Cognitive Bias In Decision Making And Leadership Styles Among Critical Care Nurses At Prince Hamza Hospital, Jordan: A Mixed Methods Study
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Date
2016-06
Authors
Ibrahim Al Qudah, Hani Nawaf
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Addressing the many challenges of critical care nursing requires unbiased decision making and leadership. Yet little is known about the relationship between decision making among critical care nurses (CCNs), and the cognitive bias that influences decision making and leadership styles in Jordan. This study aimed to address this knowledge gap by exploring cognitive bias in decision making and leadership styles among Jordanian CCNs.
A mixed methods approach was employed, with a survey of 96 CCNs (quantitative) followed by in-depth interviews with 20 CCNs (qualitative) at Prince Hamza Hospital, Jordan. Descriptive and simple linear regression (SLR) analyses of quantitative data and thematic analysis (constant comparative) of qualitative data generated the findings.
Quantitative findings indicated that CCNs perceived themselves as open-minded, with a mean score of 3.90 and a standard deviation (SD) of 0.37. Their decision making tended toward rationality (mean score 3.23, SD 0.38) compared with experientiality (mean score 3.08, SD 0.31). In regard to leadership styles, the nurses tended to be more democratic in terms of communication styles (mean score 4.26, SD 0.95) compared with authoritative styles (mean score 3.46, SD 1.02). They
chose to be more task-oriented in regard to conflict management styles (mean score 4.79, SD 1.02) compared with relational-oriented styles (mean score 4.12, SD 1.31). There was a correlation between rationality and cognitive bias (r = 0.845, P-value < 0.001), rationality and task-oriented leadership styles (r = 0.272, P-value = 0.007), cognitive bias and democratic communication styles (r = 0.247, P-value = 0.015), and cognitive bias and relational-oriented leadership styles (r = 0.268, P-value = 0.008). Simple linear regression showed a significant prediction of higher scores for rationality among CCNs who were open-minded and task-oriented ( = 0.873, 95% CI: 0.760, 0.987, P-value < 0.001 and = 0.101, 95% CI: 0.028, 0.175, P-value = 0.007) but no association was found between the selected independent factors and experientiality. Qualitative findings identified four key factors influencing CCNs‘ cognitive bias in decision making and leadership styles: ―being competent‖, ―organizational structures‖, ―feeling self-confident‖ and ―being supported‖ in the work environment.
The findings led to the conclusion that while CCNs apply critical decision making and strong leadership in their clinical practice, the identified influencing factors had both strengthening and weakening effects on CCNs‘ decision making and leadership styles. Hence, there is a need to develop strategies to facilitate effective, non-biased decision making and leadership styles among CCNs in Jordan.
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Keywords
Knowledge gap by exploring cognitive bias , in decision making and leadership styles among Jordanian.