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Shared Decision Making: A Model for Clinical Practice

Lookup NU author(s): Emeritus Professor Richard Thomson, Carole Dodd


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The principles of shared decision making are well documented but there is a lack of guidance about how to accomplish the approach in routine clinical practice. Our aim here is to translate existing conceptual descriptions into a three-step model that is practical, easy to remember, and can act as a guide to skill development. Achieving shared decision making depends on building a good relationship in the clinical encounter so that information is shared and patients are supported to deliberate and express their preferences and views during the decision making process. To accomplish these tasks, we propose a model of how to do shared decision making that is based on choice, option and decision talk. The model has three steps: a) introducing choice, b) describing options, often by integrating the use of patient decision support, and c) helping patients explore preferences and make decisions. This model rests on supporting a process of deliberation, and on understanding that decisions should be influenced by exploring and respecting "what matters most" to patients as individuals, and that this exploration in turn depends on them developing informed preferences.

Publication metadata

Author(s): Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P, Cording E, Tomson D, Dodd C, Rollnick S, Edwards A, Barry M

Publication type: Article

Publication status: Published

Journal: Journal of General Internal Medicine

Year: 2012

Volume: 27

Issue: 10

Pages: 1361-1367

Print publication date: 01/10/2012

ISSN (print): 0884-8734

ISSN (electronic): 1525-1497

Publisher: Springer New York LLC


DOI: 10.1007/s11606-012-2077-6


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