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Decision making is a complex, cognitive process often de ned as choosing a

particular course of action. Encarta World English Dictionary (200a! denes

decision making as "the process of making choices or reaching conclusions#

(para $!. %oth de nitions imply that there &as dou't a'out several courses of

action and that a choice &as made that eliminated the uncertainty.

ro'lem solving is part of decision making and is a systematic process that

focuses on analy)ing a di* cult situation. ro'lem solving al&ays includes a

decision+making step.

Decision making, on the other hand, is usually triggered 'y a pro'lem 'ut is

often handled in a manner that does not focus on eliminating the underlying

pro'lem. or example, if a person decided to handle a con- ict crisis &hen it

occurred 'ut did not attempt to identify the real pro'lem causing the con- ict,

only decision+making skills &ould 'e used.

Critical thinking, sometimes referred to as ref ective thinking, is related to evaluationandhas a 'roader scope than decision making and pro'lem solving. Dictionary.com (200!de nescritical thinking as "the mental process of actively and skillfully conceptuali)ing,applying,analy)ing, synthesi)ing, and evaluating information to reach an ans&er or conclusion#(para $!.

Decision making, one step in the pro'lem+solving process, is an important task

that relies heavily on critical thinking skills.

 he Marquis-Huston Model or Teaching Critical Thinking assists in achieving desiredlearner outcomes (ig. $.$!. %asically, the model comprises four overlapping spheres,each'eing an essential component for teaching leadership and management. he rst is adidactictheory component, such as the material that is presented in each chapter/ second, aformali)edapproach to pro'lem solving and decision making must 'e used. hird, there must'e some use of the group process, &hich can 'e accomplished through large and smallgroups and classroom discussion. inally, the material must 'e made real for the learnerso that the learning is internali)ed. his can 'e accomplished through &riting exercises,personal exploration, and values clari cation, along &ith risk+taking, as case studies areexamined.

 raditional ro'lem+olving rocess

1ne of the most &ell+kno&n and &idely used pro'lem+solving models is the

traditional

pro'lem+solving model. he seven steps follo&. (Decision+making occurs at step

.!

$. 3dentify the pro'lem.

2. 4ather data to analy)e the causes and conse5uences of the pro'lem.

6. Explore alternative solutions.

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7. Evaluate the alternatives.

. elect the appropriate solution.

8. 3mplement the solution.

9. Evaluate the results.

:lthough the traditional pro'lem+solving process is an e;ective model, its

&eakness lies in

the amount of time needed for proper implementation. his process, therefore, is

less e;ective

&hen time constraints are a consideration. :nother &eakness is lack of an initial

o'

$. Determine the decision and the desired outcome (set o'

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acione (2008!. he IDEALS odel, as it came to 'e kno&n, includes six steps fore;ectivethinking and pro'lem solving. While similar to the models already presented, themnemonic3DE:A makes this model easy to remem'er and use>Identi! the "ro#le. "WhatBs the real 5uestion &eBre facing hereC#

De$ ne the conte%t . "What are the facts and circumstances that frame this pro'lemC#Enuerate choices. "What are our most plausi'le three or four optionsC# Anal!&e o"tions. "What is our 'est course of action, all things consideredC#List reasons e%"licitl! . "AetBs 'e clear> Why are &e making this particular choiceC#Sel-correct . "1kay, letBs look at it again. What did &e missC# (p. 22!.=any other excellent pro'lem analysis and decision models exist. he model selectedshould 'e one &ith &hich the decision maker is familiar and one appropriate for thepro'lemto 'e solved. sing models or processes consistently &ill increase the likelihood thatcriticalanalysis &ill occur. =oreover, the 5uality of managementleadership pro'lem solving anddecision making &ill improve tremendously via a scienti c approach.

DECISION-MAKING TOOLS here is al&ays some uncertainty in making decisions. Fo&ever, management analystshavedeveloped tools that provide some order and direction in o'taining and using informationorthat are helpful in selecting &ho should 'e involved in making the decision. %ecausethereare so many decision aids, this chapter presents selected technology that &ould 'e mosthelpfulto 'eginning+ or middle+level managers, including decision grids, pay+o; ta'les, decision

trees, conse5uence ta'les, logic models, and program evaluation and revie& techni5ue(E?!.3t is important to remem'er, though, that any decision+making tool al&ays results in theneed for the person to make a nal decision and that all such tools are su'

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same criteria. :lthough any criteria may 'e selected, the same criteria are used toanaly)e eachalternative. :n example of a decision grid is depicted in igure $.6. When manyalternatives have'een generated or a group or committee is colla'orating on the decision, these grids areparticularly

helpful to the process. his tool, for instance, &ould 'e useful &hen changing the methodof managing care on a unit or &hen selecting a candidate to hire from a large intervie&pool. he unitmanager or the committee &ould evaluate all of the alternatives availa'le using adecision grid. 3nthis manner, every alternative is evaluated using the same criteria. 3t is possi'le to&eight some of the criteria more heavily than others if some are more important. o do this, it is usuallynecessaryto assign a num'er value to each criterion. he result &ould 'e a numeric value for eachalternativeconsidered.

Payof Tables he decision aids kno&n as "a!o' ta#les have a costHpro tHvolume relationship and areveryhelpful &hen some 5uantitative information is availa'le, such as an itemBs cost orpredicteduse. o use payo; ta'les, one must determine pro'a'ilities and use historical data, suchas ahospital census or a report on the num'er of operating procedures performed. oillustrate, apayo; ta'le might 'e appropriately used in determining ho& many participants it &ouldtaketo make an in+service program 'reak even in terms of costs.

3f the instructor for the class costs I700, the in+service director &ould need to chargeeachof the 20 participants I20 for the class, 'ut for 70 participants, the class &ould cost onlyI$0each. he in+service director &ould use attendance data from past classes and thenum'er of nurses potentially availa'le to attend to determine pro'a'le class si)e and thus ho&much tocharge for the class. ayo; ta'les do not guarantee that a correct decision &ill 'e made,'utthey assist in visuali)ing data.

Decision Trees%ecause decisions are often tied to the outcome of other events, management analystshavedeveloped decision trees. he decision tree in igure $.7 compares the cost of hiring regular sta; &ith the cost ofhiringtemporary employees. Fere, the decision is &hether to hire extra nurses at regular salaryto perform outpatient procedures on an oncology unit or to have nurses availa'le to the

unit