The University of Southampton

HLTH6079 The Essence of Decision-making

Module Overview

This module focuses on the process of making non-clinical decision-making and judgements, and how to evaluate decisions. We explore the human aspects of decision-making and its impacts on individuals, groups, and organizations. Two days are spent addressing the process of addressing dilemmas—those decisions where difficult trade-offs must be made, and where there are no clear winners. The module is particularly relevant to health care practitioners who want to develop their non-clinical decision making skills, and to help them make principled trade-offs. The module will also appeal to anyone who has an interest in the nature of non-clinical decision making, and who would like to develop or enhance their decision making skills.

Aims and Objectives

Module Aims

To help you understand the psychological, social and organisational processes and problems associated with thinking and decision-making in managerial contexts. The emphases in this module are on (1) Understanding your own decision styles and surfacing your biases in decision-making; (2) Group dynamics and decision-making; (3) Approaches to organizational decision-making; and (4) Decision-making theory. Ultimately, the module intends to help you understand the quality of decisions, and the extent to which decisions achieve utility (a numerical measure of “good”). We explore the complexities of managerial thinking and decision-making, the trade-off between rationality and intuition, and the critical role of various contextual influences. Current theories and approaches in understanding managerial thinking and decision-making are explored as are issues associated with group decision-making, conflict and negotiation. The role of structured methods and tools (such as scenario planning, net present value, internal rate of return, etc.) are considered in organizational decision-making. The logic of the module will take you through the individual and decision-making, how decisions are made in groups (and how your decisions affect others), decision-making in organizations, and theories and approaches to decision-making. We aim to provide you with personal insight into your decision-making styles, practical approaches to decision-making that you can use in your practice, and theoretical considerations that can serve as an intellectual scaffolding to help you make, and evaluate, decisions in the future. This module is informed and builds upon three modules: Leading Self (HLTH6076); Leading Others (HLTH6075), and Strategic Management (HLTH6125).


• Day 1: The Individual and the Decision • What is the essence of a decision? • Identifying your personal decision-making style • Uncovering personal biases in decision making • Attention biases • Availability • Heuristics • One-aspect focus • Motivational biases • Psycho-physical distortions • Moral thinking, values and fairness • Judgement • Day 2: The Group and the Decision • Group dynamics and decision-making • Idealized and realistic models of group decisions • Participatory decision making • Emotional intelligence and deciding • Day 3: The Organization and the Decision • Structured methods • Decision-making under conditions of complexity and uncertainty • Scenario analysis • Strategic options appraisal • Fiscal decision-making • Day 4: Decision-Making and Design • Reference dependence and choice • Design science • Intelligent design • Day 5: Decision-Making Workshop • Addressing social and organizational dilemmas • Participatory decision-making, revisited: deciding the architecture of a service design with service users (workshop with invited service users) • Reflecting on and evaluating decisions

Learning and Teaching

Teaching and learning methods

The conduct of the modules is informed by the following principles: • Learning should be relevant to practitioners and their work environments • Practitioners should be given experience and learn through errors • As much as is practical, practitioners should be involved in the planning and evaluation of their instruction • Instruction should be problem-centred In practice, this means that we will keep lectures to an absolute minimum, and will instead adhere to these principles through practice-based and activity-driven classroom time that both delineate and make real various theories and approaches to decision-making. We will give ample opportunity to participants to construct both decisions and designs, and to analyse, criticise and evaluate those designs. The instructors will act more like facilitators than lecturers. For example, rather than lecturing on decision bias, we will instead engage in activities that produce (unknowing to the participant) biased decisions. Then we will explore the theory and research behind bias. In another context, we will ask participants to make decisions under conditions of extreme complexity. Participants will quickly realise that they need structured tools, and we will then offer structured tools and approaches as the participants come to need them (this is so-called ‘just-in-time’ learning). The idea is that we want to make the learning real, and the tools and approaches useful and salient. When possible, we want to involve service users in the learning activities. This is especially important on the last day when participants will make decisions on a service architecture with service user involvement, and then reflecting on the process of participatory decision-making.

Preparation for scheduled sessions164
Completion of assessment task50
Total study time250

Resources & Reading list

Kaheman, D. & Tversky, A. (1979). Prospect theory: An analysis of decision under risk. Econometrica. ,47 , pp. 263-291.

Margolis, H (1987). Patterns, thinking, and cognition: a theory of judgment. 

Kuhn, D. (1989). Children and adults as intuitive scientists. Psychological Review. ,96 , pp. 674–689.

Shoemaker, PJH (1995). Scenario planning: A tool for strategic thinking. Sloan Management Review. ,36 , pp. 25-40.

Choice architecture..

Raiffa, H. (1982). The art and science of negotiation. 

Kramer, R. (1991). The more the merrier? Social psychological aspects of multiparty negotiations. In Bazerman, M. Lewicki, R and Heppard, B Handbook of negotiation research: Research on negotiation in organisations. 

Popper, K. R. (1962). Conjectures and refutations: The growth of scientific knowledge. 

Dawes, R. M. (1980). Social dilemmas. Annual Review of Psychology. ,31 , pp. 169–193.

Taylor, S.. Positive illusions. 

Kahneman, D., & Tversky, A. (1984). Choices, values, and frames. American Psychologist. ,39 , pp. 341–350.

Allison, G. & Zelikow, P. (1999). Essence of Decision: Explaining the Cuban Missile Crisis. 

Raelin, J.A. (202). Dialogue and deliberation as expressions of democratic leadership in participatory organizational change. Journal of Organizational Change and Management. ,25 , pp. 7-23.

Caughron, J.J. & Mumford, M.D. (2012). Embedded leadership: How do a leader’s superiors impact middle-management performance?. Leadership Quarterly. ,23 , pp. 342-353.

Kahneman, D., & Tversky, A. (1979). Prospect theory: An analysis of decision under risk. Econometrica. ,47 , pp. 263–291.

Stroop, John R (1935). Studies of Interference in Serial Verbal Reactions. Journal of Experimental Psychology. ,12 , pp. 643-62.

Keeney, R. L., & Raiffa, H. (1993). Decisions with multiple objectives: Preference and value tradeoffs.. 

Baron, J. (1998). Thinking and Deciding. 

Sabini, J., & Silver, M. (1981). Moralities of everyday life. 

Gawande, Atul (207). The Checklist. The New Yorker. ,83, no. 39 , pp. 86-­95.

Silver, M., Sabini, J., & Miceli, M. (1989). On knowing self-deception. Journal for the Theory of Social Behavior. ,19 , pp. 213–227.

Tversky, A. & Kahneman, B. (1974). Judgment under uncertainty: Heuristics and biases. Science. ,185 , pp. 1124-1131.

Dawes, R. M., & Thaler, R. H. (1988). Cooperation. Journal of Economic Perspectives. ,2 , pp. 187–197.

Thaler, R (1985). Using mental accounting in a theory of purchasing behaviour. 

Frank, R. H. (1988). Passions within reason: The strategic role of the emotions. 

Akinci, C. & Sadler-Smith, E. (2012). Intuition in Management Research: A Historical Review. International Journal of Management Reviews. ,14 , pp. 104-122.

Mudrack, P.E., Bloodgood, J.M., & Turnley, W.H., (2012). Some ethical implications of individual competitiveness. Journal of Business Ethics. ,108 , pp. 347-359.

Tversky, A., & Kahneman, D. (1981). The framing of decisions and the psychology of choice. Science. ,211 , pp. 453–458.

Nisbett, R. E., Fong, G. T., Lehman, D. R., and Cheng, P. W. (1987). Teaching reasoning. Science. ,238 , pp. 625–631.

Kahneman, D., & Knetsch, J. L. (1992). Valuing public goods: The purchase of moral satisfaction. Journal of Environmental Economics and Management. ,22 , pp. 57–70.

Ainslie, G. (1975). Specious reward: A behavioral theory of impulsiveness and impulse control.. Psychological Bulletin. ,82 , pp. 463–496.

Farmar-Bowers, Q (2010). Understanding the strategic decisions women make in farming families. Journal of Rural Studies. ,26 , pp. 141-151.

Thaler, R. H., & Sunstein, C. R (2008). Nudge: Improving decisions about health, wealth, and happiness. 

Kahneman, D., Knetsch, J. L., & Thaler, R. H. (1990). Experimental tests of the endowment effect and the Coase theorem.. Journal of Political Economy. ,98 , pp. 1325–1348.

Keeney, R. L. (1992). Value-focused thinking: A path to creative decisionmaking. 

Lord, C.G., Ross, L. & Lepper, M.R. (1979). Biased assimilation and attitude polarization: The effects of prior theories on subsequently considered evidence. Journal of Personality and Social Psychology. ,37 , pp. 2098-2109.

Samuelson, W. & Zeckhauser, R.J. (1988). Status quo bias in decision making. Journal of risk and uncertainty. ,1 , pp. 7 - 59.

Sunstein, C. R. (2005). Moral heuristics (with commentary). Behavioral and Brain Sciences. ,28 , pp. 531–573.

Do you suffer from decision fatigue?.

Allwood, C.M. & Salo, I. (2012). Decision-Making styles and stress. International Journal of Stress Management. ,19 , pp. 34-47.

Hardin, R. (2009). How do you know? The economics of ordinary knowledge. 

Alloy, L. and Abramson, L. (1979). Judgement of contingency in depressed and non-depressed students: Sadder but wiser?. Journal of experimental psychology. ,108 , pp. 441-485.

Norman, Donald (1990). The Design of Everyday Things. 

Johnston, J.H., Driskell, J.E., & Salas, E. (1997). Vigilant and hypervigilent decision making. Journal of Applied Psychology. ,82 , pp. 614-622.

Cornwall, E.Y., & Hans, V.P. (2011). Representation through participation: A Multilevel analysis of jury deliberations. Law and Society Review. ,45 , pp. 667-698.

Kahneman, D., Knetsch, J. L., & Thaler, R. H (1986). Fairness and the assumptions of economics. Journal of Business. ,59 , pp. S285-S300.

French, S. (2012). Expert judgment, meta-analysis and expert risk analysis. Decision analysis. ,9 , pp. 119-127.

Schelling, T. C. (1978). Micromotives and macrobehavior. 

Dawes, R. M., Faust, D., & Meehl, P. E. (1989). Clinical versus actuarial judgment. Science. ,243 , pp. 1668–1674.

Grove, W.M. Meehl, P.E. (1989). Comparative efficiency of informal (subjective, impressionistic) and formal (mechanical, algorithmic) prediction procedures: The clinical-statistical controversy. Psychology, Public Policy, and Law. ,2 , pp. 293-323.

Kahneman, D., & Tversky, A. (1973). On the psychology of prediction. Psychological Review. ,80 , pp. 237–251.

Zeliadt, Steven B., Scott D. Ramsey, David F. Penson, Ingrid J. Hall, Donatus U. Ekwueme, Leonard Stroud, and Judith W. Lee (2006). Why Do Men Choose One Treatment over Another. Cancer. ,106 , pp. 1865-74.

Stanovich, K. E., & West, R. F. (1998). Individual differences in rational thought. Journal of Experimental Psychology: General. ,127 , pp. 161–188.



One page problem statement


MethodPercentage contribution
Assignment  (3500 words) 100%

Repeat Information

Repeat type: Internal


Costs associated with this module

Students are responsible for meeting the cost of essential textbooks, and of producing such essays, assignments, laboratory reports and dissertations as are required to fulfil the academic requirements for each programme of study.

In addition to this, students registered for this module typically also have to pay for:

Books and Stationery equipment

There are no cost implications for this module. Students can purchase Baron, J. (1998) Thinking and Deciding (3rd ed.) (Cambridge: Cambridge University Press) if they wish, but this is not necessary

Please also ensure you read the section on additional costs in the University’s Fees, Charges and Expenses Regulations in the University Calendar available at

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