Struggling to make decisions amid COVID? It’s thought that counts

A friend of mine runs a GP surgery. For those not familiar with the UK system, a GP is a family doctor and the point of entry to healthcare. Right now, the workload is tremendous. But that’s not where the stress comes from; she’s used to workload. It’s the decision-making that is debilitating. The emergency is continual, cumulative and confusing. The decision-maker is out on her own, without a map.

At the moment she’s set up a gazebo in the surgery car park to consult with patients who may have COVID but still need access to other health care: people with diabetes, worrying lumps, or mental health problems. The gazebo initiative sounds enterprising to me. But I have no way of knowing if it’s the right decision. Neither does she. I wonder what other GPs are doing. She probably wonders too.

So, I’m glad I’m not making decisions in healthcare right now. But any decision, anywhere, is currently hard to make. Every area of life is in upheaval. It runs from government right down to families. Why is it SO hard to know what is best?

One reason is that in normal circumstances most of us, like healthcare professionals, make our decisions against a familiar framework. There is a process, a limited set of conventional options. Those protocols exist because we, or others, have thought through the issues many times over the years and come up with systems that provide a narrow menu of options. We don’t have to work it all out for ourselves.  We certainly don’t have to make immediate choices with far-reaching consequences on the back of inadequate knowledge – which pretty much describes where we are with COVID and the lockdown – in government, business and family life.

Critical thinking is paramount during the crisis. Critical thinking is what we use to solve problems, make decisions and run discussions effectively. At a time like this, with all of us trying to maintain our productivity, protect our safety and hold on to our sanity, we may benefit from some support in how to think our way through a landscape that has shifted under our feet and is still moving.

So, weirdly, one of the opportunities arising for me from this awful, unforeseen crisis is the chance to advise people on critical thinking workshop. It’s something that I love. I and my colleagues started training people in these skills over the last few years because of a growing demand, but up to now it’s been a niche interest for some of our clients.

Not anymore. Let me talk about what leaders in all organisations are experiencing at the moment, and then point the way towards some solutions.

Here is an anatomy of the problem:

• The normal decision-making framework is shattered. People are looking around the wreckage and thinking ‘Darn’ – or words to that effect – ‘Now what?!’
• Because of (1) priorities are unclear. What should I (or you, or anyone else) be working on right now? Are we frittering away valuable time on the wrong thing?
• New facts are needed – fast! Can they be found? Have they been tested? Can they be trusted? Or has someone just pulled them out of thin air, or off a spreadsheet that has no connection to the situation on the ground?
• Uncertainty of consequences. This follows from (3). I’m highly unlikely to know what the full consequences of any course of action will be. So how can I evaluate that course of action?
• Because of the impossibility of weighing up unfamiliar options with uncertain outcomes, we need to simplify the decision. So we play safe. Or roll the dice. Or trust someone or something. Or go with our gut. This is not such a bad thing. In decision-making theory this might be called a ‘heuristic’. It’s a simple rule of thumb or ‘best guess’ mechanism. Research suggests that in many situations where we face a threat, following instinct, intuition or best guess is more likely to work than a brainy calculation or obedience to authority. (An example of this is when you smell fire and leave the building, via the route that seems quickest to you, in defiance of instructions.)
• However… the heuristics in (5) are avoidance functions – ways of escaping danger. For someone working from home, avoidance behaviour can result in a variety of dysfunctional patterns, including paralysis, withdrawal, obsessive and neurotic reactions, depression, aggression, micromanagement and so on. Our instincts might save us from the jaws of death but they don’t unlock the gates of opportunity.

If this sounds familiar or insightful, then a crash course in critical thinking might interest you. I can’t provide that in a blog post. But I can show you what a course could include.

So, as I said, critical thinking skills are vital. What is it? Well, I’ve come up with 3 definitions in the last week, all of which have some merit. But here it might be useful to say that it is the art of constructive doubt. We use doubt to test and strengthen our beliefs. It might interest you to know that the words ‘prove’ and ‘proof’ were originally to do with testing. So to prove something meant to subject it to rigorous testing and show that it’s fit for purpose. Rigorous testing of a thought process is critical thinking.

Here are the stages you go through in making a sound decision. I’ve got six here, but they can be split or combined in various ways.

1. Clarify goals. Challenge and question your definition of the goal so that your aim is true throughout the rest of the process. If your goals are blurred, or off centre, your whole trajectory will get more wrong as you work through the process.
2. List known information. But question the sources, the interpretations, and the provenance of all your data.
3. List your unknowns. Don’t be tempted to stick with positive information. The unknowns are the holes.
4. List assumptions, estimates, and predictions. All of these carry a level of unreliability. Try to quantify this unreliability: What is the margin for error? What are the limitations of the methodology?
5. Find someone who disagrees with you. This is the person you least want to hear from but most need to.
6. Communicate assertively. Give people the part of the truth that they need to hear right now. If you’ve followed steps 1-5 you should be able to be transparent about what you’re doing and why. Choose your language skilfully. Telling the truth isn’t about being blunt; it’s about being precise.

I’m hoping to write another blog soon, fleshing out these ideas with more examples to add to the one I opened with. If I don’t, it will be because I’ve tried to follow the precepts I’ve laid out here… and decided that there is something even more important that has to come first.

That’s because I’m not writing this as a detached observer. I’m tapping the keyboard in the dark of my sons’ bedroom as they go to sleep, wondering which of the highly pressing things I need to do should be made a priority. Maybe when this is all over, I’ll know. Until then, I have to make the best decisions I can with the information I have.

 

For more on critical thinking, see our complete guide to Professional Development Skills.