Career and Life Planning Guidebook for Medical Residents

Not only has Ann found that maximizing health is a fundamental objective of John, she also established a connection between flex time, freedom of choice, cycling, comradery, and health. To John, these are all connected,whichwill be useful in the next stepwhenwe structure John’s responses into something we can use in our decisions. Ann should return to the branch points in the above dialog to ask about family as opposed to cycling and comradery as opposed to exercise. In addition to asking why over and over, here is a list of additional techniques and questions that can be used to nurture and develop creativity in the decisionmaker. Wish List: If you had no limitations whatsoever, then what would your objectives be? Why? Options: What makes one option better? Create real and hypothetical alternatives, e.g., ask the decision maker to describe a perfect alternative or a horrible one, real or imagined. What is the minimum acceptance level for an objective? Pursue all responses for reasons, i.e., ask why? Shortcomings: What are the major problems facing the decision maker? Is there anyway to improve the current situation? Specifically, how? If not, why? Why would this help improve the situation? Consequences: Are there any unacceptable consequences? Are there any consequences outside your influence? Given many consequences, which is the worst? Which is the best? Why? Goals: What are the goals and the objectives behind these goals? What are the constraints and the objectives behind these constraints? What are the guidelines and the objectives behind these guidelines? Different Perspectives: Can you describe the decision from a different perspective? For example, from a different person's view? From a different point in time? From a different organization's point of view? Generic Objectives: Break the decision problem into broad categories, e.g., economic, social, welfare, environmental impacts, and so on. Work within each category. Perhaps the decision maker's responses have all been within a broad category. Point this out and ask if there are impacts or consequences in any other category. In addition, there are key words that signal implicit objectives. These are: Impacts, trade-offs, consequences, concerns, fair, and balance. For example, if the decision maker indicates that trade-offs arenecessary, thenask trade-offsbetween what and whom? Why are trade-offs necessary? It often takes two to three elicitation sessions, each lasting a few hours, to fully obtain the decision maker’s values and objectives. The end result is typically a stack of papers, often more than 20 pages, containing the responses to the above questions. Now, we turn to the second step; namely, we structure these objectives into a hierarchy that Decision Analysis Applied to Job Selection 273 WWW.PHYSICIANCAREERPLANNING.COM