course materials

1. Collaborative Decision Making & Empowering Nurse Leader
Collaborative Decision Making & Empowering Nurse LeaderCollaborative Decision Making
& Empowering Nurse LeaderTeam Concepts Collaborative decision making: Empowering
nurse leaders By Linda S. Burkett, DNP, MSN, RN, FCN D ecision making is significant to
every professional organization, guiding trajectory and success. Understanding the
complexity of decision making is imperative, as is recognizing the unique human
dimensions inherent in the decision-making process.1-3 Personality type directly influences
how individuals make decisions. For this reason, decision making is an elemental
component of the Myers-Briggs Type Indicator (MBTI), a 93 forced-choice-question
personality assessment tool. Corporations have been using the MBTI for over 60 years to
develop leaders and gain insight to enhance collaboration, team building, problem solving,
career development, management training, counseling, and conflict resolution.
Foundational to the MBTI is Carl Jung’s theory of dichotomous personality types—
extraversion/introversion, energy sensing/intuition, thinking/feeling, and
judging/perceiving—which determine behaviors, inclinations, and priorities, each innate to
decision making and significant to collaborative work.2 Extraversion is a preference for the
outside world, activities, and others. Introversion is a preference for personal thoughts,
memories, and experiences. A sensing preference is characterized by a penchant for facts,
concrete data, and specifics. An intuition preference is characterized by a penchant for
assessing the big picture, focusing on relationships, connections, and identifying patterns.
Thinking reflects a person’s tendency to be objective in decision making, stepping away
from the circumstance to analyze and apply reasoning. Feeling reflects a person’s tendency
to be subjective in decision making, stepping into the circumstance, considering the impact
on all stakeholders’ values, and applying empathy. Judging indicates people who prefer to
organize the world. Collaborative Decision Making & Empowering Nurse LeaderORDER
NOW FOR CUSTOMIZED, PLAGIARISM-FREE PAPERSPerceiving indicates people who
prefer to experience the world.4 Methods The purpose of this study was to assess the
impact of MBTI educational modules for personality type www.nursingmanagement.com
comprehension and application by nurse leaders to enhance collaborative decision making.
A shared governance council at a 228-bed facility within a seven-hospital network in
western Pennsylvania was selected as a pilot study venue. The shared governance council
included full-time formal and informal nurse leaders, representing administration, inpatient
units (orthopedics, psychiatric, oncology, ICU, telemetry, ED), and outpatient radiology. All
members were female, with educational backgrounds that included diploma, associate, BSN,

2. and MSN degrees; a range of years in nursing from 5 to over 20; and a range of years in
nursing leadership from 1 to over 20. Eight of the 10 council members completed the 4-
month study. The sample size was strategic for a deepdive investigation into the topic. A
noted gap in the literature was assimilating personality types into the collaborative
decisionmaking process. The author created a conceptual framework representing the
correlation of personality types to decision-making styles and its impact on leadership
constructs. (See Figure 1.) Without a published tool to specifically measure nurse leader
collaborative decision making enhanced by MBTI application, a leadership training survey
created by Dr. Marc DeSimone was used as a focused assessment. With permission and
consultation, “How Well Do You Participate in Collaborative Decision Making?” was created
as a 10-item assessment, using a 5-point Likert scale (1 = “not at all”; 5 = “very much”). The
tool queried seven constructs of nursing leadership recognized by research findings: trust,
peer appreciation and understanding, collaboration, communication, professional growth,
ethical conduct, and Nursing Management �September 2016 7 Copyright © 2016 Wolters
Kluwer Health, Inc. All rights reserved. Team Concepts evidence-based practice.2,5-8 In
addition, it surveyed three constructs of decision evaluation: value (appropriate merit and
benefit to all stakeholders), expediency (efficient use of time and a defined process), and
pragmatism (practicality of implementing the decision within fiscal and strategic
confines).9 Every effort was made to ensure the assessment’s validity and reliability. This
study employed descriptive content analysis and survey meth- Figure 1: Conceptual
framework4,5,9,10 Decision-making process Subjective expected utility theory + type
theory MBTI personality dichotomies Define problem Extraversion/introversion Focus and
energy Collect data Identify options Sensing/intuition Information and perception Assign
utility/weigh outcomes Project risk Thinking/feeling Evaluation and synthesis Add
stakeholders’ values Make final decision Judging/perceiving Orientation to outer world
Implementation Act on decision Evaluate decision Decision value Constructs of nurse leader
decision making Trust Colleague appreciation and understanding Collaboration
Communication Professional growth Ethical conduct Evidence-based practice 8 September
2016 �Nursing Management Collaborative Decision Making & Empowering Nurse
LeaderDecision expediency odology, utilizing an interrupted time-series design of four
monthly education sessions, with pre- and postintervention assessments. Open discussion
and group observation provided qualitative data and feedback. Member self-report
methods were implemented to discern perceived improvement. Individual session
usefulness was evaluated by asking: 1. Was this session interesting to you? 2. Did this
session add new knowledge for you? 3. Do you think the session informs dimensions of
communication for collaborative decision making? 4. Was the presenter effective? 5. Did
you attend session one, completing the collaborative decision-making assessment and the
MBTI? This evaluation was completed after each session using a 5-point Likert scale (1 =
“not at all”; 5 = “very much”) to measure member buy-in and appraisal of the presented
materials. Decision pragmatism Session one began with an introduction and opening
comments made by the sole facilitator, a certified MBTI practitioner. Informed consent was
obtained, with participation signifying member agreement. The preintervention assessment
tool “How Well Do You Participate in Collaborative Decision Making?” was administered.

3. The MBTI was given and results were revealed, followed by a best-fit education module to
confirm personality type through further explanation and member self-report. Voluntarily
disclosed member personality types were then displayed on a poster, serving as a team type
table. Session two was conducted by the investigator, beginning with a review of
personality type descriptors.Collaborative Decision Making & Empowering Nurse
LeaderGroup discussion enabled a safe environment for member feedback on personality
type comprehension, self-awareness, and insight into www.nursingmanagement.com
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. Team Concepts
www.nursingmanagement.com Figure 2: Members’ dichotomous personality types 8 7 6 5 4
3 2 1 0 Extraversion/ introversion Sensing/ intuition Thinking/ feeling Judging/ perceiving
Figure 3: Nursing leadership constructs and decision evaluation improvement 50 62.5 62.5
Decision pragmatism 62.5 Decision process expediency 87.5 25 25 25 Ethical conduct
Evidence-based practice Decision value to stakeholders 50 Professional growth
Communication Collaboration Trust 0 Appreciation and understanding 100 90 80 70 60 50
40 30 20 10 0 Percent personality type propensities. Members shared new understanding
of personal inclinations toward methods of engagement, information collection, and
problem resolution. Discussion of the team type table followed, demonstrating group
strengths and personality gaps. The decision-making process was described: define the
problem; collect data; identify options; assign utility/ weigh outcomes; project risk; add
stakeholders’ values; make the final decision; act on the decision; and evaluate the decision
by value, expediency, and pragmatism.9 Discussion incorporated the influence of
personality type on each step. Four diverse activities were completed to explore personality
type influence on decision making per scenario. Clear differences in approaches and
priorities were noted by type. Session three explored the impact of individual perception
and information processing on decision making. A detailed illustration was briefly
presented. What the members recalled about the picture was discussed to demonstrate how
differently people perceive and interpret information, aligned with personality type.
Divided by type dichotomy, members were asked to resolve a nurse staffing challenge.
Solutions were compared, highlighting the influence of personality type. Session four
included recognizing team strengths and gaps by increasing member understanding, group
trust, communication, and collaboration. The decision-making process was used to navigate
a critical decision team scenario. Attention was given to personality type preferences,
outcomes, and stakeholder values. Discussion of the impact of personality type on nurse
leadership constructs, best practice, and shared governance council collaboration followed.
Additional open dialogue about the project, activities, learned knowledge, application
capacity, and personal disclosures occurred, and the postintervention assessment tool was
administered. Results The MBTI and best-fit education module disclosed member self-
report of personality type. (See Figure 2.) Most members had a preference for feeling over
thinking. What draws individuals into caring professions is typically an empathetic,
subjective viewpoint, defined as feeling.4 More members reported a preference for
extraversion over introversion, common to groups and demonstrated by participation
degrees during discussions. Sensing/intuition and judging/perceiving had equal
representation. The coded matched analysis for the pre- and postassessment revealed that

4. all members reported improvement in nursing leadership constructs and decision
evaluation. Nursing Management �September 2016 9 Copyright © 2016Collaborative
Decision Making & Empowering Nurse LeaderWolters Kluwer Health, Inc. All rights
reserved. Team Concepts (See Figure 3.) Individual improvement ranged from 10% to 70%,
according to outcome comparison. The greatest collective improvement was reported in
collaboration at 87.5%. High improvement was reported in group trust, decision process
expediency, and decision pragmatism at 62.5%. Peer appreciation and understanding, as
well as communication, revealed a 50% improvement. All other constructs reported a 25%
improvement, with the exception of personal professional growth, which showed no
perceived change during the 4-month project. Group discussion revealed that each member
declared an initial moderate-to-high regard for this construct and didn’t waiver. All four
sessions were evaluated by member report. A cumulative graph demonstrated the positive
trajectory of evaluation by session, inclusive of interest; added knowledge; informed
communication for collaborative decision making; and presenter effectiveness, which
scored highest in all four sessions. (See Figure 4.) The escalating results reflected member
buy-in and value placed on the project’s content and goals. Significant qualitative data were
gleaned from emergent themes shared by participants. (To view the themes, see the
Nursing Management iPad app.) The project sample size and supportive context created a
safe environment for personal disclosure of thoughts and reflections. Understanding the
MBTI helped members define their actions, propensities, and inclinations. Comments were
categorized into the common themes of personality type self-awareness, impact on decision
making, awareness of other council members’ personality types, understanding of MBTI
application in the workplace, and enhanced collaboration with other healthcare disciplines.
Productive and positive feedback demonstrated substantial benefits to self, peers, and the
interdisciplinary team. Collaborative Decision Making & Empowering Nurse
LeaderAcknowledged inherent limitations of the study were the small convenience sample,
an investigatorcreated tool, and self-reported data collection. The personality impact
Educating nurse leaders about personality types is increasingly significant to nursing
practice. This study exemplifies the prospective benefits Figure 4: Session total mean scores
19.25 18.87 18.1 of incorporating personality types into the nurse leader decisionmaking
process. Heightened selfawareness and peer appreciation of the impact of personality types
can improve communication and collaboration within nursing and other disciplines.
Empowering nurses to engage in decision-making forums brings sage input from the
bedside to the boardroom. NM REFERENCES 1. Barrett A, Piatek C, Korber S, Padula C.
Lessons learned from a lateral violence and team-building intervention. Nurs Adm Q.
2009;33(4):342-351. 2. Bassett S. Accountability in the NHS. Nurs Manag (Harrow).
2012;19(8):24-26. 3. DiMeglio K, Padula C, Piatek C, et al. Group cohesion and nurse
satisfaction: examination of a team-building approach. J Nurs Adm. 2005;35(3):110-120. 4.
Myers IB, McCaulley MH, Quenk NL, Hammer AL. MBTI Manual: A Guide to the Development
and Use of the Myers-Briggs Type Indicator Instrument. 3rd ed. Mountain View, CA: CPP;
2009:5-12. 5. Dougherty MB, Larson EL. The nurse-nurse collaboration scale. J Nurs Adm.
2010; 40(1):17-25. 6. Politi MC, Street RL Jr. The importance of communication in
collaborative decision making: facilitating shared mind and the management of uncertainty.

5. J Eval Clin Pract. 2011;17(4):579-584. 7. Brewton C, Eppling J, Hobley M. Our VOICE: an
interdisciplinary approach to shared governance. Hosp Top. 2012; 90(2):39-46. 8. Moore J,
Prentice D. Collaboration among nurse practitioners and registered nurses in outpatient
oncology settings in Canada. J Adv Nurs. 2013;69(7):1574-1583. 9. Hough JH, Ogilvie D. An
empirical test of cognitive style and strategic decision outcomes. J Management Studies.
2005; 42(2):417-448. 10. Dowding D, Thompson C. Measuring the quality of judgment and
decision-making in nursing. J Adv Nurs. 2003;44(1):49-57. Linda S. Burkett was an RN-BSN
program instructor. She’s currently pursuing other venues to apply the components of this
project. 17.6 The author has disclosed no financial relationships related to this article.
SESSION ONE SESSION TWO SESSION THREE SESSION FOUR DOI-
10.1097/01.NUMA.0000491131.60730.d3 10 September 2016 �Nursing Management
www.nursingmanagement.com Copyright © 2016 Wolters Kluwer Health, Inc. All rights
reserved. Collaborative Decision Making & Empowering Nurse Leader