Shared Decision Making: A Model for Clinical PracticeReport as inadecuate

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Journal of General Internal Medicine

, Volume 27, Issue 10, pp 1361–1367

First Online: 23 May 2012Received: 22 August 2011Revised: 03 January 2012Accepted: 03 April 2012


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.

Key Wordsshared decision making patient centered care  Download fulltext PDF

Author: Glyn Elwyn - Dominick Frosch - Richard Thomson - Natalie Joseph-Williams - Amy Lloyd - Paul Kinnersley - Emma Cording - Dav


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