PARA313 - Advanced Decision Making

Year

Credit points

Campus offering

Prerequisites

Teaching organisation

Unit rationale, description and aim

It is critical that all healthcare professionals understand the concepts and principles of decision making in a health care setting. Health care professionals encounter situations and problems that require expedient, insightful and competent decision making to achieve optimal patient outcomes. Contemporary approaches to professional, legal and ethical aspects of clinical decision making are explored in this unit. Skills developed in this unit assist students to start building an understanding of decision making theory and practice which will guide their future performance as a health care professional.

This unit provides opportunity for the student to develop and expand further knowledge, skills and knowledge of decision making in health care practice. Theoretical and practical aspects of advanced decision making are considered in the context of paramedicine, and other relevant interdisciplinary areas of health care. Approaches to advanced clinical assessment and actual and potential factors that influence accuracy of assessment data and possible implications for professional practice will be considered.

Students will be provided with the opportunity to apply a critical thinking approach to advanced decision making in the clinical setting and to explore the role of the paramedic in applying person-centred, culturally sensitive and informed decision making.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Describe contemporary theories and approaches to decision making in health care practice; (GA4, 5)

LO2 - Analyse personal and external factors which may influence decision making processes in health care practice; 

LO3 - Justify professional, legal and ethical responsibilities of advanced decision making in extended and specialised health care practice; (GA3)

 LO4 - Analyse clinical decision making tools and demonstrate clinical decision making skills; (GA5)

LO5 - Demonstrate decision making skills in the context of diverse health care settings;

LO6 - Demonstrate the ability to apply a person and/or family-centred approach to delivery of health care. (GA1, 2,  3,  4,  5, 6)

Graduate attributes

GA1 - demonstrate respect for the dignity of each individual and for human diversity 

GA2 - recognise their responsibility to the common good, the environment and society 

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA6 - solve problems in a variety of settings taking local and international perspectives into account

CAA Competency Standards:

The Council of Ambulance Authorities Paramedic Professional Competency Standards developed in this unit are:

Content

Topics will include:

Clinical decision making

• Skills associated with decision making
• Personal and external factors that affect decision making 
• Problem identification and analysis
• Assessment: physical and mental / health care assessments 

Diagnostic reasoning in decision making

• Recognition of cues and analysis of data in health care settings
• Factors influencing collection and interpretation of assessment data/ information
• Hypothesis formation from clinical evidence

Clinical judgements and decision making

• Assessment of alternatives
• Theories of judgement 
• Normative theories
• Descriptive theories
• Prescriptive theories 

Decision making contexts and processes in diverse health care settings

• Scope of practice
• Rural and remote health care
• Primary health care settings

Critical thinking and decision making

• Ways of thinking
• Obstacles to high-quality thinking
• Critical thinking processes / techniques

Decision-making theories

• Bayes’ theory
• Heuristics and hypothetico deductive theory
• Social judgement theory
• Novice to expert 
• Dimensions and differences in decision making theories
• Effectiveness of selected decision-making theories

Principles and practices of decision making

• Assisting people make informed decisions
• Patient involvement in decision making
• Relationship between the health professional and decision making

Techniques and skills to assist in clinical assessment

• Decision making and documentation
• Computerised systems in health care

Professional, legal and ethical responsibilities of advanced decision making in extended and specialised health care practice

• Individual differences and ethical rights in decision making
• Critical appraisal of current approaches to decision making involving mental, social and    cultural assessment of clients from diverse backgrounds and locations, including Aboriginal and Torres Strait Islander peoples.
• Ethical and legal accountability of practitioners

Learning and teaching strategy and rationale

This unit is delivered to practising paramedics who generally work rotating shifts. As such the unit is delivered fully online to allow the flexibility required by students who may not be able to attend on campus or in synchronous mode. As students are currently paramedic practitioners, a teaching and learning strategy which places them at the centre by drawing upon their own experiences best meets the learning needs of this cohort. This unit requires students to undertake 150 hours of focused learning to achieve the unit learning outcomes. 

Flexible asynchronous online learner-centred lessons are used to support student learning. There is a particular focus on the construction of knowledge via an online discussion portfolio. Case study methodology is also utilized within this unit to provide an opportunity for students to apply their understanding of clinical decision making.

Assessment strategy and rationale

In order to successfully complete this unit, students need to complete and submit three graded assessment tasks. The assessment strategy used allows students to progressively develop their knowledge and skills to the level of sophistication where they are able to synthesize and apply their knowledge and understanding of decision making frameworks in a written assignment.

The discussion portfolio enables students to discuss, explore and articulate their thoughts and opinions to demonstrate their depth of knowledge in advanced decision making theory and techniques through group learning strategies. The case study enables students to apply values, knowledge, skills and attitudes in the area of advanced decision making through active learning strategies. The written assignment provides the opportunity for students to consolidate knowledge developed throughout the unit and to think critically and reflectively on issues in clinical decision making.

Overview of assessments

Representative texts and references

Ackley, B.J, Ladwig, G. B., & Flyn Makic, M.B. (2017). Nursing diagnosis handbook: An evidence- based guide to planning care (11thed.). St. Louis, Missouri: Elsevier.

Baron, J. (2008). Thinking and deciding (4th ed.). New York: Cambridge University Press. 

Craig, J., & Smyth, R. (2012). The evidence-based practice manual for nurses (2nd ed.). Edinburgh: Churchill Livingstone Elsevier. 

Dawes, M., Davies, P., Gray, A., Mant, J., Seers, K., & Snowball, R. (2005).  Evidence based practice: A primer for health care professionals. (2nd ed.). Edinburgh: Elsevier Churchill Livingstone.

Higgs, J., Jones, M., Loftus, S., & Christensen, N. (2008). Clinical reasoning in the health profession (3rd ed.). Philadelphia: Elsevier Limited.

Jasper, M. (2013). Professional development, reflection and decision making in nursing and health care. (2nd ed.). Chichester, West Sus.: Wiley-Blackwell.

Koehler, D., & Harvey, N. (2007). Blackwell handbook of judgement and decision making. Oxford: Blackwell Publishing Ltd.

Rhoads, J., &  Petersen, S.W. (2013). Advanced health assessment and diagnostic reasoning. (2nd ed.)  Burlington, Massachusetts: Jones & Bartlett Learning.

Rubenfeld, M.G., & Scheffer, B. K. (2015). Critical thinking tactics for nurses: Achieving the IOM competencies. Burlington, Massachusetts Jones & Bartlett Learning. 

Taylor, B. (2010). Reflective practice for healthcare professionals: A practical guide. (3rd ed.) 

Maidenhead, U.K.; Open University Press.