Caught between a rock and a hard place: how project practitioners navigate ethical tensions in decision-making

To establish older women's (≥75years) information preferences regarding 2 breast cancer treatment options: surgery plus adjuvant endocrine therapy versus primary endocrine therapy. To quantify women's preferences for the mode of information presentation and decision-making (DM) style. This was a UK multicentre survey of women, ≥75years, who had been offered a choice between PET and surgery at diagnosis of breast cancer. A questionnaire was developed including 2 validated scales of decision regret and DM preferences. Questionnaires were sent to 247 women, and 101 were returned (response rate 41%). The median age of participants was 82 (range 75 to 99), with 58 having had surgery and 37 having PET. Practical details about the impact, safety, and efficacy of treatment were of most interest to participants. Of least interest were cosmetic outcomes after surgery. Information provided verbally by doctors and nurses, supported by booklets, was preferred. There was little interest in technology-based sources of information. There was equal preference for a patient- or doctor-centred DM style and lower preference for a shared DM style. The majority (74%) experienced their preferred DM style. Levels of decision regret were low (15.73, scale 0-100). Women strongly preferred face to face information. Written formats were also helpful but not computer-based resources. Information that was found helpful to women in the DM process was identified. The study demonstrates many women achieved their preferred DM style, with a preference for involvement, and expressed low levels of decision regret.

Process and Content of Decision Making by Advanced Cancer Patients

Globally-expanding organisations that are trying to capitalise on distributed skills are increasingly using virtual project teams to shorten product development time and increase quality. These virtual teams, which are distributed across countries, cultures, and time zones, are required to use faster and better ways of interacting. Past research has shown that virtual teams that use computer-mediated communication (CMC) instead of face-to-face communication are less cohesive because they struggle with mistrust, controlling behaviour , and communication breakdowns. This study aims to determine whether project practitioners in South Africa perceive virtual teams that use videoconferencing as suffering from the same CMC disadvantages described in past research in other environments; and if they do, what the possible causes could be. This paper reports on a survey of 106 project practitioners in South Africa. The results show that these project practitioners prefer face- to-face communication over CMC, and perceive virtual teams using videoconferencing to be less cohesive and to suffer from mistrust and communication breakdowns, but not from increased conflict and power struggles. The perceived shortcomings of videoconferencing might result from virtual teams that use this medium having less time to build interpersonal relationships.

While shared clinical decision-making (SDM) is the preferred approach to decision-making in mental health care, its implementation in everyday clinical practice is still insufficient. The European Psychiatric Association undertook a study aiming to gather data on the clinical decision-making style preferences of psychiatrists working in Europe. We conducted a cross-sectional online survey involving a sample of 751 psychiatrists and psychiatry specialist trainees from 38 European countries in 2021, using the Clinical Decision-Making Style - Staff questionnaire and a set of questions regarding clinicians' expertise, training, and practice. SDM was the preferred decision-making style across all European regions ([central and eastern Europe, CEE], northern and western Europe [NWE], and southern Europe [SE]), with an average of 73% of clinical decisions being rated as SDM. However, we found significant differences in non-SDM decision-making styles: participants working in NWE countries more often prefer shared and active decision-making styles rather than passive styles when compared to other European regions, especially to the CEE. Additionally, psychiatry specialist trainees (compared to psychiatrists), those working mainly with outpatients (compared to those working mainly with inpatients) and those working in community mental health services/public services (compared to mixed and private settings) have a significantly lower preference for passive decision-making style. The preferences for SDM styles among European psychiatrists are generally similar. However, the identified differences in the preferences for non-SDM styles across the regions call for more dialogue and educational efforts to harmonize practice across Europe.

BackgroundDialysis is often initiated in the United States without exploring patients' preferred decision-making style, and conservative kidney management (CKM) is infrequently presented. To improve kidney therapy (KT) decision-making, research on nephrologists' comfort with various decision-making styles, attitudes towards CKM, and reports of patients' lived experiences with KT decision-making is needed.MethodsWe surveyed 28 nephrologists and 58 of their patients aged ≥75years. The nephrologist survey was designed to gauge their comfort levels with decision-making styles and attitudes towards CKM. The patient survey assessed experiences in making KT decisions.ResultsThe average age of nephrologists was 43years, and that of patients was 82years. Nephrologists rated themselves as comfortable with various decision styles: paternalistic (60.7%), shared decision-making (92.8%), and patient-driven decision-making (67.8%). Nearly 57% of nephrologists felt challenged or were neutral in determining CKM's suitability, and 39% reported difficulties in discussing CKM with patients or were neutral. Only 38 % of patients recalled discussing CKM with their nephrologists, and a minority reported discussing CKM-related topics such as life expectancy (24.7%), quality of life (QOL) (45.1%), and end-of-life care (17.5%).ConclusionsMost nephrologists displayed comfort with various decision-making styles; however, many described difficulties in guiding patients toward CKM. In contrast, patients reported gaps in vital aspects of KT decision-making and CKM choices, such as discussions of life expectancy, QOL, and end-of-life care. Raising awareness of blind spots in decision-making skills and educating nephrologists in KT decision-making to include CKM and other person-centered aspects of care are needed.

Previous studies have indicated a predominance of passive decision-making styles among women with early-stage breast cancer in the UK offered a choice between breast-conserving surgery (BCS) and mastectomy. The aim of this study was to determine current decision-making styles and establish their association with operation choice and breast unit mastectomy rate. A questionnaire survey was conducted among women from three specialist breast units representing high, medium and low case mix-adjusted mastectomy rates. Of 697 consecutive patients, 356 (51.1 per cent) completed the questionnaire, a mean of 6.9 (range 1.3-48.6) weeks after surgery. Some 262 women (73.6 per cent) underwent BCS and 94 (26.4 per cent) had a mastectomy. Some 218 patients (61.2 per cent) achieved their preferred decision-making style. The proportions of women achieving an active decision-making style were high, particularly for those choosing mastectomy (83 versus 58.0 per cent for BCS; P < 0.001) and in the high mastectomy rate unit (79.6 versus 53 and 52.2 per cent for medium and low rate units respectively; P < 0.001). More women chose an active decision-making style than in previous UK studies. The provision of greater treatment selection autonomy to women suitable for BCS may not reduce mastectomy rates.

Decision-making between mental health clinicians and patients is under-researched. We tested whether mental health patients are more satisfied with a decision made (i) using their preferred decision-making style and (ii) with a clinician with the same decision-making style preference. As part of the CEDAR Study (ISRCTN75841675), a convenience sample of 445 patients with severe mental illness from six European countries were assessed for desired clinical decision-making style (rated by patients and paired clinicians), decision-specific experienced style and satisfaction. Patients who experienced more involvement in decision-making than they desired rated higher satisfaction (OR=2.47, P=0.005, 95% CI 1.32-4.63). Decisions made with clinicians whose decision-making style preference was for more active involvement than the patient preference were rated with higher satisfaction (OR=3.17, P=0.003, 95% CI 1.48-6.82). More active involvement in decision-making than the patient stated as desired was associated with higher satisfaction. A clinical orientation towards empowering, rather than shared, decision-making may maximise satisfaction.

A Review of:&#x0D; Serrano, S. C. &amp; Avilés, R. A. (2016). Academic librarians and project management: An international study. portal: Libraries and the Academy, 16(3), 465-475. http://dx.doi.org/10.1353/pla.2016.0038&#x0D; &#x0D; Abstract&#x0D; &#x0D; Objective – To investigate academic librarians’ project management education and training, project management skills and experiences, and perceptions of project management courses within the library and information science (LIS) curriculum.&#x0D; &#x0D; Design – Online questionnaire.&#x0D; &#x0D; Setting – 70 universities worldwide with LIS programs and at least one project management course. &#x0D; &#x0D; Subjects – 4,979 academic librarians were invited to complete the online questionnaire; 649 librarians participated.&#x0D; &#x0D; Methods – From the identified institutions, the authors invited academic librarians to participate in a 17-question survey via e-mail. The survey was available in both English and Spanish and was validated via a pilot trial. A total of 649 individuals participated, for a response rate of 13%. The survey included questions related to geographic region and institution affiliation, university education and librarian training associated with project management, project participation and use of project management software or methods, and project management courses in LIS curriculums, and a final open-ended comment section. &#x0D; &#x0D; Main Results – Of the 649 librarians who participated in the survey, 372 were from North and South America (58%). The next highest number of responses came from Europe (38%), followed by low response rates from Africa, Asia, and Oceania. Respondents reported working in a variety of library departments and identified themselves as being one of a director or manager, assistant librarian, or library page. Of the 436 respondents who reported having a university degree, 215 attended an LIS Master’s level program, and 12 studied at the doctoral level. The majority of respondents indicated they have had training in project management, participating in formal coursework, conferences, webinars, or other self-directed learning methods. Of the 459 academic library staff responding to the question, 40% considered project management courses of “high importance in the university curriculum” and 26 % responded that project management courses were “extremely important in their field of expertise and working environment” (p. 472). The consensus among participants was that project management courses should be included in both undergraduate and graduate level LIS curricula.&#x0D; &#x0D; Conclusion – The high participation of librarians in project management, compared to the limited formal education received, suggests that courses in project management, including software and methodology, are needed in LIS university curricula. Additionally, less than 40% of academic librarian survey respondents were trained in LIS; other professions are working as librarians and therefore may have insufficient knowledge and skills to manage the projects they direct. The research results confirm the relationship between strategic planning and project management skills. The authors conclude that universities should revise their LIS curricula to include and require additional project management courses.

BackgroundResearch has shown that traditional medicine and Traditional Health Practitioners (THPs) represent the first line of healthcare for the majority in sub-Saharan Africa (SSA). In this context, understanding traditional beliefs...

Aim. To study the content characteristics of responsibility of police officers with different decision-making styles.Methodology. The main method was the method of psychodiagnostics, implemented using the following methods: the Melbourne Decision-making Questionnaire, the method of "Multidimensional functional Diagnostics of responsibility" by V. P. Pryadein. The methods of mathematical data processing were frequency analysis and correlation analysis by R. Spearman.Results. The study determines how strongly the characteristics of the different components of responsibility are represented. It is revealed that the dominant decision-making style of police officers is a sense of vigilance. The relationship between vigilance as a style of decision-making with stenic emotionality and the ability to overcome difficulties has been established. The relationship between vigilance and dynamic ergidity, cognitive meaningfulness, subject performance, stenic emotionality, regulatory internality and ability to overcome difficulties has been proved.Research implications. Taking into account the existing theoretical provisions on the problem under study, the substantive characteristics of police officers' responsibility in the relationship with the way they prefer to make decisions were determined. The obtained data expand the understanding of the psychological characteristics of specialists in the studied professional field. These data can be used by psychologists to support specialists in their professional self-determination, to predict success and identify risks in the process of their professional development.

Background: The Diabetes Prevention Program (DPP) showed that lifestyle change or metformin is equally efficacious in preventing diabetes in women who have had gestational diabetes mellitus (GDM). Few studies have investigated the relationship between education and willingness to engage in either intervention and between education and preferred decision-making style.Methods: Within a large health system, we surveyed insured women 18–64 years old with a history of GDM, identified through the electronic health record. We estimated preference for decision-making style and interest in DPP lifestyle change and/or metformin by educational level, using multivariate logistic regression models controlling for age, race, and ethnicity.Results: Our sample (n = 264) was 36% Latino, 29% Asian, 28% non-Latino white, and 5% African American, with a mean age of 37 years. In terms of education, 31% had a postgraduate degree, 41% were college graduates, and 29% did not graduate from college. In multivariate analyses, willingness to engage in either intervention did not vary by education. Women who did not graduate from college were more likely to leave medical decisions to their provider (p = 0.004) compared to women with a college or postgraduate degree. However, regardless of education, over 80% of women preferred to make medical decisions themselves or jointly with their provider.Conclusions: Most women prefer to play an active role in their own medical decisions and have an interest in both evidence-based diabetes prevention strategies. This suggests that shared decision-making is appropriate for many women with a history of GDM and different levels of educational attainment.

Treatment options for female stress urinary incontinence (SUI) are often offered in a stepped-care approach. However, the shift towards patient-centred care and shared decision making (SDM) has prompted an increased interest in patients' perceptions of treatment decision making. This scoping review maps the available qualitative research on women's perceptions of the treatment decision-making process for SUI and identifies knowledge gaps. This scoping review was performed according to the Preferred Reporting Items for Systematic review and Meta-Analysis guidelines. Three databases were searched using a systematic search strategy, without restriction in publication date or language. After thorough screening, 19 of the initial 3,473 publications were included. Four themes were identified; pre-existing experiences and notions that women bring to the consultations (things women consider before their consultation); treatment and patient characteristics (treatment aspects and personal values patients deem important); aspects of the consulting health care professional and facilities (availability of treatment options and counselling styles of physicians); ways of reaching a decision (three different ways that women used to make their decision. There were gaps in the literature on aspects affecting women's treatment preferences, their preferred decision-making style and how they want to be involved in this decision-making process. This scoping review provides a global overview of women's perceptions on and preferences for treatment for SUI, and highlights a lack of knowledge on women's ideas of the treatment decision process. To provide clinicians with better guidance for their counselling and decision-making approaches, studies on women's perceptions of the decision-making process and the different decision-making styles are needed.

This paper examines the factors that influence the quality of training and education on project management. The authors present the results of two questionnaire-based surveys. The goal of the first survey was to find what factors influence the quality of project management education, according to the perspective of trainers, professors, and training providers. The respondents included Chinese and European academics and professionals, such as project managers, software developers, financial managers and professors. The respondents were not only involved in project management training but also served as team members or team managers, thus ensuring a balanced overview of theoretical and practical issues. The goal of the second survey was to explore the definition “quality” to trainees and students. Although there were small differences of perspective, both trainers and trainees have the same approach toward a qualitative project management education.

IntroductionDuring past two decades project management has become one of the most popular management concepts mainly because of its applicability across industries (Whittington et al., 1999; Bryde, 2003; Lenfle, Loch, 2010). Various authors (e.g. Aram, Noble, 1999; Jaafari, 2003; Ives, 2005) agree that a key benefit of project management is its flexibility and ability to deal with complex problems, uncertainty and chaos. Its wide applicability and flexibility, as well as its capacity for quick response and numerous tools and techniques that can be employed during all phases of projects, enabled project management to displace traditional structures such as divisional and functional structures (Kerzner, 2010; Davies et al., 2011).The Project Management Institute (PMI), one of the top professional associations in the world, identified seven project-intensive industries in which it expects the greatest growth of need of the project manager role. PMI (2013) states that just in those seven industries, between 2010 and 2020, nearly 16 million project managers will be needed worldwide. This demonstrates that the spread of project management practice has not stopped and that there is the potential for further application of project management across industries.The continuous spread of project management is connected with a major problem - the project failure rate is high. Studies (Chong, 1993; Zimmerer, Yasin, 1998; e.g. Johnson, 2009; Pfeifer, 2010; Chen, Bozeman, 2012) show that, in general, approximately 7 out of 10 projects fail. Of these failed projects, 60% to 70% are caused by human factors, particularly insufficient leadership by project manager and poor risk management. With the rising number of project-based companies and institutions mentioned proportions of project failures have not been improving. Authors (Winter et al., 2006; Atkinson, 2008; Ojiako et al., 2011; Egginton, 2012) agree that project manager education needs a paradigm shift because the current methods of education no longer reflect needs of the practice.On the one hand institutions across sectors have become aware of the importance of project management education and training (Winter et al., 2006; Egginton, 2012). On the other hand, institutions doubt the economic effectiveness of investment in employee education and training (McLinden, 1995; Wang, 2003; Lien et al., 2007). The crucial question for institutions is whether project management training would have an impact on project failure rates (Starkweather, Stevenson, 2011). The main focus of project management training on so-called hard skills has been questioned and authors agree on the importance of soft skills in relation to improvement of project failure rates. Another key discipline that is emphasized is project risk management (Pant, Baroudi, 2008; Buganza et al., 2013; Ramazani, Jergeas, 2014).Risk management should be an integral part of project management. In project management we deal only with pure risk; that is, the risk of not completing the project (Davies, 2006; Tichý, 2006; Smejkal, Rais, 2006; Chapman, Ward, 2007). An enormous number of projects (approximately more than half of unsuccessful projcests) are unsuccessful for reasons given in the appropriate application of risk management to anticipate and solve. As regards the public sector, it is even more pronounced (Pfeifer, 2010; Chen, Bozeman, 2012).Project risks can be classified as follows. The first division is based on the fact whether the risk arises within the project or company or whether it comes from the environment (Smejkal, Rais, 2006; Tichý, 2006; Kafka, 2009). These risks are further divided into:* Internal risks coming or arising within the project or entity which realizes the project. These risks may be favourably affected by the project manager's appropriate intervention.* External risks coming from the external environment and which the project manager cannot control. …

Training of project managers: current practice and future developments in Denmark