Decision Making in Paramedic - Reasoning Pathway of Each of the Crew Members - Assignment Example

Decision Making in Paramedic - Reasoning Pathway of Each of the Crew Members In a paramedic emergency, each crewmember making decision on the diagnosis of the situation can be influenced based on the reasoning pathway taken in the case. In most cases, paramedics make decisions based on thinking patterns that they have learned in prior or are familiar with. This kind of thinking pathway is influenced by intuitive decision-making. Intuitive / pattern decision-making can thus be termed as a process by which information that is acquired through associated learning is stored in a long term memory and accessed unconsciously to form the basis of decision-making (Gigerenzer 2011, pp.451–482). Joshua in making his decision concerning the diagnosis of Samuel settles on the diagnosis to be a severe asthma attack with possible musculoskeletal involvement. Intuitively, this decision could be influenced by his learning and work exposure. As a volunteer firefighter, Joshua might have probably been influenced by the cases he had witnessed in other paramedical emergencies that befitted the same diagnosis. Tanya in her decision of settling on the diagnosis of Samuel to be an asthma attack could be influenced by the pattern reasoning based on policy guidelines that she has been part of its development. This could equally be influenced by the fact that Tanya had not been exposed to a significant number of situations where asthma exists with other comorbid conditions (Frederick 2005, pp.25–42). Hypothetico-deductive reasoning can be used in the situation of Samuel as a means of elimination of other potential diagnoses. Hypothetico-deductive reasoning model employs the scientific model in elimination of the unfavorable or undesirable decisions. The model involves setting of hypothesis then testing the feasibility of the hypothesis to arrive at a decision (Sprenger 2011, pp.497). Application of Hypothetico-deductive reasoning would first entail use of experience in making the diagnosis. The decision maker would consider the problem and attempts to make sense out of the situation. The person then gathers data and look for previous explanation that may be related to the problem. The second step is the formation of hypothesis; prediction of the feasibility of the hypothesis is then determined to ascertain its accuracy. The process then resolves with testing of the hypothesis. Testing of the hypothesis is done by looking for evidence and through observation that will help in eliminating other potential diagnosis and helps the decision maker to arrive at the best possible diagnosis. Application of Hypothetico-deductive reasoning in the case of Samuel would help the paramedics to eliminate potential diagnosis of angina and asthma as they would be distinctively be eliminated through hypothesis testing process (Guerrero et al. 2005, pp.1343). Question 2 Influence of knowledge and experience in decision-making According to (Considine et al. 2007, pp.725) Knowledge and experience have a crucial role in decision-making especially in the paramedical work. Decision-making in a paramedical situation will be different between a novice and an experienced practitioner. A novice practitioner is an individual who is relatively new to the practice area, and his or her decisions are influenced more by knowledge acquired through the learning experience at school. On the other hand, an experienced practitioner is an individual with vast knowledge and skills in the practice area, and his or her decisions are greatly influenced by skills acquired through practice. The decision made by Joshua pertaining the diagnosis of Samuel is greatly influenced by his five years’ experience working as a volunteer firefighter and ambulance officer as well as working as a paramedic. The working experience of Joshua gives provides a high chance of exposing him to paramedical cases where he had witnessed other patients probably with the same condition and managed in a similar manner using oxygen, nebulization, and positioning. In the case of Samuel, Tanya is more of a novice practitioner in comparison to Joshua. The decisions made by Tanya to arrive at the diagnosis of the situation to be an asthma attack is influenced more by her educational experience other than the skills acquired through practice. Owing to the fact that Tanya has in the recent past been working with her team leader to develop materials for internship and being a member of a policy development committee, she is influenced more by literature sources more than the acquired skills (Nicolas 2004, pp.29). Question 3 Hypothetico-deductive versus intuitive reasoning The knowledge level determines the capability of for application for clinical decision-making. The more advanced, the learner is, the reasoning process become, it, therefore, implies that more advanced and skilled practitioners would employ an analytical method as an influence in decision making while the less experienced practitioners would employ the intuitive decision making approach. Intuitive reasoning is categorically important to the novice practitioners as it helps in saving of time. The intuitive decision-making model does not require a present ideas and knowledge in making decision rather would benefit from the observed traits that are related to the cognitively stored information in the subconscious mind to reach a decision (Ribarsky et al. 2009, pp.254–262). Nevertheless, intuitive decision-making model is more prone to error as the decision made is not based on any factual evidence that can be proven by scientific methods. Additionally, intuitive decision-making is prone to suffer biases, as it would majorly depend on the prior subconsciously stored information by the decision maker, which may not be applicable in all decision-making situations. Analytical decision-making, on the other hand, is important, as the decision is made based on scientifically proven and tested traits that lead to making of exact and concrete decisions especially in the medical situations. However, critics of analytical decision-making point at considerable cognitive resources that are needed to perform analysis as a major source of error that may make the method lead to poor decision-making (Patel & Arocha 2004, pp 32). Question 4 Factors influencing clinical decision-making According to Callaghan (2012, pp 223), decision pertaining the diagnosis and treatment of Samuel’s condition is influenced both by interpersonal and environmental factors. The nature with which the patient presents could be a factor that is responsible for the decision-making pertaining to the diagnosis of the condition. Being a child, Samuel could be presenting with exacerbated signs and symptoms of asthma that may motivate the paramedics to make an overrated situation of diagnosis. Severity of signs and symptoms majorly affects the novice decision makers who are not exposed to a variety of ways through which a particular condition presents. Psychological and social factors are equally critical influences in decision-making. Making a diagnosis of the condition of Samuel by the two paramedics is chiefly influenced by past medical and diagnostic situations that have psychological implications on the decisions made by the paramedics. The position Samuel sits (leaning forward) has a psychological implication of the decision made by Joshua to support positioning as an intervention for the treatment. Together with signs and symptoms the patient presents with, the decision made by the paramedics are affected by social and psychological factors (Gunnarsson & Warrén Stomberg 2009, pp 83). References Nicolas , Rolland , 2004. Knowledge management impacts on decision making process. Journal of Knowledge Management, 8, pp.20–31. Callaghan, K.S.N., 2012. Factors influencing diagnostic decision-making. Journal of Primary Health Care, 4, pp.223–230. Considine, J., Botti, M. & Thomas, S., 2007. Do Knowledge and Experience Have Specific Roles in Triage Decision-making? Academic Emergency Medicine, 14, pp.722–726. Frederick, S., 2005. Cognitive Reflection and Decision Making. Journal of Economic Perspectives, 19, pp.25–42. Gigerenzer, G. & Gaissmaier, W., 2011. Heuristic decision making. Annual review of psychology, 62, pp.451–482. Guerrero, J.C., Vargas, J.M. & Real, R., 2005. A hypothetico-deductive analysis of the environmental factors involved in the current reptile distribution pattern in the Canary Islands. Journal of Biogeography, 32, pp.1343–1351. Gunnarsson, B.M. & Warrén Stomberg, M., 2009. Factors influencing decision making among ambulance nurses in emergency care situations. International Emergency Nursing, 17, pp.83–89. Patel, V.L. & Arocha, J.F., 2004. Thinking and Reasoning in Medicine. In Cambridge Handbook of Thinking and Reasoning. pp. 1–34. Ribarsky, W., Fisher, B. & Pottenger, W.M., 2009. Science of analytical reasoning. Information Visualization, 8, pp.254–262. Sprenger, J., 2011. Hypothetico-Deductive Confirmation. Philosophy Compass, 6, pp.497–508. Read More