The Journal of Psychology

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Decision-Making Styles in Medical Students and

Healthcare Professionals: The Roles of Personality
Traits and Socio-Emotional Intelligence Factors

Martin Sedlár & Jitka Gurňáková

To cite this article: Martin Sedlár & Jitka Gurňáková (27 Jun 2024): Decision-Making
Styles in Medical Students and Healthcare Professionals: The Roles of Personality
Traits and Socio-Emotional Intelligence Factors, The Journal of Psychology, DOI:
10.1080/00223980.2024.2369618

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The Journal of Psychology
https://doi.org/10.1080/00223980.2024.2369618

Decision-Making Styles in Medical Students and

Healthcare Professionals: The Roles of Personality Traits
and Socio-Emotional Intelligence Factors
Martin Sedlár and Jitka Gurňáková
Institute of Experimental Psychology of the Centre of Social and Psychological Sciences, Slovak Academy
of Sciences

ABSTRACT ARTICLE HISTORY

Intuitive and deliberative styles can be considered the best-known Received 25 October
decision-making styles, which are thought to be linked to actual 2023
workplace performance. However, there is a limited research on indi- Accepted 12 June 2024
vidual differences in these styles among individuals who provide KEYWORDS
healthcare. Therefore, adopting the self-report approach, this study Big Five; emotional
examines the roles of the Big Five personality traits and socio-emotional intelligence; social
intelligence factors in intuitive and deliberative decision-making styles intelligence;
among medical students and healthcare professionals. The research decision-making styles;
sample consists of 203 participants (50 medical students, 153 health- healthcare
care professionals) who completed the Big Five Inventory, the Trait
Meta-Mood Scale, the Tromsø Social Intelligence Scale, and the
Preference for Intuition and Deliberation Scale. The regression analy-
ses revealed that attention to one’s emotions and social information
processing were positively related to intuitive decision-making style,
while the clarity of one’s emotions and social awareness were nega-
tively related to intuitive decision-making style. It was further shown
that conscientiousness, neuroticism, repair of one’s emotions, and
social information processing were positively related to deliberative
decision-making style. The findings highlight the importance of per-
sonality and socio-emotional intelligence in understanding
decision-making. Specifically, they point out that Big Five personality
traits better explain deliberative style, while socio-emotional intelli-
gence factors better explain intuitive style.

Introduction
Decision-making, defined simply as the process of reaching a judgment or choosing
an option, is one of the most critical skills needed to reduce errors and improve safety
and quality of performance in complex environments such as healthcare (Flin et al.,
2017). In particular, decision-making in healthcare involves consideration of a variety
of diagnostic, therapeutic and prognostic options, patient values, needs, and service
costs, making it complicated and fraught with uncertainty (Hunink et al., 2014). Such

CONTACT Martin Sedlár martin.sedlar@savba.sk Institute of Experimental Psychology of the Centre of Social and
Psychological Sciences, Slovak Academy of Sciences, Dúbravská cesta 9, 841 04 Bratislava, Slovakia.
Supplemental data for this article can be accessed online at https://doi.org/10.1080/00223980.2024.2369618.
© 2024 Taylor & Francis Group, LLC
2 M. SEDLÁR AND J. GURŇÁKOVÁ

decision-making places a great responsibility on healthcare professionals for the health

and lives of their patients. In other words, healthcare professionals are burdened
because they should do their best to make the right decisions based on clinical evi-
dence in order to help patients and not harm them.
As healthcare professionals make decisions on a daily basis, they can naturally
become accustomed to making decisions in some way in a given decision-making
situation. This response pattern, which is determined by the situation, task features,
and individual differences, is called decision-making style (Thunholm, 2004). There
are several conceptualizations of decision-making styles (Leykin & DeRubeis, 2010),
and their common parts are intuitive and deliberative styles. Intuitive style is about
relying on hunches and gut feelings, and deliberative style is about relying on evalu-
ation and reasoning (Betsch, 2004). The two styles correspond to the dual process
theory, which postulates that there are two systems underlying thinking processes,
System 1, referred to as intuitive, fast, experiential, heuristic, etc., and System 2, referred
to as analytic, slow, rational, systematic, etc. (for a review, see Evans, 2008). Both
intuitive and deliberative styles play a significant role in actual decision-making and
performance (Alaybek et al., 2022; Flin et al., 2017); however, the use of only intuition
or only deliberation across different situations is error-prone; a combination of the
two is closer to optimal (Croskerry & Norman, 2008). This implies that, for better
and safer performance, healthcare professionals should have both the intuitive and
deliberative styles in their repertoire and combine them wisely according to their
suitability for the clinical decision-making situation at hand.
Given the importance of decision-making styles to performance in the workplace,
a valuable question is who are the healthcare professionals who tend to make only
intuitive decisions, who tend to make only deliberative decisions, and who tend to
combine both decision-making styles? The answer can be traced to their individual
differences (Thunholm, 2004), but as recommended, one should carefully consider
which individual differences are worth pursuing as direct predictors (Appelt et al.,
2011; Mohammed & Schwall, 2009). As decision-making style involves basic cognitive
abilities such as general information processing practices, self-evaluation, and
self-regulation (Thunholm, 2004), personality traits as characteristics related to affect,
behavior, cognition, and desire (Wilt & Revelle, 2015) should be of importance. Indeed,
several studies have revealed the roles of Big Five personality traits (John & Srivastava,
1999) in decision-making (e.g., Bayram & Aydemir, 2017; Witteman et al., 2009), but
only very weak-to-weak associations of Big Five personality traits with decision-making
styles were shown in a meta-analysis (Wang et al., 2017). It follows that there are
probably other, more relevant individual differences.
Such individual differences may be emotional (intrapersonal; Salovey et al., 1995)
and social (interpersonal; Silvera et al., 2001) intelligence as they have to do with
cognitive information processing required to deal effectively with one’s emotional states
and social situations, which has been empirically supported by their relevance to
decision-making (e.g., Jokić & Purić, 2019; Khan et al., 2016; Schutte et al., 2010).
However, the two types of intelligence are usually grouped and measured together
without a clear distinction between them and their factors (Di Fabio & Kenny, 2012;
Laborde et al., 2010), while their individual factors/abilities have shown different
associations with decision-making styles of weak-to-moderate strength (Avsec, 2012;
 The Journal of Psychology 3

Ibrahim & Elsabahy, 2020; Rezaei & Jeddi, 2020). Thus, individual emotional and
social intelligence abilities may explain additional variance in decision-making styles
that is not explained by Big Five personality traits.
The above-mentioned studies on the Big Five personality traits and socio-emotional
intelligence abilities in relation to decision-making were conducted on the general
population and only provide indications of relationships that could also occur in other,
more specific samples. Given some peculiarities in the personality traits and
socio-emotional abilities of healthcare professionals (Louwen et al., 2023), it is possible
that these are somewhat differently related to decision-making styles in medical stu-
dents and healthcare professionals, which is therefore worth investigating closer.
Nevertheless, there are very few and varied quantitative studies to date that are more
or less relevant to this issue and have been conducted on a sample of medical students
and healthcare professionals (Dilawar et al., 2021; El Othman et al., 2020; Halama &
Gurňáková, 2014; Kamhalová et al., 2013; Parker-Tomlin et al., 2019).
In contrast to most previous studies, the current study aims to use the self-report
approach to examine not only the roles of Big Five personality traits, but also emo-
tional intelligence factors and social intelligence factors in intuitive and deliberative
decision-making styles. Importantly, it examines this topic in medical students and
healthcare professionals. Our study thus contributes to the existing literature by pro-
viding evidence on individual differences in decision-making styles that can have
potentially serious and far-reaching consequences in the healthcare workplace.

Personality Traits and Decision-Making Styles

The well-known model of the Big Five personality traits – extraversion, agreeableness,
conscientiousness, neuroticism, and openness (John & Srivastava, 1999), conceptualized
as characteristics related to affect, behavior, cognition, and desire (Wilt & Revelle,
2015) – has been used in several studies examining decision-making or processing
styles. There is substantive evidence that these traits explain both intuitive and delib-
erative styles (Bayram & Aydemir, 2017; Dewberry et al., 2013; El Othman et al., 2020;
Pacini & Epstein, 1999; Riaz et al., 2012; Witteman et al., 2009), but only few research-
ers have focused on their role in the decision-making styles of medical students (El
Othman et al., 2020) and healthcare professionals (Halama & Gurňáková, 2014;
Parker-Tomlin et al., 2019). However, the above studies have shown mixed results in
terms of the significance, strength, and direction of the relationships between each
trait and the two styles, which could be due to differences in the measures used and
differences in the samples. Therefore, we prefer to describe here in more detail the
results (mean sample size-weighted correlations) of a meta-analysis (Wang et al., 2017),
highlighting the fact that some traits are more strongly related to one or the other
style. When comparing the two styles, conscientiousness had a significantly stronger
relationship with deliberative (r = .22) than intuitive style (r = .03), openness had a
significantly stronger relationship with deliberative (r = .26) than intuitive style (r =
.18), and extraversion had a significantly stronger relationship with intuitive (r = .17)
than deliberative style (r = .08). Agreeableness had an equivalent relationship with
deliberative (r = .10) and intuitive style (r = .09) and neuroticism had also an equiv-
alent relationship with deliberative (r = −.02) and intuitive style (r = −.01).
4 M. SEDLÁR AND J. GURŇÁKOVÁ

As can be seen in the meta-analysis results (Wang et al., 2017), the deliberative
style had the strongest positive relationships with conscientiousness and openness, and
the intuitive style had the strongest positive relationships with extraversion and open-
ness, while the relationships with agreeableness and neuroticism were rather negligible.
These relationships correspond to the characteristics of the traits as follows (John &
Srivastava, 1999). Conscientiousness is characterized by deliberation, a sense of order,
and a sense of duty, which is undoubtedly relevant for deliberate, thoughtful decisions.
Extraversion is characterized by positive emotionality, sociability, and activity, which
is more of a predisposition to intuitive, emotionally laden decisions. Openness is
characterized by intellectual curiosity, creativity, and broad interests, which goes hand
in hand with greater access to more thoughts and feelings, so this trait seems to play
a role in both deliberative and intuitive decisions. Agreeableness, which is characterized
by trust, altruism, sympathy, and neuroticism, which is characterized by negative
emotionality, impulsiveness, and self-consciousness, seem to be rather irrelevant for
intuitive and deliberative decision-making styles. At the same time, it must be said
that the relationships between the traits and the styles found in the meta-analysis were
very weak to weak (Wang et al., 2017). In addition, some studies have indicated that
the Big Five personality traits explained more of the variance in deliberative than
intuitive style (Bayram & Aydemir, 2017; Pacini & Epstein, 1999; Witteman et al.,
2009). This opens up the possibility of looking for more relevant psychological factors
of the decision-making styles. Such factors may be factors of emotional and social
intelligence.

Socio-Emotional Intelligence Factors and Decision-Making Styles

There are several conceptualizations of intrapersonal and interpersonal abilities in the
literature, which are usually measured together and grouped under the term “emotional
intelligence” (O’Connor et al., 2019). These abilities do matter in decision-making
(Avsec, 2012; Di Fabio & Kenny, 2012; Ibrahim & Elsabahy, 2020; Jokić & Purić, 2019;
Khan et al., 2016; Laborde et al., 2010; Rezaei & Jeddi, 2020; Schutte et al., 2010),
but only a few quantitative studies proved this with regard to decision-making styles
of medical students (El Othman et al., 2020) and healthcare professionals (Dilawar
et al., 2021; Kamhalová et al., 2013). Much of this research examined the total score
of emotional intelligence in decision-making; limited research examined the role of
individual emotional and social abilities in intuitive and deliberative style. Specifically,
Avsec (2012) found that managing and regulating one’s own and others’ emotions were
significantly positively related to both deliberative (r = .29) and intuitive style (r =
.30), perceiving and understanding one’s own and others’ emotions were significantly
positively related to both deliberative (r = .21) and intuitive style (r = .36), and
expressing and labeling one’s own and others’ emotions were also significantly positively
related to both deliberative (r = .20) and intuitive style (r = .35). Ibrahim and Elsabahy
(2020) found that perceiving emotions was significantly positively related to both
deliberative (r = .61) and intuitive style (r = .46), managing one’s own emotions was
also significantly positively related to both deliberative (r = .65) and intuitive style (r
= .43), managing others’ emotions was significantly positively related to deliberative
style (r = .41), and using emotions was significantly negatively related to deliberative
 The Journal of Psychology 5

style (r = −.50). Rezaei and Jeddi (2020) showed that social information processing
was significantly positively related to both deliberative (r = .33) and intuitive style
(r = .19), while deliberative style was significantly positively related to social awareness
(r = .29) and social skills (r = .36). Two things emerge from the above findings. First,
since weak-to-moderate correlations were found between the abilities and the styles,
the abilities may increase the explained variance of the deliberative and intuitive styles
and explain the two styles beyond the Big Five personality traits. Second, because each
ability was found to be differentially related to the decision-making styles, this may
indicate that each ability differs to a certain extent in how closely it is interwoven
with cognitive information processing required to deal with one’s own emotional states
and social situations. Accordingly, a greater differentiation between abilities seems to
be beneficial to better understand decision-making. For this reason, we refer to
socio-emotional intelligence in our study and distinguish between self-report emotional
intelligence and self-report social intelligence.
We use the term “emotional intelligence” in line with Salovey et al. (1995) to refer
to three intrapersonal abilities concerning one’s own emotional state, corresponding to
the following three factors. The attention factor denotes a self-report ability to attend
to and value one’s emotional states. The clarity factor denotes a self-report ability to
understand and discriminate clearly among one’s emotional states. The repair factor
denotes a self-report ability to regulate one’s emotional states. Although these are ways
of dealing with various feelings and moods, we assume that distinguishing between
them and regulating them requires more cognitive effort and deliberative processing
than paying attention to them, which can be seen as a kind of monitoring in which
feelings and moods are not processed much further. This is in line with the findings
demonstrating that emotional abilities should not only be positively associated with
intuitive processes using gut feelings and hunches, but also with deliberative processes
using rational evaluation and reasoning (Avsec, 2012; Ibrahim & Elsabahy, 2020).
We use the term “social intelligence” in line with Silvera et al. (2001) to refer to
interpersonal abilities concerning feelings, thoughts, and behaviors of others, corre-
sponding to three factors. The social information processing factor reflects a self-report
ability to understand other people’s feelings and messages transferred during interper-
sonal communication. The social skills factor reflects a self-report ability to interact
with others with ease and certainty even in new social situations. The social awareness
factor reflects a self-report ability to be aware of or unsurprised by events in social
situations. These abilities allow us to understand social contexts and behave accordingly,
based on more cognitively demanding processes such as perspective-taking and judging
others (Silvera et al., 2001). We therefore assume that all social abilities should be
positively associated with deliberative style. Since social processing involves processing
the feelings and thoughts of others, this factor should also be positively associated
with intuitive style. The proposed relationships are consistent with those found and
mentioned above (Rezaei & Jeddi, 2020).

Hypotheses
The present study aims to examine whether the Big Five personality traits together
with socio-emotional intelligence abilities explain intuitive and deliberative
6 M. SEDLÁR AND J. GURŇÁKOVÁ

decision-making styles in medical students and healthcare professionals. Although these

traits and abilities are considered non-cognitive individual differences (Louwen et al.,
2023), they are more or less related to cognitive information processing, as we describe
below, and may therefore play roles in decision-making styles.
Both examined styles represent usual ways of arriving at decisions: intuitive is based
on relying on gut feelings and affect, and deliberative is based on explicit evaluation
and reasoning (Betsch, 2004). Following characteristics of the Big Five personality
traits (John & Srivastava, 1999) and the results of the meta-analysis (Wang et al.,
2017), extraverts’ inclination to positive emotionality and acting before thinking may
prone them to engage mainly in intuitive decision-making style, and conscientious
people’s tendency to cautiousness and thinking before acting seems to be associated
with deliberative decision-making style. Since people with high openness are charac-
terized by breadth, depth, and complexity of mental life due to their access to more
thoughts and feelings, they may tend to be both deliberative and intuitive in
decision-making. Thus, we hypothesize that extraversion is significantly positively
related to intuitive style (H1), conscientiousness is significantly positively related to
deliberative style (H2), and openness is significantly positively related to both intuitive
(H3) and deliberative style (H4).
Furthermore, we hypothesize that socio-emotional intelligence significantly explains
decision-making styles above and beyond the Big Five personality traits (H5), as it is
potentially more relevant for decision-making (Dilawar et al., 2021; El Othman et al.,
2020; Jokić & Purić, 2019) and as suggested by the strength of associations of personality
traits (Wang et al., 2017) and socio-emotional intelligence factors (Ibrahim & Elsabahy,
2020; Rezaei & Jeddi, 2020) with decision-making styles. Due to the lack of previous
studies examining individual factors of socio-emotional intelligence in this sense, we base
the following hypotheses mainly on the conceptualization of emotional intelligence (Salovey
et al., 1995) and social intelligence (Silvera et al., 2001). Since the attention factor is about
paying attention to one’s feelings and moods, which does not require a great deal of
cognitive effort, it may be positively related to intuitive decision-making style. On the
other hand, the factors clarity and repair seem to require more cognitive effort to dis-
tinguish between and regulate emotions, so they may be positively related to deliberative
decision-making style. Since social processing, social skills, and social awareness are based
on more cognitively demanding processes to understand social contexts, they may be
positively related to deliberative decision-making style. Besides, social processing may also
be positively related to intuitive decision-making style, as it processes the feelings and
thoughts of others. In sum, we hypothesize that the attention to one’s feelings is signifi-
cantly positively related to intuitive style (H6), the clarity of one’s feelings, repair of one’s
feelings, social skills, and social awareness are significantly positively related to deliberative
style (H7, H8, H9, H10, respectively), and the social processing is significantly positively
related to both intuitive (H11) and deliberative style (H12).

Method
Participants
Participants were recruited in the international professional exercise and competition
called Rallye Rejvíz1 in 2015 and 2016. An e-mail request to participate in the online
 The Journal of Psychology 7

Table 1. Characteristics of Participants (N = 203).

Characteristic Sample
Age, years
 Range 21–55
Mean (SD) 29.94 (6.74)
Sex, n (%)
Man 124 (61.1)
Woman 79 (38.9)
Occupational status, n (%)
Medical student 50 (24.6)
 Healthcare professional 153 (75.4)
Work experience in healthcare, years
 Range 0–30
Mean (SD) 6.68 (6.38)
Country, n (%)
 Slovakia 64 (31.5)
 Czechia 139 (68.5)

survey along with informed consent and a set of scales were sent to all Slovak- and
Czech-registered competitors. After excluding duplicates (if participating in the research
both years, the earlier responses were used) and incomplete surveys, the research
sample consists of 203 medical students and healthcare professionals (physicians, para-
medics, nurses, ambulance drivers, and emergency dispatchers). Characteristics of the
participants are given in Table 1.

Measures
We used the already translated Slovak versions of the measures described below, with
the exception of the one measuring personality traits, which was back-translated into
Slovak for this research. Since Slovak and Czech languages are very similar, the Czech
versions of the measures were created with the help of a native speaker.

Big Five Personality Traits

The Big Five Inventory (John & Srivastava, 1999) was used to measure five personality
traits: Extraversion (eight items; e.g., I see myself as someone who is outgoing, sociable),
Agreeableness (nine items; e.g., I see myself as someone who is helpful and unselfish),
Conscientiousness (nine items; e.g., I see myself as someone who does a thorough job),
Neuroticism (eight items; e.g., I see myself as someone who gets nervous easily), and
Openness (10 items; e.g., I see myself as someone who values artistic, esthetic experi-
ences). Participants responded on a 5-point scale (1 = strongly disagree, 5 = strongly
agree). Higher scores represent more extraversion, agreeableness, conscientiousness,
neuroticism, and openness.

Emotional Intelligence
The Trait Meta-Mood Scale (Salovey et al., 1995; Slovak version by Látalová & Pilárik,
2014) was used to assess three factors of self-report emotional intelligence: Attention
(13 items; e.g., I pay a lot of attention to how I feel), Clarity (11 items; e.g., I am
usually very clear about my feelings), and Repair (six items; e.g., I try to think good
thoughts no matter how badly I feel). Participants responded on a 5-point scale
8 M. SEDLÁR AND J. GURŇÁKOVÁ

(1 = strongly disagree, 5 = strongly agree). Higher scores represent better attention, clarity,
and repair of one’s feelings.

Social Intelligence
The Tromsø Social Intelligence Scale (Silvera et al., 2001; Slovak version by Baumgartner
& Vasiľová, 2006) was used to assess three factors of self-report social intelligence:
Social Information Processing (seven items; e.g., I can often understand what others
are trying to accomplish without the need for them to say anything), Social Skills (seven
items; e.g., I am good at entering new situations and meeting people for the first time),
and Social Awareness (seven items; e.g., Other people become angry with me without
me being able to explain why). Participants responded on a 7-point scale (1 = describes
me extremely poorly, 7 = describes me very well). Higher scores represent better social
information processing, social skills, and social awareness.

Decision-Making Styles
The Preference for Intuition and Deliberation Scale (Betsch, 2004; Slovak version by
Ballová Mikušková et al., 2015) was used to measure two decision-making styles:
Intuition (nine items; e.g., My feelings play an important part in my decisions) and
Deliberation (nine items; e.g., Before making decisions I think them through). Participants
answered on a 5-point scale (1 = strongly disagree, 5 = strongly agree). Higher scores
represent a higher tendency to rely on intuition and deliberation when making decisions.

Covariates
Participants also provided information on their age (in years), sex (1 = man, 2= woman),
occupational status (1 = medical student, 2 = healthcare professional), and work experience
in healthcare (in years).

Statistical Analyses
All analyses were performed using IBM SPSS Statistics 20. Firstly, reliability (Cronbach’s
alpha), descriptive, and correlation analysis (Pearson) were carried out. The resulting
correlations were also corrected for attenuation, i.e., for the measurement error due
to the imperfect reliability of the measures, based on the disattenuation formula using
the corresponding Cronbach’s alpha reliabilities (Schmidt & Hunter, 1996). Perfect
reliabilities were assumed for covariates that were measured with single questions.
Thereafter, to address the main aim of the study, hierarchical regression analyses were
used to examine direct relationships of personality traits, factors of emotional intelli-
gence, and factors of social intelligence with decision-making styles. In regression
analyses explaining intuitive and deliberative decision-making style, personality traits
were entered into Model 1, and factors of emotional and social intelligence were
entered into Model 2. These regression analyses were conducted with and without
covariates. It should be noted that they were conducted on the basis of uncorrected
correlations, as regression analysis relies on significance tests to determine which
variables are important, and values corrected for attenuation cannot be tested for
significance (Muchinsky, 1996).
 The Journal of Psychology 9

Results
Correlation Analysis
Results of the correlation analysis given in Table 2 show weak-to-moderate significant
relationships with decision-making styles. Intuitive style was positively related to open-
ness, attention, repair, social information processing, and social skills, and deliberative
style was positively related to conscientiousness, openness, clarity, repair, and social
information processing.
The disattenuated correlation matrix (Supplementary Table 1) showed that the
magnitude of most reported correlations was stronger, but not dramatically stronger,
than in the attenuated correlation matrix (Table 2), while the disattenuated correlations
were consistent with the predicted values in terms of the reliabilities and correlations
of our study (Muchinsky, 1996). It can be concluded that there were no substantial
measurement errors in our data. The disattenuated correlation matrix (Supplementary
Table 1) also showed that none of the correlations between the individual personality
traits, the socio-emotional intelligence factors, and the decision-making styles were
excessively strong. These variables can therefore be regarded as measures of different
constructs. However, there was a very strong correlation between age and work expe-
rience in healthcare. As work experience in healthcare is already reflected in occupa-
tional status, only age was used as a covariate in the subsequent regression analyses
in addition to sex and occupational status. This was done to avoid multicollinearity.

Hierarchical Regression Analyses

The results of the regression analyses with covariates are given in Table 3. According
to the results of the first regression analysis, Model 1 with covariates and Big Five
personality traits significantly explained 5% of the variance in intuitive style (R = .30,
R2 = .09, adjusted R2 = .05, p < .05), while only openness was significantly positively
related to intuition. Model 2 with added factors of emotional and social intelligence
significantly explained 38% of the variance in intuitive style (R = .65, R2 = .42, adjusted
R2 = .38, p < .001), and the explained variance increased significantly (ΔR2 = .33, p
< .001). In Model 2, attention and social information processing were significantly
positively related to intuition; clarity and social awareness were significantly negatively
related to intuition. Openness was no longer significantly related to intuition. Among
covariates, age was significantly positively related to intuition.
According to the results of the second regression analysis, Model 1 with covariates
and Big Five personality traits significantly explained 19% of the variance in deliber-
ative style (R = .48, R2 = .23, adjusted R2 = .19, p < .001), while conscientiousness,
neuroticism, and openness were significantly positively related to deliberation. Model
2 with added factors of emotional and social intelligence significantly explained 26%
of the variance in deliberative style (R = .56, R2 = .31, adjusted R2 = .26, p < .001),
and the explained variance increased significantly (ΔR2 = .08, p < .01). In this Model
2, repair and social information processing were significantly positively related to
deliberation. Among personality traits, conscientiousness and neuroticism remained
significantly related to deliberation; openness was no longer significantly related to
deliberation. Among covariates, occupational status was significantly negatively related
to deliberation.
 10

Table 2. Descriptive Statistics and Correlation Matrix.

Variable M SD α 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16.
1. Age 29.94 6.74 – –
M. SEDLÁR AND J. GURŇÁKOVÁ

2. Sex – – – −.20 –
3. OS – – – .47 −.39 –
4. WE 6.68 6.38 – .87 −.13 .45 –
5. Extraversion 3.76 0.70 .84 −.04 .02 −.00 −.04 –
6. Agreeableness 3.86 0.56 .74 −.03 −.07 .07 .00 .18 –
7. Conscientiousness 3.83 0.57 .80 .03 −.04 .15 .07 .34 .29 –
8. Neuroticism 2.40 0.68 .83 −.03 .24 −.16 −.05 −.45 −.30 −.52 –
9. Openness 3.79 0.52 .76 −.02 −.08 −.13 −.08 .37 .27 .33 −.25 –
10. Attention 3.46 0.55 .81 −.05 .36 −.20 −.04 .02 .13 −.04 .18 .12 –
11. Clarity 3.66 0.47 .71 .07 −.04 .06 .07 .27 .09 .31 −.40 .24 .17 –
12. Repair 4.00 0.56 .69 .04 .06 −.02 .03 .34 .24 .29 −.41 .32 .15 .41 –
13. Social processing 5.12 0.76 .80 .01 .05 −.00 .02 .22 .12 .22 −.21 .37 .21 .39 .35 –
14. Social skills 4.98 1.07 .85 −.05 .00 −.04 −.04 .68 .23 .29 −.41 .41 .07 .41 .43 .49 –
15. Social awareness 4.85 0.91 .75 .03 .04 −.03 .00 .16 .16 .19 −.26 .15 .08 .39 .34 .32 .44 –
16. Intuition 3.33 0.52 .74 .07 .13 −.09 .05 .12 .11 .10 −.05 .22 .52 .06 .18 .38 .17 −.03 –
17. Deliberation 3.76 0.47 .68 .03 −.06 −.04 .03 .07 .10 .37 −.04 .29 −.02 .16 .22 .29 .12 .02 .11
Note. N = 203. OS: occupational status; WE: work experience in healthcare. Sex was coded as 1 = man, 2 = woman. Occupational status was coded as 1 = medical student, 2 = healthcare
professional. Correlations in bold are significant. Correlations of r > .14 are significant at p < .05. Correlations of r > .17 are significant at p < .01. Correlations of r > .23 are sig-
nificant at p < .001.
 The Journal of Psychology 11

Table 3. Hierarchical Regression Analyses Explaining Intuitive and Deliberative Decision-Making Styles
(with Covariates).
Intuition Deliberation
Variable B SE β p B SE β p
Model 1
 Age .01 .01 .14 .075 .00 .01 .06 .385
 Sex .15 .08 .14 .078 −.12 .07 −.12 .090
 Occupational status −.10 .10 −.09 .316 −.14 .09 −.12 .120
 Extraversion .02 .06 .03 .740 −.03 .05 −.04 .605
 Agreeableness .06 .07 .06 .402 −.01 .06 −.01 .922
 Conscientiousness .02 .08 .03 .755 .38 .07 .46 <.001
 Neuroticism .00 .07 .00 .982 .17 .06 .24 .004
 Openness .19 .08 .19 .020 .17 .07 .19 .011
R = .30, R2 = .09, adjusted R2 = .05, R = .48, R2 = .23, adjusted R2 = .19,
F(8, 194) = 2.36, p < .05 F(8, 194) = 7.09, p < .001
Intuition Deliberation
Variable B SE β p B SE β p
Model 2
 Age .01 .00 .13 .045 .00 .00 .06 .429
 Sex −.06 .07 −.06 .394 −.13 .07 −.13 .072
 Occupational status −.10 .08 −.09 .229 −.17 .09 −.15 .049
 Extraversion −.01 .06 −.01 .875 −.02 .06 −.03 .713
 Agreeableness −.03 .06 −.03 .587 .02 .06 .03 .703
 Conscientiousness .06 .06 .06 .368 .37 .06 .44 <.001
 Neuroticism −.11 .06 −.14 .082 .24 .06 .34 <.001
 Openness .03 .07 .03 .694 .09 .07 .10 .195
 Attention .49 .06 .52 <.001 −.12 .06 −.14 .058
 Clarity −.21 .08 −.19 .006 .07 .08 .07 .374
 Repair .04 .06 .04 .579 .16 .06 .18 .016
 Social processing .22 .05 .32 <.001 .15 .05 .24 .002
 Social skills .02 .05 .04 .652 −.03 .05 −.06 .585
 Social awareness −.10 .04 −.17 .010 −.06 .04 −.12 .106
R = .65, R2 = .42, adjusted R2 = .38, F(14, R = .56, R2 = .31, adjusted R2 = .26, F(14,
188) = 9.81, p < .001 188) = 6.02, p < .001
ΔR2 = .33, ΔF(6, 188) = 18.08, p < .001 ΔR2 = .08, ΔF(6, 188) = 3.78, p < .01
Note. N = 203. In both models in both regression analyses, all tolerance statistics values were above 0.1 (ranging from
0.34 to 0.79) and all variance inflation factor values were below 3 (ranging from 1.18 to 2.93), suggesting no mul-
ticollinearity problem (Field, 2018). Sex was coded as 1 = man, 2 = woman. Occupational status was coded as 1 = med-
ical student, 2 = healthcare professional. Significant relationships are in bold.

The results of the regression analyses without covariates can be found in Supplementary
Table 2. In view of the significance of the relationships and the explained variances,
they show similar results to the regression analyses with covariates (Table 3). In addi-
tion, they showed that openness was significantly positively and attention significantly
negatively related to deliberation. Since regression analyses with covariates generally
improve the accuracy of the models, their results are discussed.

Additional Exploratory Analyses of Suppressor Effects

A comparative examination of the results of the correlation (Table 2) and regression
analyses (Table 3) revealed that some regression relationships were stronger than the
corresponding bivariate relationships. These discrepancies indicate the presence of
suppressor variables. “A suppressor variable is a variable which increases the predictive
validity of another variable (or set of variables) by its inclusion in a regression equa-
tion” (Conger, 1974, p. 36). The inclusion of the suppressor variable in a regression
12 M. SEDLÁR AND J. GURŇÁKOVÁ

Table 4. Total and Direct Effects.

Variable B SE β p
Direct effects
 NE → DE .15 .05 .21 .005
 CO → DE .40 .06 .48 <.001
 SA → IN −.09 .04 −.16 .017
 SP → IN .29 .05 .43 <.001
 CL → IN −16 .07 −.15 <.001
Total effects
 NE → DE −.03 .05 −.04 .604
 CO → DE .31 .05 .37 <.001
 SA → IN −.02 .04 −.03 .709
 SP → IN .26 .04 .38 <.001
 CL → IN .07 .08 .07 .357
Note. N = 203. CO: conscientiousness; NE: neuroticism; CL: clarity; SP: social processing; SA: social awareness; IN: intuition;
DE: deliberation.

Table 5. Indirect Effects.

Unstandardized Completely standardized
95% Boot CI 95% Boot CI
Path Effect BootSE [LL, UL] Effect BootSE [LL, UL]
NE → CO → DE −.17 .04 [−.25, −.11] −.25 .05 [−.35, −.16]
CO → NE → DE −.09 .03 [−.16, −.03] −.11 .04 [−.19, −.04]
SP → SA → IN −.04 .12 [−.08, −.01] −.05 .03 [−.11, −.01]
SA → SP → IN .08 .02 [.04, .12] .14 .04 [.07, .22]
CL → AT → IN .08 .04 [.01, .16] .08 .03 [.01, .15]
CL → SP → IN .15 .04 [.08, .22] .13 .03 [.08, .20]
Note. N = 203. CO: conscientiousness; NE: neuroticism; AT: attention; CL: clarity; SP: social processing; SA: social
awareness; IN: intuition; DE: deliberation.

equation provides a more accurate description of the relationships under investigation.

Testing a suppressor effect is statistically similar to testing a mediation effect. In a
mediation model, a suppressor effect exists when the inclusion of the mediator (M)
increases the predictive validity of the predictor (X) on the outcome (Y), i.e., the direct
effect of the predictor is greater than its total effect, and the direct and indirect effects
of the predictor on the outcome have opposite signs (MacKinnon et al., 2000). Hence,
to test the suppressor effects, exploratory mediation analyses were conducted using
the PROCESS macro, Version 4.2, Model 4. To test the significance of the indirect
effects, the bootstrapping method based on 5000 samples and 95% confidence intervals
was used.
Tables 4 and 5 show the results of four simple mediation analyses (X = conscien-
tiousness, M = neuroticism, Y = deliberation; X = neuroticism, M = conscientiousness,
Y = deliberation; X = social awareness, M = social processing, Y = intuition; X =
social processing, M = social awareness, Y = intuition) and a mediation analysis with
two parallel mediators (X = clarity, M1 = attention, M2 = social processing, Y = intu-
ition). Taking into account the above-mentioned criteria (MacKinnon et al., 2000), it
can be said that the analyses revealed the following effects. The suppressor effect of
conscientiousness on the relationship between neuroticism and deliberation. The sup-
pressor effect of neuroticism on the relationship between conscientiousness and delib-
eration. The suppressor effect of social processing on the relationship between social
awareness and intuition. The suppressor effect of social awareness on the relationship
 The Journal of Psychology 13

between social processing and intuition. The joint suppressor effect of attention and
social processing on the relationship between clarity and intuition.

Discussion
Examining individual differences in intuitive and deliberative decision-making styles
is important given the impact of intuition and deliberation on actual performance in
the workplace (Alaybek et al., 2022; Croskerry & Norman, 2008; Flin et al., 2017) and
the lack of research on this topic among individuals who provide healthcare services
(Dilawar et al., 2021; El Othman et al., 2020; Halama & Gurňáková, 2014; Kamhalová
et al., 2013; Parker-Tomlin et al., 2019). Therefore, the purpose of the present study
was to examine the roles of the Big Five personality traits and factors of the self-report
socio-emotional intelligence in intuitive and deliberative decision-making styles in
medical students and healthcare professionals. The results of regression analyses showed
that attention to one’s emotions and social information processing were positively
related to intuitive style, while the clarity of one’s emotions and social awareness were
negatively related to intuitive style. They also showed that conscientiousness, neurot-
icism, repair of one’s emotions, and social information processing were positively
related to deliberative style.
Among the personality traits, higher conscientiousness and neuroticism were related
to more deliberation. In the case of conscientiousness, this result met our expecta-
tions and is in line with several previous studies (Bayram & Aydemir, 2017; Dewberry
et al., 2013; El Othman et al., 2020; Pacini & Epstein, 1999; Parker-Tomlin et al.,
2019; Riaz et al., 2012; Wang et al., 2017; Witteman et al., 2009). Conscientious
people are goal-oriented, cautious, thoughtful, and have a sense of order and duti-
fulness (Costa et al., 1991), and this perfectly matches with their predominant use
of a deliberative decision-making style as a more cognitively demanding style. We
did not expect neuroticism to be significantly positively related to deliberation, but
this result still seems reasonable even if it contradicts the results of some previous
studies (El Othman et al., 2020; Pacini & Epstein, 1999; Parker-Tomlin et al., 2019;
Witteman et al., 2009). The vulnerable, un-self-confident, anxious, and insecure side
of neurotic individuals (John & Srivastava, 1999) can lead them to more deliberative
decision-making, just to make sure they are correct, which may be amplified by the
importance of making optimal healthcare-related decisions. This interpretation is
consistent with a study (Perkins & Corr, 2005, p. 25) showing that anxiety, as a facet
of neuroticism, is “an important component of motivated cognition, essential for
efficient functioning in situations that require caution, self-discipline and the general
anticipation of threat,” which is only true for individuals with better cognitive abil-
ities. Our interpretation is also consistent with a study (Byrne et al., 2015) suggesting
that highly neurotic individuals who automatically reduce their increased anxiety
levels under pressure may effectively use their cognitive resources to think about
important decisions. Otherwise, highly neurotic individuals are more likely to make
impulsive decisions, as their increased anxiety levels under pressure may increase
pressure-related intrusive thoughts that reduce cognitive resources. Noteworthy, addi-
tional exploratory analyses showed that the discussed relationship between neuroticism
and deliberation was subject to the suppressor effect of conscientiousness, and the
14 M. SEDLÁR AND J. GURŇÁKOVÁ

relationship between conscientiousness and deliberation was subject to the suppressor

effect of neuroticism. This means that the real relationships between these two per-
sonality traits and deliberation remained hidden until both traits were included together
in the regression equation and removed (suppressed) the irrelevant variance in each
other. Thus, both higher conscientiousness and higher neuroticism play an important
synergic role in a higher tendency to use deliberative style in medical students and
healthcare professionals.
Furthermore, it was revealed that consistent with our hypotheses and the literature
(Bayram & Aydemir, 2017; Pacini & Epstein, 1999; Parker-Tomlin et al., 2019; Wang
et al., 2017; Witteman et al., 2009), higher openness characterized by a rich mental
life (John & Srivastava, 1999) with access to more thoughts, feelings, and impulses in
awareness (McCrae & Costa, 1997) was found to be related to a higher tendency to
use both intuition and deliberation. Adding emotional and social intelligence factors
to the regression equation, the openness trait was, however, no longer significantly
related to decision styles. This suggests a typical redundancy situation, or indirect
relationships through one or more socio-emotional intelligence factors, as found pre-
viously (El Othman et al., 2020).
Each of the three factors of emotional intelligence were related to decision styles,
which corresponds with previous findings on the roles of emotional abilities in
decision-making (e.g., Avsec, 2012; Di Fabio & Kenny, 2012; El Othman et al., 2020;
Jokić & Purić, 2019; Khan et al., 2016). Here, it was found that a better ability to
attend to and value one’s emotional states was related to a higher tendency to rely
on intuition, which is characterized by using emotions and hunches in decision-making.
Furthermore, a better ability to regulate one’s emotional states, which requires more
cognitive effort, was related to a higher tendency to rely on deliberation. Similarly,
Kamhalová et al. (2013) found that higher cognitive and behavioral engagement in
regulating emotions was related to more vigilance and rationality in the decision-making
of healthcare professionals. Contrary to our expectation, the clarity factor correlated
significantly positively with deliberative style, but this relationship was no longer
significant in the regression analysis, indicating a redundancy situation. In fact,
according to the regression analysis, the clarity factor was negatively related to intu-
itive style. So, the more a person understands and can discriminate among his
emotional states, the lower the tendency to use intuition. This finding is still justi-
fiable as the clarity lay in more explicit reasoning about emotional states, not in
their mindless utilization. However, our additional analyses showed that the rela-
tionship between clarity and intuition was only detectable when the attention factor
and the social processing factor were simultaneously included in the regression
equation alongside the clarity factor. Strictly speaking, the relationship was subject
to the joint suppressor effect of attention and social processing. This means that
better emotional clarity of medical students and healthcare professionals is indeed
significantly associated with their lower tendency to use intuitive style, but only in
the case of their poorer attention to emotions as well as their poorer processing of
social information.
Two of the three factors of social intelligence were related to decision styles. This
is congruent with the importance of socio-emotional abilities in decision-making
and processing styles (e.g., Dilawar et al., 2021; Ibrahim & Elsabahy, 2020; Laborde
 The Journal of Psychology 15

et al., 2010; Schutte et al., 2010). Better processing of social information (e.g., feel-
ings, thoughts, or nonverbal messages from others; Silvera et al., 2001) was related
to both a higher tendency to rely on intuition and deliberation, just as we hypoth-
esized and was found in a previous study (Rezaei & Jeddi, 2020). So, being able to
process a variety of social information predisposes people to naturally use both
quicker and slower decision-making styles. This social information processing was
the only variable that was positively related to both decision-making styles resembling
thought processes of System 1 and System 2, the combination of which is considered
optimal (Croskerry & Norman, 2008). Although social awareness was not positively
related to deliberation as expected, it was negatively related to intuition. This means
that being aware of or unsurprised by events in social situations is not associated
with a higher tendency to use deliberative style, but with a lower tendency to use
intuitive style. Noteworthy, exploratory analyses again showed suppressor effects. The
relationship between social processing and intuition was suppressed by social aware-
ness, and the relationship between social awareness and intuition was suppressed by
social processing. In other words, the real relationships between the two factors of
social intelligence and intuition were masked until the two factors were entered
together into the regression equation and removed (suppressed) the irrelevant vari-
ance in each other. Thus, better social processing and poorer social awareness are
mutually important for a higher tendency to use intuitive style in medical students
and healthcare professionals. Contrary to our expectations, social skills were not
associated with deliberative style. This could be because social skills are more of a
behavioral factor of social intelligence, while the other two factors are more cognitive
in their nature (Silvera et al., 2001).
Overall, as expected, emotional and social intelligence factors explained the vari-
ance in both decision-making styles above and beyond the Big Five personality traits
in a sample of medical students and healthcare professionals. While the Big Five
personality traits significantly explained 19% of the variance in deliberative style,
the addition of emotional and social intelligence factors significantly increased the
explained variance to 26%. While the Big Five personality traits significantly explained
5% of the variance in intuitive style, the addition of emotional and social intelligence
factors significantly increased the explained variance to 38%. These findings provide
clear proof that the Big Five personality traits mainly explain deliberative style and
socio-emotional intelligence factors mainly explain intuitive style. The former finding
is in line with previous research (Bayram & Aydemir, 2017; Pacini & Epstein, 1999;
Witteman et al., 2009), which showed that the Big Five personality traits better
explain deliberative rather than intuitive style. Moreover, the latter finding showed
that socio-emotional intelligence factors better explain intuitive rather than deliber-
ative style.

Implications
Our study sheds light on the factors associated with intuitive and deliberative
decision-making styles. Specifically, it revealed that better attention to one’s emotions
and poorer social awareness were associated with a stronger preference for intuitive
style. Higher conscientiousness, higher neuroticism, and better repair of one’s emotions
16 M. SEDLÁR AND J. GURŇÁKOVÁ

were associated with a stronger preference for deliberative style. Better social infor-
mation processing was the only factor associated with a stronger preference for both
intuitive and deliberative styles.
Thus, our findings provide a deeper understanding of decision-making and could
be useful for both those at the “sharp end” of health system (healthcare professionals
in the direct contact with patients) and those at the “blunt end” of health system (e.g.,
executives, managers, administrators, regulators, policy-makers, system designers) to
improve the healthcare provided. First, it should be acknowledged that personality
traits and socio-emotional intelligence are related to decision-making styles that can
play a role in actual decisions and performance in the workplace (Alaybek et al., 2022;
Flin et al., 2017), but rather than using the intuitive style or the deliberative style
across the spectrum of situations, a combined use of the two styles depending on the
appropriateness in a given situation is closer to optimal (Croskerry & Norman, 2008).
Then, appropriate system changes could be proposed and implemented. Such a change
could start with raising awareness among medical students and healthcare professionals,
focusing on the pitfalls of favoring intuitive or deliberative decisions and how their
personality traits and socio-emotional intelligence can contribute to their decision-making.
At the same time, this awareness-raising could emphasize self-reflection and
self-knowledge, as they are important for better, more informed decision-making.
Knowledge about intuitive and deliberative decision-making could also be considered
and, if possible, incorporated into the training of medical students and healthcare
professionals and into the development of decision-support tools.

Limitations and Recommendations for Future Research

There are three potential limitations of this study, therefore, the applicability and
generalizability of our findings should be viewed with caution. First, the research
sample is quite specific. It consisted exclusively of participants who were highly moti-
vated to participate in the Rallye Rejvíz (International professional exercise and com-
petition for emergency medical services crews), which is open to healthcare professionals
working in emergency medical services and healthcare professionals and medical
students interested in emergency medical services. Additionally, participants in our
study were also motivated to participate in the research. Such participants could have
had different characteristics and a different way of making decisions than other health-
care professionals and medical students. We recommend verifying our results on a
different sample. Second, because of the cross-sectional nature of our study and the
use of self-report measures of personality traits, socio-emotional abilities, and
decision-making styles, we cannot draw conclusions about the demonstration of the
variables examined in actual performance or about the causality of the relationships
examined. It should also be pointed out that the observation of intuitive and deliber-
ative styles in itself “does not constitute evidence for dual processes arising from two
distinct cognitive systems,” System 1 and System 2 (Evans, 2008, p. 263). Therefore,
the use of other research designs and performance-based measures could be considered
in future studies. Third, adding individual factors of emotional and social intelligence
to the regression equation could have increased the explained variance more than
adding total scores of emotional intelligence and social intelligence. We did this
 The Journal of Psychology 17

intentionally to disentangle relationships between these factors and decision-making

styles and recommend doing so in the future to reveal such specifics.

Conclusion
A lack of research has been conducted trying to explain decision-making styles by
socio-emotional intelligence along with personality traits; this is even more true among
medical students and healthcare professionals. Therefore, our study has focused on this
issue, while differentiating self-report emotional (intrapersonal) intelligence and self-report
social (interpersonal) intelligence. We found that the Big Five personality traits explained
more of the variance in the deliberative style than in the intuitive style, while the
socio-emotional intelligence factors explained more of the variance in intuitive style than
in deliberative style. Specifically, medical students and healthcare professionals who
tended to make intuitive decisions were better at paying attention to their feelings but
were not very good at discriminating among them clearly; they were better at processing
social information but not very good at using it to behave appropriately in social situ-
ations. Those who tended to make deliberative decisions were more conscientious and
neurotic and were better at repairing their feelings and processing social information.
As outlined, only those who were better at processing social information tended to make
both intuitive and deliberative decisions. In summary, the findings point to the impor-
tance of personality and socio-emotional intelligence in understanding decision-making
styles of medical students and healthcare professionals.

Note
1. The Rallye Rejvíz is a simulation-based international professional exercise and competition
for emergency medical services crews, which takes place annually in Czechia. Although
healthcare professionals working in emergency medical services are of course the largest
group of participants in this competition, other healthcare professionals and medical stu-
dents interested in emergency medical services are also welcome. There are several catego-
ries of the competition, including the student category (student teams), the national cate-
gory (Slovak and Czech professional teams), and the international category (professional
teams from the rest of the world). Within the categories, the teams compete against each
other in carefully prepared tasks of varying difficulty, representing pre-hospital situations
that emergency medical services teams may face in the real world. Each team’s performance
in each task is rated by expert judges (experienced and trained in rating clinical perfor-
mance in the field) based on predetermined criteria. For more information on this compe-
tition, please visit https://rallye-rejviz.cz/en/.

Author Contributions
Martin Sedlár: conceptualization, formal analysis, methodology, investigation, resources, and writing –
original draft. Jitka Gurňáková: methodology, investigation, resources, and writing – review and editing.

Ethical Approval and Patient Consent

The study was carried out in accordance with the Ethical Principles of Psychologists and Code
of Conduct introduced by the American Psychological Association and The European Code of
18 M. SEDLÁR AND J. GURŇÁKOVÁ

Conduct for Research Integrity. All participants gave informed consent to participate in the
research.

Disclosure Statement
The authors declare no conflict of interest.

Funding
This study was supported by the Scientific Grant Agency of the Ministry of Education, Science,
Research and Sport of the Slovak Republic and Slovak Academy of Sciences (Grant No. VEGA
2/0083/22: strategies, resources, and consequences of emotion regulation in the provision of
health care).

Author Notes
Martin Sedlár is an experienced researcher interested in issues of personality and cognition in
the context of social, occupational, and health psychology. Some of his publications deal with
healthcare professionals working in emergency medical services. He has been a co-investigator of
several research grants.
Jitka Gurňáková is an experienced researcher who has dedicated most of her academic career to
the study of decision-making and non-technical skills of healthcare professionals working in
emergency medical services. She has led several research grants on this topic and is the pioneer
of naturalistic decision-making research in Slovakia.

ORCID ID
Martin Sedlár https://orcid.org/0000-0003-1512-2740
Jitka Gurňáková https://orcid.org/0000-0003-0651-5542

Data Availability Statement

The data that support the findings of this study are available on request from the correspond-
ing author.

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