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

particular course of action. Encarta World English Dictionary (2009a) defines

decision making as the process of making choices or reaching conclusions
(para 1). Both defi nitions imply that there was doubt about several courses of
action and that a choice was made that eliminated the uncertainty.
Problem solving is part of decision making and is a systematic process that
focuses on analyzing a diffi cult situation. Problem solving always includes a
decision-making step.
Decision making, on the other hand, is usually triggered by a problem but is
often handled in a manner that does not focus on eliminating the underlying
problem. For example, if a person decided to handle a confl ict crisis when it
occurred but did not attempt to identify the real problem causing the confl ict,
only decision-making skills would be used.
Critical thinking, sometimes referred to as refl ective thinking, is related to evaluation
and
has a broader scope than decision making and problem solving. Dictionary.com (2009)
defi nes
critical thinking as the mental process of actively and skillfully conceptualizing,
applying,
analyzing, synthesizing, and evaluating information to reach an answer or conclusion
(para 1).

Decision making, one step in the problem-solving process, is an important task

that relies heavily on critical thinking skills.
The Marquis-Huston Model for Teaching Critical Thinking assists in achieving desired
learner outcomes (Fig. 1.1). Basically, the model comprises four overlapping spheres,
each
being an essential component for teaching leadership and management. The fi rst is a
didactic
theory component, such as the material that is presented in each chapter; second, a
formalized
approach to problem solving and decision making must be used. Third, there must
be some use of the group process, which can be accomplished through large and small
groups and classroom discussion. Finally, the material must be made real for the learner
so that the learning is internalized. This can be accomplished through writing exercises,
personal exploration, and values clarifi cation, along with risk-taking, as case studies are
examined.

Traditional Problem-Solving Process

One of the most well-known and widely used problem-solving models is the
traditional
problem-solving model. The seven steps follow. (Decision-making occurs at step
5.)
1. Identify the problem.
2. Gather data to analyze the causes and consequences of the problem.
3. Explore alternative solutions.

4. Evaluate the alternatives.

5. Select the appropriate solution.
6. Implement the solution.
7. Evaluate the results.
Although the traditional problem-solving process is an effective model, its
weakness lies in
the amount of time needed for proper implementation. This process, therefore, is
less effective
when time constraints are a consideration. Another weakness is lack of an initial
objectivesetting
step. Setting a decision goal helps to prevent the decision maker from becoming
sidetracked.

Managerial Decision-Making Models

To address the weaknesses of the traditional problem-solving process, many
contemporary
models for management decision making have added an objective-setting step.
These models
are known as managerial decision-making models or rational decision-making
models.
One such model suggested by Decision-making-confi dence.com (n.d.) includes
the following
steps:
1. Determine the decision and the desired outcome (set objectives).
2. Research and identify options.
3. Compare and contrast these options and their consequences.
4. Make a decision.
5. Implement an action plan.
6. Evaluate results.

The IDEALS Model

A more contemporary model for effective thinking and problem solving was developed by

Facione (2006). The IDEALS model, as it came to be known, includes six steps for
effective
thinking and problem solving. While similar to the models already presented, the
mnemonic
IDEALS makes this model easy to remember and use:
Identify the problem. Whats the real question were facing here?
Defi ne the context. What are the facts and circumstances that frame this problem?
Enumerate choices. What are our most plausible three or four options?
Analyze options. What is our best course of action, all things considered?
List reasons explicitly. Lets be clear: Why are we making this particular choice?
Self-correct. Okay, lets look at it again. What did we miss? (p. 22).
Many other excellent problem analysis and decision models exist. The model selected
should be one with which the decision maker is familiar and one appropriate for the
problem
to be solved. Using models or processes consistently will increase the likelihood that
critical
analysis will occur. Moreover, the quality of management/leadership problem solving and
decision making will improve tremendously via a scientifi c approach.

DECISION-MAKING TOOLS
There is always some uncertainty in making decisions. However, management analysts
have
developed tools that provide some order and direction in obtaining and using information
or
that are helpful in selecting who should be involved in making the decision. Because
there
are so many decision aids, this chapter presents selected technology that would be most
helpful
to beginning- or middle-level managers, including decision grids, pay-off tables, decision
trees, consequence tables, logic models, and program evaluation and review technique
(PERT).
It is important to remember, though, that any decision-making tool always results in the
need for the person to make a fi nal decision and that all such tools are subject to human
error.
Beinhocker, Davis, and Mendonca (2009, p. 58) agree, suggesting that while data,
computing
power, and mathematical models have transformed many realms of management from
art
to science, that the economic downturn experienced worldwide late in the fi rst decade
of the
21st century, pointed out the folly of the reliance by banks, insurance companies, and
other
on fi nancial models that assumed economic rationality, linearity, equilibrium, and bellshaped
distributions. Beinhocker et al. point out that while it would be wrong to eliminate the
use of
such tools, they caution managers to look inside the black boxes that advanced
quantitative
tools often represent so that they can better understand their functioning, assumptions,
and
limitations (p. 58).

Decision Grids
A decision grid allows one to visually examine the alternatives and compare each against
the

same criteria. Although any criteria may be selected, the same criteria are used to
analyze each
alternative. An example of a decision grid is depicted in Figure 1.3. When many
alternatives have
been generated or a group or committee is collaborating on the decision, these grids are
particularly
helpful to the process. This tool, for instance, would be useful when changing the method
of
managing care on a unit or when selecting a candidate to hire from a large interview
pool. The unit
manager or the committee would evaluate all of the alternatives available using a
decision grid. In
this manner, every alternative is evaluated using the same criteria. It is possible to
weight some of
the criteria more heavily than others if some are more important. To do this, it is usually
necessary
to assign a number value to each criterion. The result would be a numeric value for each
alternative
considered.

Payoff Tables
The decision aids known as payoff tables have a costprofi tvolume relationship and are
very
helpful when some quantitative information is available, such as an items cost or
predicted
use. To use payoff tables, one must determine probabilities and use historical data, such
as a
hospital census or a report on the number of operating procedures performed. To
illustrate, a
payoff table might be appropriately used in determining how many participants it would
take
to make an in-service program break even in terms of costs.
If the instructor for the class costs $400, the in-service director would need to charge
each
of the 20 participants $20 for the class, but for 40 participants, the class would cost only
$10
each. The in-service director would use attendance data from past classes and the
number of
nurses potentially available to attend to determine probable class size and thus how
much to
charge for the class. Payoff tables do not guarantee that a correct decision will be made,
but
they assist in visualizing data.

Decision Trees
Because decisions are often tied to the outcome of other events, management analysts
have
developed decision trees.
The decision tree in Figure 1.4 compares the cost of hiring regular staff with the cost of
hiring
temporary employees. Here, the decision is whether to hire extra nurses at regular salary
to perform outpatient procedures on an oncology unit or to have nurses available to the
unit