and increases clinical reasoning. (apply theoretical models)
1. Identify the problem
2. Gather data
3. Explore alternatives
4. Evaluate the alternatives
5. Select the appropriate
solution
6. Implement the solution.
7. Evaluate the results
1.Traditional Problem-
Solving Process
Weakness
The amount of time needed for proper implementation.
Lack of an initial objective-setting step.
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Eliminates the weakness of the traditional model by adding a
goal-setting step
1. Determine decision & set objectives
2. Identify options
3. Compare options & consequences
4. Make a decision
5. Implement action plan
6. Evaluate results
2. Managerial Decision-Making Models
3. The Nursing Process
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Theoretical Approaches to PS & DM
Decision-Making Process
Identify the decision
Collect data
Identify criteria for decision
Identify alternatives
Choose alternative
Implement alternative
Evaluate steps in decision
Simplified Nursing Process
Assess
Plan
Implement
Evaluate
State problem
Collect info & analyze problem
Develop, analyze
alternatives
Select, justify alternative
Develop strategies to implement
Evaluate and prevent
occurrence
4.Integrated ethical PS model
• Requires the identification of strategies to prevent problem
recurrence
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5.Intuitive DM model
Is a rapid, automatic process of recognizing familiar problems instantly and using experience to identify solutions
Use of gut feeling to take appropriate action that impact outcomes
Should be
founded on scientific knowledge
Used in conjunction with evidence-based practice
Used when time is limited or systematic DM is not possible
Critical Elements in PS and DM Define Objectives Clearly Gather Data Carefully
Setting, problem (what and where, when), who is affected, what is happening, underlying issues, consequences…
Take the time necessary Use an evidence-based approach Generate Many Alternatives
At least two ↑ Number of people working on the problem. Brainstorming
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Think Logically Draw inferences from information People think illogically in 3 ways:
Overgeneralizing: A has a characteristic >> all As are the same Affirming the consequences: B is good then
A is bad Arguing from analogy: A is present in B
then A & B are alike Choose and Act Decisively
Individual Variations In D M Gender o Men & women have different structures and wiring in the
brains and use brains differently: Parts of frontal lobe, limbic cortex and white matter are larger in women. Grey matter is larger in men
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Values consciously or subconsciously values influence
perception, information gathering, processing and final outcome address or ignore problems
Life Experience
e.g. ↑ life experience → ↑ alternatives. Good or bad previous decisions affect future
decisions. Autonomy more experience for DM
Individual Preference Preferring one alternative over another due to: Individual risks such as physical, economic, and emotional risks, and time and energy expenditures.
Brain Hemisphere Dominance and Thinking Style
Analytical thinker: linear, left-brain thinkers (think Systematically)
Intuitive thinker: creative,, right-brain thinkers (think intuitively)
Organization needs all types of thinkers
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Overcoming Individual Vulnerability in Decision Making Values Values clarification decreases confusion, through
understanding their personal beliefs and feelings Life experience Use available resources, Involve other people, Analyze
decisions Individual Preference self-awareness, honesty, and risk taking Individual Ways of Thinking Use both types of thinkers, use group process, talking
management problems over with others, and developing whole-brain thinking
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Qualities of Successful Decision Makers: Courage Sensitivity Energy Creativity
Decision Making in Organizations
Effect of Organizational Power on Decision Making
Decisions of powerful people in organizations → congruent with their own preferences and values.
People having little power in organizations → consider the preference of the powerful.
The powerful also can inhibit the preferences of the less powerful.
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Decision Making in Organizations
Rational and Administrative Decision Making
Economic Man (Rational)
Administrative Man
Economic Man (Rational)
Very rational decisions.
Complete knowledge of the problem or decision situation.
Complete list of possible alternatives.
Rational system of ordering preference of alternatives.
Selects the decision that will maximize utility function
Administrative Man
Decisions that are good enough.
Knowledge is always fragmented.
Impossible to predict all alternatives accurately.
Usually chooses from among a few alternatives.
The final choice is “satisficing” rather than maximizing.
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Decision Making Tools
Decision Grid
Allows one to visually examine the alternatives and compare each against the same criteria.
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Decision Making Tools
Payoff Tables
Have a cost – profit relationships and the probabilities of certain outcomes using current information and historical data.
Decision Trees
Is a graphic method that can help managers visualize the alternatives available, outcomes, information needs for a specific problem over time.
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Decision Making Tools
Consequence Tables
List the objectives for solving a problem down one side of a table and rates how each alternative would meet the desired objective.
Objectives for problem
solving
Alternative 1 Alternative 2 Alternative 3
1. Reduce the number of falls
2. Meets regulatory standards
3. Is cost effective
4. Fits present policy guidelines
Decision Score
X
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X
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Decision Making Tools
Logic Models
Schematic or picture of how program is intended to operate. Schematic includes resources, processes, and desired outcomes and depicts exactly what the relationships are between the three components.
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Decision Making Tools
Program Evaluation and Review Technique (PERT)
A flowchart that predicts when events and activities must take place if a final event is to occur.
Network system model for planning and control under uncertain conditions.
See figure 1-5
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Pitfalls in Using Decision Making Tools
Confirmation Bias: is a tendency to affirm one’s initial impression and preferences as other alternatives are evaluated.
Individuals past influence current decisions
Biases can be reduced by using correct decision making style and involving others when appropriate.