Rationality versus reality: the challenges of evidence-based decision making for health policy makers

<p>Abstract</p> <p>Background</p> <p>Current healthcare systems have extended the evidence-based medicine (EBM) approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process.</p> <p>Discussion</p> <p>We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM) and evidence-based policy making (EBPM) because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence.</p> <p>Summary</p> <p>In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial suggestions about how the EBDM/EBPM process can be improved.</p

The Relationship of Career Mentoring to Early Career Outcomes

This study examines the relationship of career mentoring to the promotions, compensation and satisfaction of 148 early career managers and professionals in Belgium. The results support the conclusion that career mentoring is particularly related to early career promotion histories, to general work satisfaction and career satisfaction. Career mentoring was unrelated to total compensation. These results occurred even after controlling for a variety of factors identified by Pfeffer (1977) and Whitely et al. (1991). Several reasons are provided for the relationship between career mentoring and these early career outcomes. The results suggest a number of areas for future career mentoring research.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Faculty and administrator views of influences on professional programs

Administrators in professional programs perceive influences on the program from within the university as stronger than do faculty but the two groups do not perceive the strength of societal influences, professional community influences, or internal levels of curriculum debate differently. After controlling for program and institutional sizes and institutional types, these differences between faculty and administrator views regarding relationships between the program and the university appear characteristic of certain professional fields. The analysis was based on subsamples drawn from a data base of survey responses from 873 administrators and 849 faculty members in ten professional fields representing 732 programs in 346 colleges and universities.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43601/1/11162_2004_Article_BF00992306.pd