https://interimcfo.wordpress.com/2021/01/04/what-they-dont-teach-in-school-decision-making/

Abstract:  This article is a continuation of the theme of ‘What they don’t teach in school.’ The subject of this article is the importance of the development of your decision-making skill.

In my article on career advancement, I observed the correlation between decision-making ability, career, and income level.  So how do you improve your decision making or cognitive ability?  Several strategies have proven successful for many people.  Unfortunately, most of them require doing something that can be very hard – exercising and expanding your brain.  Ziglar, Foreman others have argued that most of us rarely use more than 10% of our intellectual capacity at any given time so we have plenty of unexploited potential.  So how do you develop your cognitive capability?  One thing for me was taking courses in software development.  The most challenging course I encountered in college was a computer programming course that I took as an elective!  Computers do not do what you intend; they do exactly what you tell them.  Computer programming requires the development of precise and highly structured instruction sets.  The skillset required to develop computer code has excellent application to problem-solving that goes along with improved decision making.

One day, I was sitting in a conference room in a Catholic hospital listening to debate about whether or not to buy upgraded lights for neurosurgery operating rooms or continue pouring money into a failed clinical program.  The longer this discussion went on, the more frustrated I became.  Finally, when I could take no more, I accused the leadership team of decision making on a scale that ran from the Ouija Board to a Magic Eight Ball.  The reaction that provoked surprised me.  I had no idea Catholics did not like Ouija Boards, and I had heard about being excoriated by a Nun, but I had not yet had the experience.  I asked the Nun whether or not she thought it was important for a neurosurgeon to be able to see what he was doing in the OR?

Interestingly, some of the young people in the room had no idea what a magic eight ball was.  In the ensuing discussion, I reminded the leadership team that their continuing, collective engagement in non-evidence-based, politicized, expeditious decision-making was too often focused on non-strategic initiatives or lost causes instead of pursuing the best interests of the institution and its patients.  I told the group that this type of reasoning was one of the primary reasons the organization had come to make my acquaintance in the first place.  I am lucky I did not get fired on the spot, but everyone in that room that day learned something.  For the leadership team, the lesson was that they had to resolve to do a better job making decisions.  I have argued that an organization’s performance, however that is measured, is a direct function of the efficacy of the leadership team’s decision-making.  To this day, I keep a Magic Eight Ball on my desk.  It reminds me of my innocent dispassion about Catholics’ sensitivity to something as simple as an Ouija Board and my admonition to that leadership team and myself never to stop improving decision-making capability.

Another of the things that have helped me a lot is the study of ‘sadistics.’ I know.  The mediocre performance of my first and second articles on this topic is sufficient evidence of how well accepted this idea is.  I will not try to sell you on this idea again other than observing that statistics arose from the need for an objective structure to analyze and interpret data.  If this is not improved decision making, I do not know what is.

Self-study helps decision making.  There are books, articles, and other resources available for research to better understand topics that you do not comprehend as well as you envision.  Two of my favorite resources are Wikipedia and YouTube.  What you can find is amazing.  While some concepts can be hard to read and grasp at first, academic articles can be beneficial, especially if you understand the underlying statistical analysis.  In an earlier post, I referenced an article on Normative Decision Theory by Chua.  This research looks into how people make decisions in the absence of complete information.  When was the last time you had complete information at the point you had to make a decision?  There is never enough time or information. Decisions regularly occur in situations where data is incomplete and may be inaccurate.  Improving your ability to make better calls in this fog is crucial to leadership at higher levels.

To be sure, collegiate courses help improve your cognitive abilities, although plenty of University programs fall way short of achieving cognitive gains in decision-making ability among their graduates.  I think the issue is not so much with what you know but how well you learn to apply academic and theoretical intelligence to real-world problems and challenges.  Everyone would be better served if more university programs offered courses focused on applied decision making.  My practice has convinced me that one of the critical factors that lead to unacceptable organizational performance is a consistent track record of decision making that does not produce the expected results.

In undergraduate school, I took an elective course on logic.  I can’t remember what I was thinking when I made this decision, but like many of my electives, this one ended up requiring a disproportionate amount of time and energy.  However, the return on investment has been immense.  Not only did I learn a lot about disciplined decision making, I learned how to spot flaws in arguments whose logic is not sound.  The study of logic is vital if you ever intend to spend time developing computer code.

Since college, I discovered philosophy, which most liberal arts students have in their core curriculum.  You could spend a lifetime studying Socrates, Aristotle, and other philosophers that advanced society by advocating for the cause of beneficial argument and probing assumptions.  If you haven’t already done so, I highly recommend you pick up a copy of Plato and let me know if it changes your life.

Finally, the University of Alabama at Birmingham’s Doctorate in Healthcare Administration program mantra is, ‘Evidence-Based Decision Making in Healthcare Administration.’ As is the case in other disciplines, academics worldwide are conducting research in healthcare administration and continually publishing learning that is beneficial to practitioners.  Sadly, I cannot remember a case where a leader stopped a team in the process of making a decision and sent them to the literature to find all available evidence on the topic before committing to a course of action.  Then they are surprised when things do not work out as they expect?

One of the ironies of healthcare is that physicians and other clinicians are deeply ingrained with objective, evidence-based decision-making theory and practice.  One of the reasons that clinicians get so frustrated with healthcare administrators is when they see what appears (accurately) to them be malaise in organizational decision-making.  A couple of one-liners come to mind.  The road to failure is paved with good intentions.  The road to disaster is littered with run-over squirrels.

The upshot of all of this is that your preparation for higher stakes decision making supports career advancement aspirations.  I promise you that anything you do to improve your decision-making ability will serve you very well long into the future.

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