EoE Module 11 References-Elwyn et al J Gen Intern Med 2012 Shared decision making A model for clinical practice

Elwyn et al J Gen Intern Med 2012 Shared decision making A model for clinical practice

Pdf Summary

The article, "Shared Decision Making: A Model for Clinical Practice" by Glyn Elwyn and colleagues, proposes a practical approach to shared decision making (SDM) in clinical settings. SDM allows clinicians and patients to collaboratively make healthcare decisions, emphasizing patient involvement and informed choices. Despite its potential benefits, SDM is not widely implemented due to the lack of clear guidance for routine clinical practice.<br /><br />The authors introduce a three-step model for SDM: choice talk, option talk, and decision talk. <br /><br />**Choice Talk:** This step involves introducing the patient to the idea that various options are available, emphasizing the importance of individual preferences, and addressing uncertainties. The objective is to ensure patients are aware of the choices and understand that treatment decisions involve their values and preferences.<br /><br />**Option Talk:** The second step involves providing detailed information about the available options, discussing the pros and cons, and exploring the patient’s reactions and preferences using decision support tools. High-quality information must be given to patients to prevent decisions made from a place of ignorance. <br /><br />**Decision Talk:** This final step focuses on supporting the patient as they deliberate on their options, aiding them in forming preferences and making informed decisions. Clinicians should offer guidance and reassurance, helping patients navigate potential uncertainties and encouraging them to take the time needed for deliberation, even outside the clinical setting.<br /><br />The model acknowledges challenges such as low health literacy and cultural differences and stresses the importance of clinician-patient communication skills. It underscores the need for clinicians to accept the ethical rationale behind SDM, ensuring informed and patient-centered decision-making. The article concludes that while the model simplifies a complex process, it provides a useful framework for integrating SDM into clinical practice effectively.

Keywords

shared decision making

clinical practice

patient involvement

choice talk

option talk

decision talk

healthcare decisions

patient-centered

communication skills

decision support tools