Critical Decision-making Skills Research Articles

The ATLS® Course: Empowering Healthcare Professionals for Excellence in Trauma Care.

The Advanced Trauma Life Support (ATLS) course has become an indispensable tool in preparing health care professionals to provide optimal trauma care.
 This article highlights the impact of the ATLS course on empowering healthcare professionals for excellence in trauma care.
 By providing a standardized framework, enhancing critical decision-making skills, and promoting interdisciplinary collaboration, the ATLS course equips practitioners with the knowledge and skills necessary to effectively respond to trauma emergencies. Additionally, the course prepares healthcare professionals for the unpredictable nature of trauma care through simulation-based training and fosters a culture of continuous professional growth.
 Through its emphasis on standardization, critical thinking, and continuing education, the ATLS course plays a vital role in improving patient outcomes and establishing a foundation for excellence in trauma care.
 Conclusion: The ATLS course stands as a testament to the commitment of healthcare professionals to provide excellent trauma care. It empowers practitioners with the necessary knowledge, skills, and standardized approach to save lives in the critical moments following traumatic events.

A Model “Critical Decision-Making Model”, Case-Study of Ghana, West Africa

Introduction: Security and Police organizations in West Africa do not have Critical Decision-making Models to guide the Officer in deciding the Use of Force option. The various Security and Police Services do not appear to place emphasis on ethical policing leading to officer extrajudicial killing and rent- seeking behaviors. Method: Using Ghana’s legal framework on the use of force as a case study, author conducted desk-top review of Critical Decision-making Models of other jurisdictions and did content analysis of Ghana’s Incident and Public Order Management Manual, and Use of Force Order, GPS 004-15 as well as the legislative and Constitutional exceptions and immunities for the use of force. Author conducted twenty interviews opportunistically with police officers for validation. Finding: Police Organizations like the Ghana Police Service, have “Incident and Public Order Management Manual”, designed “to provide direction and information to assist commanders, planners, advisors to prepare for and manage events where there is risk to public safety…” It is a generic Standard Operating Procedure, SOP for incident management. They also have an SOP on the Use of Force, listing the events during which force can be used. These documents do not detail issues of proportionality. There is no emphasis on Critical Decision-making in the training of officers in the Use of Force evaluation. Modalities for risk assessment, and de-escalation of threat levels are not part of the SOP or Incident and Public Order Management. The Police in West Africa have negative public image, accused of being trigger happy, brutal in conducting arrests, and corrupt, which could be the result of the lack of adequate training on ethical policing, familiarity with Critical Decision-making skills, the position of the law on the use of force and accountability. Recommendations: The author has proposed a Critical Decision-making Model, admonished police organizations in West Africa, to create country specific models that are simple, functional, and least restrictive in conducting and controlling the offender during arrests. Conclusion: The author anticipates the proposed model or its derivatives would influence police training on Critical Decision-making, as an essential tool for law enforcement.

Analysis of entrepreneurial implementation intention on vocational education student at Universitas Padjadjaran: An Empirical Analysis

Entrepreneurship is an innovative and creative process that can add value to products, create job opportunities, raise productivity, revitalize, and diversify markets, improve social welfare, and, more broadly, develop the economy. Entrepreneurship education encourages the founding of new businesses by students and alums and equips them with critical decision-making skills that enhance the success of graduates in the job market. That is why we seek to develop better entrepreneurs. Part of that is raising their intentions to start a business; another is making their intentions more realistic. To do both requires a deeper, richer understanding, and analysis of an entrepreneurial implementation intention in vocational education students is essential. In this study, researchers want to know what variables affect Entrepreneurial Implementation Intention in vocational education students at Universitas Padjadjaran. The results of this study found that Entrepreneurial Knowledge affects the main determinant of this research to encourage the increase of Entrepreneurial Implementation Intention.

Simulation-Based Learning, an Essential Tool for Control Process in Food Engineering Education

Abstract Simulation-based learning has become an essential tool for food engineers in education and industry. The students from food engineering higher education usually have difficulties to understand abstract concepts of the process control, to make links among microbiology, biochemistry and automation of the technological process from food industry. The present paper describes a methodology for teaching the process control by developing a control level process using simulation-based learning. The used of this metode highlighted that the students developed competence toward “thinking like a scientist”, developed argumentation and critical decision-making skills and reinforced research-planning and experimental design skills.

Implementation of Critical Threshold Concept in Clinical Transplantation: A New Horizon in Distance Learning

<p><strong><em>Background: </em></strong><em>While variations in medical practice are a norm and each patient poses a multitude of challenges, many clinicians are not comfortable in dealing with unexpected complex issues even though they may have enough knowledge as demonstrated by passing a number of tricky certifying (or exit) examinations.</em><em> </em><em>One reason for the lack of self-efficacy, even if being endowed with good knowledge, is that we are not good in learning from errors. A regular reflective practice offers superb learning opportunities when a clinician is </em><em>“</em><em>stuck in a mire</em><em>”</em><em>. Difficult clinical situations warrant a flexible and,</em><em> </em><em>at the same time,</em><em> </em><em>an evidence-based approach</em><em> </em><em>to ensure that</em><em> </em><em>crucial decision-making process is correct and efficient. Each clinical case offers a great opportunity to reinforce these </em><em>“</em><em>threshold concepts</em><em>”</em><em>, however</em><em>, not everyone of us is “blessed” with these crucial not-so-difficult-to-acquire skills so necessary to be a life-long learner. </em></p><p><em>The faculty of this course (a totally on-line MSc in Transplant Sciences) aims for unceasing engagement with students in order to facilitate them to negotiate through </em><em>“</em><em>stuck places</em><em>”</em><em> and </em><em>“</em><em>tricky bends</em><em>”</em><em> in their own work place. This course, not just meant for knowledge transfer, provides a platform</em><em> </em><em>that allows participants (the students and faculty) to learn from each other’s experience</em><em> </em><em>by using </em><em>“</em><em>e-blackboard</em><em>”</em><em>.</em><em> </em><em>The mainstay of this course are twofold: (a) Emphasis on achieving critical decision-making skills</em><em>,</em><em> (b) Regular feedback to allow reflective practice</em><em> </em><em>and, thereby, constantly learning from errors and reinforcing good practices. The aim of this article is to assess the performance of educators and how well the </em><em>“</em><em>ethos of critical threshold</em><em>”</em><em> has been accepted from the perspective of students. </em></p><p><strong><em>Methods:</em></strong><strong><em> </em></strong><em>The critical thresholds</em><em> </em><em>of each</em><em> </em><em>chapter in 4 modules</em><em> </em><em>of this totally on-line course were defined to a razor-sharp precision.</em><em> </em><em>Learning objectives of learning activity were</em><em> </em><em>defined to achieve constructive alignment with critical threshold. We employed level 1,</em><em> </em><em>2, 4 and 5 of Kirkpatrick pyramid</em><em>, </em><em>(a) for the</em><em> </em><em>evaluation of performance of educators of program, and (b) to evaluate the acceptance of this non-traditional format in clinical medicine education by postgraduate 80 students in 22 countries.</em><strong><em></em></strong></p><p><strong><em>Results:</em></strong><em> Students’ survey (Kirkpatrick level 1) was done only for module 1 of cohort 1 reported students’ satisfaction rate of 93%. Excluding a total of 12 drop-outs in 2 modules (n=10 in first cohort’s module 1, and n=2 in module 2), as many as 93% of</em><em> </em><em>students of first cohort</em><em> </em><em>passed module. Nine out of 60 registrants of module 1 in 2nd cohort took recess for one year requesting to join back as a part of 3rd cohort commencing one year later, all 51 who continued passed though 3 of them had to resit. All those who passed module 1 (both cohorts) and 2 (1st cohort) registered for their respective next module (return on investment Kirkpatrick level 5). </em></p><strong><em>Conclusion: </em></strong><em>For a successful model in distance learning in clinical transplantation it is imperative for the students to accomplish well defined “critical-decision making” skills. In order to learn critical thresholds, a regular feedback is integral to learning from reflective practice. This course equips the students to develop skills of negotiating “sticky mire”, as obvious from perceived high return of investment.</em>

VFR Into IMC: Using Simulation to Improve Weather-Related Decision-Making

Safety-related training policies restrict pilots from encountering challenging weather during flight training. This potentially inhibits the development of critical decision-making skills. To identify gaps in weather-related flight training, high-fidelity weather-simulation was developed to re-create historical weather events. Sixteen visual-only pilots and 16 instrument-rated pilots flew a simulated cross-country flight under visual flight rules in marginally visual weather that encountered instrument conditions. Procedural performance and experience-related demographic factors were analyzed to identify key flight skills and experience that contributed to safe weather-related decisions. Previous experience with actual instrument weather was found to be the only statistically significant demographic predictor of safe performance. Pilots who performed more safely were more likely to use in-cockpit weather information during the flight to detect and avoid instrument weather. Implications of this study and opportunities for future research are discussed.

The effectiveness of tools used to evaluate successful critical decision making skills for applicants to healthcare graduate educational programs: a systematic review protocol

The effectiveness of tools used to evaluate successful critical decision making skills for applicants to healthcare graduate educational programs: a systematic review protocol

Individual Differences in Decision‐making Competence

Throughout their lives, people make decisions about their health, finances, and environmental impacts. Research on decision-making competence examines the decision-making skills people need to improve their real-world decisions and to obtain better life decision outcomes (Bruine de Bruin, Parker, & Fischhoff, 2007; Parker & Fischhoff, 2005). If critical decision-making skills can be improved through teaching and decision support, this research ultimately brings the promise of designing interventions that improve the outcomes of people's decisions and, hence, their overall quality of life. In addition to having practical implications, research on decision-making competence contributes important theoretical and methodological insights to the field of judgment and decision-making. Theoretically, research on decision-making competence improves our understanding of the cognitive and non-cognitive processes that shape people's ability to make decisions, as well as their development throughout the lifespan (for reviews, see Bruine de Bruin, Parker, & Fischhoff, 2011; Finucane & Lees, 2005; Peters & Bruine de Bruin, in press; Peters, Hess, Auman, & Vastfjall, 2007). Methodologically, research on decision-making competence aims to improve the reliability of commonly studied judgment and decisionmaking tasks, seen in consistent performance across decision problems, as well as their validity, seen in relationships to obtaining better life decision outcomes. Moreover, it stimulates the use of more sophisticated data analysis methods, in particular, model comparison techniques (e.g., Tomlinson, Marewski, & Dougherty, 2011). Despite its potential promise, the topic of individual differences in decision-making competence has received relatively little attention in the field of judgment and decision-making. Possibly, this scarcity is due to researchers having traditionally focused on identifying decision-making biases, and on the situational conditions rather than the individual differences that contribute to these biases. Furthermore, studying individual differences often requires access to diverse populations that vary in their decision-making competence and life experiences, and the means to recruit samples that are large enough to provide statistical power. Moreover, validating individual-differences measures poses the challenge of identifying objective criterion variables that provide unambiguous evidence of good decision-making (Finucane & Lees, 2005; see also Stanovich & West, 2000). Possibly, researchers have also been discouraged by studies on individual differences in decision-making styles, which have identified few stable personal characteristics that consistently affect decision-making across tasks and contexts (Appelt, Milch, Handgraaf & Weber, 2011). Yet, the few studies that have examined individual differences in decision-making competence have shown the feasibility of overcoming these challenges (Appelbaum & Grisso, 1988; Del Missier, Mantyla & Bruine de Bruin, 2011; Finucane et al., 2002; Finucane & Guillon, 2010; Finucane & Lees, 2005; Finucane, Mertz, Slovic, & Schmidt, 2005; Parker & Fischhoff, 2005; Smith, Shanteau, & Johnson, 2004), with recent work introducing valid and reliable instruments targeting various age groups (Bruine de Bruin et al., 2007; Finucane & Guillon, 2010; Parker & Fischhoff, 2005). This special issue of the Journal of Behavioral Decision-Making aims to swell interest in decision-making competence through the presentation of novel research efforts.

Breaking News: Simulation Drives Innovation in Teaching, Learning, and Clinical Practice

Breaking News: Simulation Drives Innovation in Teaching, Learning, and Clinical Practice

Cybersex and the E‐teen: What Marriage and Family Therapists Should Know

Adolescents who use the Internet regularly (the "e-teen") present a new set of challenges for marriage and family therapists. This article introduces marriage and family therapists to (a) the basic technological concepts and unique psychological characteristics of the Internet important in understanding and addressing adolescent online sexual behavior, (b) the appropriate developmental expectations for teens online, including risk-taking behaviors and critical decision-making skills, and (c) suggested strategies for assessment, prevention, and intervention when dealing with problematic online sexual behavior in adolescents. Marriage and family therapists cannot ignore the role the Internet plays in adolescent sexual development and its implication for the family. This article will serve as a primer for the marriage and family therapist when presented with adolescents who engage in online sexual behaviors.

The introduction of nurse-initiated thrombolysis in coronary care

Nurse-initiated thrombolysis has emerged as an organizational strategy to improve the delivery of thrombolytic agents to patients suspected of having an acute myocardial infarction. This article will outline the evolution of nurse-initiated thrombolysis on the coronary care unit in the authors' trust and present data on the critical decision-making skills of those nurses who have expanded their practice. Patients who were assessed, and whose thrombolysis was initiated by a nurse designated to deliver this treatment, had "door-to-needle" times consistent with the current targets of the National Service Framework for Coronary Heart Disease (Department of Health (DoH), 2000). A cardiologist acting as a "gold standard" reviewed the assessments of the first 50 patients seen by nurses able to deliver thrombolysis, finding each treatment decision appropriate. This gives support to the notion that appropriately trained and experienced nurses can assess and make treatment decisions in this acute care situation.

Training Complex Tasks in a Functional Context

We have reviewed training programs for complex skills that have strong decision-making components, such as nuclear power plant operations and air traffic control. In each case, we found that an ISD approach is routinely applied to training-program design. The ISD framework can aid training designers in designing individual modules of instruction but seems to provide insufficient guidance on designing the larger training-program structure. We found two types of problems. First, because a good understanding of skill acquisition is not used to drive training-program design, training activities can be ineffective or inefficient. Second, because it is difficult to get insights on cognitive skills with traditional task analysis, the core decision-making task is not trained explicitly. Trainees are typically on their own to discover decision-making skills. We developed an alternative framework for training-program design called the Functional Context Approach. This approach attempts to restore efficiency to skill acquisition and improve training of critical decision-making skills.

Teaching critical decision-making skills to students concerning patients with acute abdominal pain

The clinical performance of junior hospital staff concerning the management of patients with acute abdominal pain, may be enhanced by placing greater emphasis on teaching clinical decision-making skills during the pre-intern year. Final year medical students at the Royal Prince Alfred Hospital (RPAH) took part in a teaching session where groups of 6–8 rotated through six stations, each structured to present a critical management problem concerning a patient with acute abdominal pain. Students, guided by a tutor, spent 25 minutes at each station, working through the sequence of data acquisition and data analysis before making a management decision. To assess the educational value of the programme, the study group completed a sequence of pre-test, structured teaching and post-test over a period of 2 weeks. Their multiple choice question (MCQ) performance was compared with a control group from a different campus who also did the pre-and post-test but without the teaching. The study group (n = 38) significant...

Exploring the use of computer simulation to teach critical decision-making skills to pediatric nursing students.

I T IS vitally important that even beginning nurses have the ability to make appropriate judgements and effectively problem-solve in the care of their clients. The extent to which nursing students are given opportunities to learn both the theory and practice of critical decision-making skills depends on available time as well as on the choice of educational strategies used. Since it is well known that instructional time in nursing education is severely limited, essential factual material delivered by straight lecture is almost a practical necessity. Yet we expect students to make appropriate and effective nursing decisions in practice situations based primarily on facts. In addition to this, safety factors prohibit the free exercise of all possible alternatives in actual practice. Therefore, it would seem prudent to investigate the use of simulations (representative cases) in the educational setting. Students would be able to problem-solve independently and safely, thus freeing up instructor time as well as negating severe consequences to actual clients. It is from five basic premises that I explore the use of computer simulation to teach critical decision-making skills to nursing students: ( 1) the complexity of nursing today requires an ability to make critical decisions; (2) critical thinking is a universally expected behavior of professional nurses; (3) critical decision-making