Neuroscience Behind Decision-Making

The quality of a decision is decided by the process that is followed for the decision-making rather than on the outcome/ final result. For example, let's take a patient presenting with breast lump for evaluation. Here the problem is the breast lump. The outcome is the diagnosis, staging, treatment, and finally the cure. More than the final diagnosis, what was the process followed for the final diagnosis plays an important role, like the examination findings, differential diagnosis, workup, and multidisciplinary team discussion. When we work as a functional team, the strength of every member has a synergistic effect that will mask individual weaknesses. Each member brings a different perspective to a problem and can work up the problem in different ways. They add to the alternative possibilities. Every team member comes with a cognitive bias which is a decision-making trap that affects all of us as we try to make choices. Among them, confirmation bias is a tendency to gather and rely upon information that confirms our existing views, while avoiding information that might disconfirm the same. These biases are subconscious and difficult to recognize or overcome at an individual level and require the help of the team members to overcome.

Leadership Quality and Team Success

A team leader plays an important role in the success of a cancer team.The aim is to help the members do a better job, alleviate fear, provide psychological safety, be inclusive, and have a process-oriented approach to decision making. Although the quality of work involves everyone in the team, it is the responsibility of the leader to assure the highest quality of service to every cancer patient. Apart from the above-mentioned key attributes of a successful leader, the leadership style plays an important role in the formation of an effective team. No one leadership style suits every team. In a newly formed inexperienced team, a directive style works, in an emergency,an autocratic leadership style works whereas in a highly experienced team with experts in various fields like the one managing cancer, a participatory or democratic style is necessary for effective management. In a resource-limited setting, treating cancer under the constraints of significantly limited health care poses unique challenges that are not well addressed by existing guidelines. A leader needs to play an important role in minimizing costs and maximizing benefits. A successful team always strikes the fine balance between the cost, outcome, and toxicity.

Attributes of A Functional Team

The key attributes of a successful team are the diversity in its expertise, independence in decision-making, decentralization of decisions, and the ability of the leader to aggregate the team members' opinions before making a final decision. Dissent, conflicts, and debates are common among successful team members and these conflicts are mostly intellectual and issue-based. Despite the dissents, the team provides psychological safety to each member. A participatory leadership style always helps in grooming a well-functional team.

Attributes of A Dysfunctional Team

On the contrary dysfunctional team perform less than an individual member. Group thinking is common and a culture of yes or no prevails in these teams. There are no effective debates or dissents in the team meeting with most members following a culture of yes or no without having an issue-based discussion and will not substantiate their decision. Debates in a dysfunctional team involve lots of emotions leading to personality clashes. Analysis paralysis is another negative attribute of a dysfunctional team where they perform numerous investigations without coming to a final diagnosis.

Conclusion

In a nutshell, no one is smarter than everyone.Teamwork and a process-oriented approach improve the quality of the decision leading to the best possible outcome. On the other hand when everybody is responsible then nobody is responsible denotes a dysfunctional team leading to the worst possible outcome. Group dynamics, leadership pattern, and team composition decides whether a team is functional or dysfunctional.