Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Do doctors, nurses and managers have different thinking styles?

Ruth M. Sladek A C , Malcolm J. Bond B and Paddy A. Phillips B
+ Author Affiliations
- Author Affiliations

A Research to Practice Group, Department of Medicine, Flinders University, Flinders Medical Centre, Bedford Park, SA 5042, Australia.

B School of Medicine, Flinders University, Sturt Road, Bedford Park, SA 5042, Australia. Email: malcolm.bond@flinders.edu.au; paddy.phillips@flinders.edu.au

C Corresponding author. Email: ruth.sladek@flinders.edu.au

Australian Health Review 34(3) 375-380 https://doi.org/10.1071/AH09791
Submitted: 8 June 2009  Accepted: 12 November 2009   Published: 25 August 2010

Abstract

A study of the preferred thinking styles among senior health professionals is reported. A total of 49 medical consultants, 50 senior nurses and 53 health managers from two public teaching hospitals in Adelaide, Australia, were invited via a personal letter to complete a questionnaire comprising measures of thinking style (the Rational Experiential Inventory) and cognitive style (two dimensions of the Myers–Briggs Type Indicator®). Managers reported a higher preference for ‘rational’ reasoning than nurses, whereas medical consultants reported a lower preference for ‘experiential’ reasoning than both managers and nurses. Cognitive style was largely homogenous. Although generalisation of the findings may be limited due to small sample sizes and the self-selection of participants, an understanding of the thinking styles of senior health professionals will likely inform the design and evaluation of future change strategies.

What is known about the topic? Research outcomes cannot change population health unless they are adopted, but changing the practices of healthcare workers to reduce ‘know–do’ gaps is not simple. Although there is some evidence to support professionally-oriented strategies such as educational outreach, audit and feedback and reminders, success is sometimes limited, potentially reflecting the limited use of theory in informing the choice of implementation strategies. Non-theoretical approaches may obscure the behavioural determinants of, and mechanisms for, change, making it impossible to generalise lessons learned form one situation to other contexts.

What does this paper add? This paper highlights the growing recognition of the need for theory in this important field, and examines a psychological theory for its potential use. Findings provide useful preliminary descriptive data about thinking dispositions within and between three key groups of healthcare decision-makers: senior consultants, senior nurses and managers. It adds to a modest but accumulating research base that explores the tenets of a specified theory among healthcare professionals, reporting reliable differences between individuals in terms of cognitive processing (i.e. how they prefer to think).

What are the implications for practitioners? Those faced with implementing change should consider theoretically-driven approaches in their selection of strategies. Based on the theory explored herein, two versions of a message, each targeting a different cognitive processing mode, should be more successful than one version only. This should be true for all three professional groups, and represents a testable strategy for future research.

Additional keywords: cognition, communication, personality.


Acknowledgements

Dr Ruth Sladek was funded by a National Institute of Clinical Studies (NICS) scholarship. The National Institute of Clinical Studies (NICS) is part of the National Health and Medical Research Council (NHMRC). NICS’ role within the NHMRC is to improve health care by getting the best available evidence from health and medical research into everyday practice.


References


[1] Eccles M , Mittman B . Welcome to implementation science. Implement Sci 2006; 1: 1. Available at http://www.implementationscience.com/content/1/1/1 [Editorial, verified 27 July 2010].

[2] Eccles MP , Armstrong D , Baker R , Cleary K , Davies H , Davies S , Glasziou P , Ilott I et al. An implementation research agenda. Implement Sci 2009; 4: 18. Available at http://www.implementationscience.com/content/4/1/18 [Editorial, verified 27 July 2010].

[3] Grimshaw J,  Thomas R,  MacLennan G,  Fraser C,  Ramsay CR,  Vale L,  Whitty P,  Eccles MP, et al. Effectiveness and efficiency of guidelines dissemination and implementation strategies. Health Technol Assess 2004; 8 111–21.
[verified 27 July 2010].

[7] Grol R , Wensing M , Eccles M . Improving Patient Care: The Implementation of Change in Clinical Practice. Edinburgh: Elsevier Butterworth Heinemann, 2005.

[8] Michie S,  Johnston M,  Abraham C,  Lawton R,  Parker D,  Walker A. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care 2005; 14 26–33.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed | [verified 27 July 2010].

[11] Davies P,  Walker A,  Grimshaw J. Theories of behavior change in studies of guideline implementation. Proceedings of the British Psychological Society 2003; 11 120.
[verified 27 July 2010].

[16] Perkins MB,  Jensen PS,  Jaccard J,  Gollwitzer P,  Oettingen G,  Pappadopulos E,  Hoagwood KE. Applying theory-driven approaches to understanding and modifying clinicians’ behavior: what do we know? Psychiatr Serv 2007; 58(3): 342–8.
Crossref | GoogleScholarGoogle Scholar | PubMed | [verified 27 July 2010].

[18] Epstein S. The self-concept revisited. Am Psychol 1973; 28 404–16.
Crossref | GoogleScholarGoogle Scholar | PubMed | CAS | [verified 27 July 2010].

[28] Sladek RM,  Bond MJ,  Phillips PA. Why don’t doctors wash their hands? A correlational study of thinking styles and hand hygiene. Am J Infect Control 2008; 36 399–406.
Crossref | GoogleScholarGoogle Scholar | PubMed | [verified 27 July 2010].

[30] Eisenberg JM. Physician utilization: the state of research about physicians’ practice patterns. Med Care 2002; 40 1016–35.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[31] Denis JL,  Hebert Y,  Langley A,  Lozeau D,  Trottier LH. Explaining diffusion patterns for complex health care innovations. Health Care Manage Rev 2002; 27 60–73.
PubMed |

[32] Corsini RJ , Auerbach AJ , eds. Concise encyclopaedia of psychology, 2nd edn. New York: Wiley; 1996.

[33] Short EA . Words and phrases used in written communication by eight different personality types as measured by the Myers–Briggs Type Indicator®: A contribution to the theory. PhD dissertation, Brisbane, Queensland: Queensland University of Technology; 2005.

[34] Pacini R,  Epstein S. The relation of rational and experiential information processing styles to personality, basic beliefs, and the ratio-bias phenomenon. J Pers Soc Psychol 1999; 76 972–87.
Crossref | GoogleScholarGoogle Scholar | PubMed | CAS |

[35] Myers IB , McCaulley MH , Quenk NL , Hammer AL. MBTI manual: a guide to the development and use of the Myers–Briggs Type Indicator®, 3rd edn. Palo Alto, CA: Consulting Psychologists Press; 1998.

[36] Dunning D . Introduction to type and communication. Palo Alto, CA: Consulting Psychologists Press; 1999.

[37] Batha K,  Carroll M. Metacognitive training aids decision making. Aust J Psychol 2007; 59 64–9.
Crossref | GoogleScholarGoogle Scholar |