After a month of building decision-making skills, a group of Boston University School of Management students put them to the test by ranking a series of fictional patients based on who most deserved a chance at survival.

“Learning can’t happen unless we’re uncomfortable,” said SMG Professor Jack McCarthy, who teaches Organization Behavior 221.

The class completed an activity last week in which students worked in teams to rank fake patients in order of who deserves a liver transplant most. McCarthy said he has used this activity for more than 20 years.

The students formed teams, each of which had a mix of men and women, and reviewed patient profiles to reach a consensus on which patient to grant the liver transplant, students said.

While some students found this activity offensive and unethical, others found it very useful in learning the difficulties behind making group decisions.

“Some students were shocked, but not many said ‘I really don’t think I should be doing this,’” said William Maness, an SMG sophomore in the class. “I can see that it is a little heavy for an activity about learning to make decisions in a group, but I am not opposed to it as an exercise.”

There was no easy decision and no clear winner, Maness said.

McCarthy said the exercise is meant to force students to rank the applicants, as well as to address any concerns students may have with making such difficult decisions. No correct ranking exists, however, as the point is to understand different decision-making processes.

Deepika Sud, another SMG sophomore in the class, said some people may have taken the exercise the wrong way, but it was useful nonetheless.

“I don’t think [McCarthy] meant for this exercise to be as controversial as it was,” Sud said. “It was meant to make us think like a team.”

Students had to make sure they had valid reasons behind their decisions, Mannes said.

“Our professors concluded this exercise saying, ‘You will have to make really hard decisions in the business world, such as laying off workers, and you should have values and goals behind those decisions,’” Maness said.

“We know there are people on the frontier of life and death, and what we’re doing is trivial by comparison,” McCarthy said. “What I do know is that there will be decisions . . . that will challenge you and will force you to think ‘Why did I make that decision?’ Our values and belief systems guide us in ways that are sometimes hard to understand.”

The teaching assistants assigned students the activity in the first week of February, as it was meant to help students transition from individual decision making to group decision making. The liver transplant activity is the first exercise the team has to do together.

“We started the year learning about our own personal values and morals,” Maness. “This was the first time we had to check those against the rest of the team and learn how to make a group consensus.”

While this case may have seemed extreme, McCarthy said it makes students consider how each of their values, backgrounds and beliefs influence their respective decision-making processes. Adding the group aspect to this only made it more confusing.

“The activity helps students become aware of the values they are already operating on and that the decisions they make are driven by many of the values that they believe they hold,” said Sandra Deacon, another OB221 professor.

Despite the controversial topic the exercise involves, much of the feedback from students has been positive, the professors said.

Deacon said a student who took the class 20 years ago came back and told her he still remembers the exercise.

“He refused to rank anyone and made a production in class about tearing up a piece of paper and writing one through five on it and then picking randomly, rather than making a decision,” Deacon said.

Sud said the exercise not only taught students about controversies related to decision making, but also helped them address subjects they tend to avoid.

She said, “It started the conversation about making decisions and how different people approach different situations.”

Emily Overholt contributed to the reporting of this article.