Management decision-making in nursing

This study developed a new, valid and reliable evaluation instrument to measure the level, type and pattern of management decisions of fifteen nursing students. The management decision score achieved using this instrument was correlated with two psychological determinants of management decision making: creativity and problem-solving ability. The instrument was a written patient management problem in case format, answered by a free form written response. The student responses were classified for type of management decision according to the sub-categories of technical, inter-personal, environmental and unique. Using statistical analysis a significant difference was found in the type of management decisions most frequently selected by the study sample. The students predominantly selected technical type decisions. This preference for one type of management decision may be due to a number of psychological and environmental factors. These factors may program and mold the type of management decisions student nurses make early in their career. Low but positive correlations were found between the total management score and the two psychological tests. This finding supports the authors cited in the literature who state that although creativity augments the type of management decision making, it is not present or encouraged widely in the nursing profession. These factors are worth considering when the profession becomes concerned over ritualization and lack of individuality in patient care. The tool is easy to administer, lends itself to a variety of professional settings and shows promise with further refinement for computer application.

A study of ethical decision-making in hypothetical scenarios by secondary school principals /

The purpose of the study,was to investigate the ways in which secondary school principals make decisions that have an ethical dimension, and the reasons they use to justify their choices. The ethical principles and concepts, as well as the scenarios, were adapted from The Ethics ofSchool Administration by Strike, Haller, and Soltis (1998). In this study, 32 secondary principals from a school board in Ontario were asked to complete a descriptive survey which was designed to have principals make administrative decisions in response to 5 hypothetical scenarios. The open-ended questions were expected to elicit responses that were reflective of the principals' actual decision-making strategies. The survey also required them to justify and explain their reasons for each decision. The data were analyzed and 4 major categories ofjustifications emerged: pedagogy, legalism, moral code, and democracy. The results indicate that the decisions made by principals are grounded in various perspectives. While the data did not indicate any explicit knowledge of ethical principles and concepts, the principals' responses suggest sound and valid reasoning for their decision making, addressing the principles and concepts from a variety of viewpoints and using diverse justifications.

Youth Involvement in Organizational Decision Making: The Connection to Youth Initiative and Organizational Functioning

Studying positive adolescent development requires an examination of the mutually beneficial associations between youth and their environment. These youthcontext relations include both the contributions that youth make to others and society and the youth-context interactions that might predict positive youth outcomes. Community and youth-serving organizations, where youth may be involved in decision-making roles such as service delivery, advocacy, or on boards of directors, can provide one important context for youth contributions and for positive adolescent development. Research on the outcomes of youth involvement in organizational decision-making, however, is limited, and largely consists of exploratory qualitative studies. This dissertation is formatted as an integrated article dissertation. It begins with a review of the literature on contexts of structured youth activities and positive youth development. This review is intended to describe theory on development-context relations, in which development is considered an interactive process that occurs between individuals and their contexts, as it pertains the positive development of youth who are involved in various structured activities (e.g., volunteering). This description follows with a review of current research, and conclusions and rationale for the current studies. Following this theoretical and research background, the dissertation includes reports of two studies that were designed to address gaps in the research on youth involvement in organizational decision-making. The first was a qualitative research synthesis to elucidate and summarize the extant qualitative research on the outcomes of youth involvement in organizational decision making on adults and organizations. Results of this study suggested a number of outcomes for service provision, staff, and broader organizational functioning, including both benefits to organizations as well as some costs. The second study was a quantitative analysis of the associations among youth involvement, organizations' learning culture, and youth initiative, and relied on survey data gathered from adults and youth in community-based organizations with youth involvement. As expected, greater youth involvement in organizational decision making was associated with higher learning culture within the organization. Two dimensions of youth involvement, greater program engagement and relationships with adults, were related to greater youth initiative. A third dimension, sense of ownership, was not- .-.- associated with youth's level of initiative. Moreover, the association between relationships with adults and youth initiative was only significant in organizations with relatively low learning culture. Despite some limitations, these studies contribute to the research literature by providing some indication of the potential benefits and costs of youth involvement and by making an important contribution toward the early stages of context-level analyses of youth development. Findings have important implications for practitioners, funders, future research, and lifespan development theory.

Exploring the Ethical Decision-Making Processes of Community Care Providers

While there has been a recent shift away from isolated, institutionalized living conditions, persons with Intellectual Disabilities (ID) may still experience restricted access to choice when it comes to making decisions about the basic aspects of their lives. A tension remains between protecting individuals from harm and promoting their right to independence and personal liberties. This tension creates complex questions and ethical concerns for care providers supporting persons with ID. This study explored the ethical decision-making processes of care providers and specifically, how care providers describe the balance of protecting supported individuals from harm while promoting their right to self-determination. Semi-structured interviews were conducted with six care providers employed by a local community agency that supports young and older adults with ID. Data were analysed using thematic analysis and broader themes were developed following phases of open and selective coding. Results indicated that care providers described ethical decision-making processes as frequent, complex, subjective, and uncomfortable. All participants described the importance of promoting independent decision-making among the individuals they support and assisting supported individuals to make informed decisions. Participants also reported work colleagues and supervisors as primary sources of information when resolving ethical concerns. This suggests that complex ethical decision-making processes are being taken seriously by care providers and supervising staff. The results of this study are well-positioned to be applied to the development of a training program for frontline care providing staff supporting individuals in community care settings.

The Influence of Arousal on Moral Decision-making for Individuals with and without Mild Head Injury

Recent research has shown that University students with a history of self-reported mild head injury (MHI) are more willing to endorse moral transgressions associated with personal, relative to impersonal, dilemmas (Chiappetta & Good, 2008). However, the terms 'personal' and 'impersonal' in these dilemmas have functionally confounded the 'intentionality' of the transgression with the 'personal impact' or 'outcome' of the transgression. In this study we used a modified version of these moral dilemmas to investigate decision-making and sympathetic nervous system responsivity. Forty-eight University students (24 with MHI, 24 with no-MHI) read 24 scenarios depicting moral dilemmas varying as a function of 'intentionality' of the act (deliberate or unintentional) and its 'outcome' (physical harm, no physical harm, non-moral) and were required to rate their willingness to engage in the act. Physiological indices of arousal (e.g., heart rate - HR) were recorded throughout. Additionally, participants completed several neurocognitive tests. Results indicated significantly lowered HR activity at baseline, prior to, and during (but not after) making a decision for each type of dilemma for participants with MHI compared to their non-injured cohort. Further, they were more likely than their cohort to authorize personal injuries that were deliberately induced. MHI history was also associated with better performance on tasks of cognitive flexibility and attention; while students' complaints of postconcussive symptoms and their social problem solving abilities did not differ as a function of MHI history. The results provide subtle support for the hypothesis that both emotional and cognitive information guide moral decision making in ambiguous and emotionally distressing situations. Persons with even a MHI have diminished physiological arousal that may reflect disruption to the neural pathways of the VMPFC/OFC similar to those with more severe injuries.

Social competence following mild head injury and moderate traumatic brain injury: Investigating the neuropsychological relationships between arousal, social decision-making and depression

Client-directed long-term rehabilitative goals and life satisfaction following head injury emphasize the importance of social inclusion, rather than cognitive or physical, outcomes. However, very little research has explored the socio-emotional factors that pose as barriers to social reintegration following injury. This study investigates social barriers following head injury (i.e., decision-making - Iowa Gambling Task [IGT] and mood – depression) and possible amelioration of those challenges (through treatment) in both highly functioning university students with and without mild head injury (MHI) and in individuals with moderate traumatic brain injury (TBI). An arousal manipulation using emotionally evocative stimuli was introduced to manipulate the subject’s physiological arousal state. Seventy-five university students (37.6% reporting a MHI) and 11 patients with documented moderate TBI were recruited to participate in this quasi-experimental study. Those with head injury were found to be physiologically underaroused (on measures of electrodermal activation [EDA] and pulse) and were less sensitive to the negative effects of punishment (i.e., losses) in the gambling task than those without head injury, with greater impairment being observed for the moderate TBI group. The arousal manipulation, while effective, was not able to maintain a higher state of arousal in the injury groups across trials (i.e., their arousal state returned to pre-manipulation levels more quickly than their non-injured cohort), and, subsequently, a performance improvement was not observed on the IGT. Lastly, head injury was found to contribute to the relationship between IGT performance and depressive symptom acknowledgment and mood status in persons with head injury. This study indicates the possible important role of physiological arousal on socio- emotional behaviours (decision-making, mood) in persons with even mild, non-complicated head injuries and across the injury severity continuum.

Educational Technology Decision-Making: A Case Study on Technology Acquisition for 746,000 Ontario Students

Very little research has examined K–12 educational technology decision-making in Canada. This collective case study explores the technology procurement process in Ontario’s publicly funded school districts to determine if it is informed by the relevant research, grounded in best practices, and enhances student learning. Using a qualitative approach, 10 senior leaders (i.e., chief information officers, superintendents, etc.) were interviewed. A combination of open-ended and closed-ended questions were used to reveal the most important factors driving technology acquisition, research support, governance procedures, data use, and assessment and return on investment (ROI) measures utilized by school districts in their implementation of educational technology. After participants were interviewed, the data were transcribed, member checked, and then submitted to “Computer-assisted NCT analysis” (Friese, 2014) using ATLAS.ti. The findings show that senior leaders are making acquisitions that are not aligned with current scholarship and not with student learning as the focus. It was also determined that districts struggle to use data-driven decision-making to support the governance of educational technology spending. Finally, the results showed that districts do not have effective assessment measures in place to determine the efficacy or ROI of a purchased technology. Although data are limited to the responses of 10 senior leaders, findings represent the technology leadership for approximately 746,000 Ontario students. The study is meant to serve as an informative resource for senior leaders and presents strategic and research-validated approaches to technology procurement. Further, the study has the potential to refine technology decision-making, policies, and practices in K–12 education.

Tribunals and Guidelines: Exploring the Relationship Between Fairness and Legitimacy in Administrative Decision-Making

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Analogy in Decision-Making

In the context of decision making under uncertainty, we formalize the concept of analogy: an analogy between two decision problems is a mapping that transforms one problem into the other while preserving the problem's structure. We identify the basic structure of a decision problem, and provide a representation of the mappings that pre- serve this structure. We then consider decision makers who use multiple analogies. Our main results are a representation theorem for "aggregators" of analogies satisfying certain minimal requirements, and the identification of preferences emerging from analogical reasoning. We show that a large variety of multiple-prior preferences can be thought of as emerging from analogical reasoning.

Understanding economic decision-making under social norms prescribing behaviours

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

Heuristic solution methods for multi-attribute vehicle routing problems

Le Problème de Tournées de Véhicules (PTV) est une clé importante pour gérér efficacement des systèmes logistiques, ce qui peut entraîner une amélioration du niveau de satisfaction de la clientèle. Ceci est fait en servant plus de clients dans un temps plus court. En terme général, il implique la planification des tournées d'une flotte de véhicules de capacité donnée basée à un ou plusieurs dépôts. Le but est de livrer ou collecter une certain quantité de marchandises à un ensemble des clients géographiquement dispersés, tout en respectant les contraintes de capacité des véhicules. Le PTV, comme classe de problèmes d'optimisation discrète et de grande complexité, a été étudié par de nombreux au cours des dernières décennies. Étant donné son importance pratique, des chercheurs dans les domaines de l'informatique, de la recherche opérationnelle et du génie industrielle ont mis au point des algorithmes très efficaces, de nature exacte ou heuristique, pour faire face aux différents types du PTV. Toutefois, les approches proposées pour le PTV ont souvent été accusées d'être trop concentrées sur des versions simplistes des problèmes de tournées de véhicules rencontrés dans des applications réelles. Par conséquent, les chercheurs sont récemment tournés vers des variantes du PTV qui auparavant étaient considérées trop difficiles à résoudre. Ces variantes incluent les attributs et les contraintes complexes observés dans les cas réels et fournissent des solutions qui sont exécutables dans la pratique. Ces extensions du PTV s'appellent Problème de Tournées de Véhicules Multi-Attributs (PTVMA). Le but principal de cette thèse est d'étudier les différents aspects pratiques de trois types de problèmes de tournées de véhicules multi-attributs qui seront modélisés dans celle-ci. En plus, puisque pour le PTV, comme pour la plupart des problèmes NP-complets, il est difficile de résoudre des instances de grande taille de façon optimale et dans un temps d'exécution raisonnable, nous nous tournons vers des méthodes approcheés à base d’heuristiques.

Disease, Disparities and Decision Making: Mandatory HIV Testing of Prospective Immigrants to Canada

Étude de cas / Case study

The psychophysics of decision making in a two-direction random dot motion target selection task

La tâche de kinématogramme de points aléatoires est utilisée avec le paradigme de choix forcé entre deux alternatives pour étudier les prises de décisions perceptuelles. Les modèles décisionnels supposent que les indices de mouvement pour les deux alternatives sont encodés dans le cerveau. Ainsi, la différence entre ces deux signaux est accumulée jusqu’à un seuil décisionnel. Cependant, aucune étude à ce jour n’a testé cette hypothèse avec des stimuli contenant des mouvements opposés. Ce mémoire présente les résultats de deux expériences utilisant deux nouveaux stimuli avec des indices de mouvement concurrentiels. Parmi une variété de combinaisons d’indices concurrentiels, la performance des sujets dépend de la différence nette entre les deux signaux opposés. De plus, les sujets obtiennent une performance similaire avec les deux types de stimuli. Ces résultats supportent un modèle décisionnel basé sur l’accumulation des indices de mouvement net et suggèrent que le processus décisionnel peut intégrer les signaux de mouvement à partir d’une grande gamme de directions pour obtenir un percept global de mouvement.