Unit 5 / Decision Making, Problem Solving and Critical Thinking
Session 13 (1 hour)
Objectives
1. Describe definition, concepts and process of Problem solving, decision making and
critical thinking.
2. Describe critical thinking skills and characteristics of critical thinker.
3. Relate critical thinking skill to problem solving and decision-making.
4. Apply critical thinking, problem solving and decision making in nursing practice,
education and administration to ensure quality patient care.
Introduction
Nurse managers are expected to use knowledge from various disciplines to solve
problems with patients, staff and the organization as well as problems in their own
personal and professional lives. They are also constantly faced with the necessity of
making decisions in dynamic situations. Critical thinking helps the nurse managers see all
sides of an issue and look for different and exciting ways to solve problems. Problem
solving is used inconsistently and often interchangeably with decision making in
organizational functions. They are not synonyms although they appear similar and may in
some instances depend on one other. However decision-making is a subset of problem
solving. Decision-making within problem solving results when a dynamic situation is
recognized, using critical thinking skills problem is identified and solution is sought.
Critical thinking thus includes and depends upon decision-making and problem solving
skills, which draw upon creative abilities.
Problem Solving can be defined as a process used when a gap is perceived between an
existing state (what is going on) and between a desired state (what should be going on). A
variety of methods can be used to solve problems.
 Trial and error method: often practiced by managers who lacks management expertise
 Experimentation, reliance on past experience, self-solving etc.
One practical method of problem solving is use of seven-step process:
 Define the problem
 Gather information
 Analyze information
 Develop alternate solutions
 Make a decision
 Implement the decision
 Evaluate the solution
Decision-making can be defined as the systematic process of establishing criteria by
which alternative courses of action are developed and selected. Decision-making is a
necessary component of leadership, power, influence, authority and delegation (John
1993). Decisions call for judgment, which result either in effective and efficient or
inefficient management of patient care. Decision-making and problem solving are
associated with nursing process.
Advantages of systematic approach in Decision Making
A comprehensive and systematic approach in decision making has many advantages:
1. It is characterized by order and direction that enables managers to determine where
they are.
2. Provide framework for data gathering which is relevant to the decision.
3. Allows application of previous knowledge and experiences that minimize errors and
improve patient care.
4. Increase managers confidence and ability to make sound decisions.
Steps in Decision Making Process
Most commonly used mode of the decision making process consists of 6 steps:
Step I :
Identify and define an area of concern.
It is critical before taking any step to take a decision. To be clear about the
problem or concern you are addressing.
Step II :
Gather and Analyze Information.
Try to gather all the necessary information about the problem or concern
in order to accurately understanding the situation. Decisions make without
adequate information would not produce an appropriate result.
In gathering information, the manager depends on good communication
and assessment skills. Once you gather enough information, you will then
analyze and interpret the data. This is an essential step where information
is critically analyzed and dealt with.
Step III :
Establish Goals.
This is an essential step prior to proper planning and taking a decisive
action. At this stage a manager should consider what he needs to
accomplish and when. In addition one should draw specific criteria to
measure the anticipate outcome.
Step IV :
Seek Alternatives.
There are frequently several approaches to any given problem or concern.
The more strategies you generate, the more likely you are to identify an
effective action. Then, from the alternatives you will determine the
appropriate action to be taken. In this phase of the decision making
process, you will use your knowledge, experiences and review the ability
of your team members. Your alternative choice should also be taken into
consideration its consequences. Then choose the alternative which will
most likely achieve the desired outcome.
Step V :
Implement the selected strategy
Once the strategy has been selected, it follows logically that it will be
implemented. In this phase managers should decide who will implement
the decision. It is necessary to know that the manager remains responsible
and accountable for the outcome. Because the manager is still responsible
and accountable for the outcome, he will have to maintain amount of
control over the implementation. A sound communication skill and a clear
guideline is necessary to achieve the expected outcome.
Step VI : Evaluate Outcomes
This is a final step of the decision making process. In this phase, the
manager will compare the actual outcomes from the desired outcome. If
the decision was effective, then the actual matches the desired outcomes.
It not effective, then the situation remains the same or perhaps worse than
the original status.
You may wish to evaluate other factors such as efforts and time and the impact on
staff or organization and ultimately the cost involved. If you were not satisfied, you
will want to consider other alternatives to similar concerns in the future.
If your decision was ineffective you will need to review the steps again. Take into
consideration the following:
1.
Problems/concerns were not correctly identified.
2.
Assessment was not complete or properly analyzed.
3.
Goals were unrealistic
4.
Decision taken without considering other possible alternatives and consequences.
5.
The strategy chosen was incorrectly implemented due to lack of specific
guidelines.
6.
Evaluation of responses was incomplete or situation changed rapidly.
Critical thinking is a human cognitive process of purposeful, self-regulatory judgment,
which results in interpretation, analysis, evaluation and inference as well as an
explanation of the evidence or context upon which the judgment is based.(American
Philosophical Association 1990 Quoted by Facion1994)
Cognitive skills and sub skills of critical thinking:
Cognitive skills
Sub skills & examples
Interpretation:
Comprehend and express
meaning of experiences,
data, situation, event etc.
 Categorization
 Decoding sentences
 Clarifying meaning
eg. Recognize a problem with out bias, categorize and
organize what you are studying, identifying authors purpose,
theme, point of view, etc.
Analysis: identify the
relationship among
statements, questions,
concepts reasons,
descriptions, opinions etc.
 Examining ideas
 Identifying arguments
 Analyzing arguments
e.g. Identifying similarities and differences between two
approaches to the solution of a given problem, unstated
assumptions, constructing a way to represent conclusions.
Evaluation: assess the
credibility of the judgment,
descriptions opinions etc.
 Assessing claims
 Assessing arguments
e.g. comparing strength and weaknesses, source
of information, evidence to support conclusion etc.
Inference: identify and
secure evidence to draw
reasonable conclusions.
 Querying evidence
 Conjecturing (formulate) alternatives
 Drawing conclusions
e.g. securing information needed for synthesis from
multiple source, usefulness to resolve uncertainty.
Explanation: State the
results of ones reasoning to
justify in terms of
evidence, concepts and
context upon the judgment
is based.
 Sating results
 Justifying procedures
 Presenting arguments
e.g. Standards, policies, describe methods, design a graphic
display, to site evidence that led you to accept or reject
authors opinion on an issue, factors for deciding final course
grade etc.
Self-regulation: Self
consciously to monitor
one’s cognitive activities,
questioning, confirming,
validating or correcting
one’s results.
 Self reflection or examination
 Self correction
e.g. Examine your views on controversial issues with
sensitivity, possible influences, biases, self-interest and to
monitor how well you understand and comprehend the issue
and the judgment, realization of the misjudgment etc.
Characteristics of a critical thinker:
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Concern for synthesizing new information,
Remain well-informed,
Inquisitiveness with regard to a wide range of issues,
Trust in the processes of reasoned enquiry,
Alertness to opportunities to use critical thinking skill,
Self-confidence in one’s own abilities to reason,
Open-mindedness regarding divergent world views,
Flexibility in considering alternatives and opinions,
Understanding of the opinions of other people,
Fair-mindedness in appraising reasoning,
Honesty in facing one’s own biases, prejudices, stereotypes, egocentric and
socio-centric tendencies,
 Prudence in suspending, making or altering judgments,
 Willingness to consider and revise views where honest reflection suggests that
change is warranted.
Creative decision-making is important and a supportive management climate is
necessary to turn an average problem solver into ones who develop innovative solutions.