A three-talk model for shared decision making: Multistage consultation process

Glyn Elwyn, Marie Anne Durand, Julia Song, Johanna Aarts, Paul J. Barr, Zackary Berger, Nan Cochran, Dominick Frosch, Dariusz Galasiski, Pål Gulbrandsen, Paul K.J. Han, Martin Härter, Paul Kinnersley, Amy Lloyd, Manish Mishra, Lilisbeth Perestelo-Perez, Isabelle Scholl, Kounosuke Tomori, Lyndal Trevena, Holly O. WittemanTrudy Van Der Weijden

Research output: Contribution to journalArticle

Abstract

Objectives To revise an existing three-talk model for learning how to achieve shared decision making, and to consult with relevant stakeholders to update and obtain wider engagement. Design Multistage consultation process. Setting Key informant group, communities of interest, and survey of clinical specialties. Participants 19 key informants, 153 member responses from multiple communities of interest, and 316 responses to an online survey from medically qualified clinicians from six specialties. Results After extended consultation over three iterations, we revised the three-talk model by making changes to one talk category, adding the need to elicit patient goals, providing a clear set of tasks for each talk category, and adding suggested scripts to illustrate each step. A new three-talk model of shared decision making is proposed, based on "team talk," "option talk," and "decision talk," to depict a process of collaboration and deliberation. Team talk places emphasis on the need to provide support to patients when they are made aware of choices, and to elicit their goals as a means of guiding decision making processes. Option talk refers to the task of comparing alternatives, using risk communication principles. Decision talk refers to the task of arriving at decisions that reflect the informed preferences of patients, guided by the experience and expertise of health professionals. Conclusions The revised three-talk model of shared decision making depicts conversational steps, initiated by providing support when introducing options, followed by strategies to compare and discuss trade-offs, before deliberation based on informed preferences.

Original languageEnglish (US)
Article numberS7
JournalBMJ (Online)
Volume359
DOIs
StatePublished - 2017

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Decision Making
Referral and Consultation
Public Opinion
Patient Preference
Communication
Learning
Health
Surveys and Questionnaires

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Elwyn, G., Durand, M. A., Song, J., Aarts, J., Barr, P. J., Berger, Z., ... Van Der Weijden, T. (2017). A three-talk model for shared decision making: Multistage consultation process. BMJ (Online), 359, [S7]. https://doi.org/10.1136/bmj.j4891

A three-talk model for shared decision making : Multistage consultation process. / Elwyn, Glyn; Durand, Marie Anne; Song, Julia; Aarts, Johanna; Barr, Paul J.; Berger, Zackary; Cochran, Nan; Frosch, Dominick; Galasiski, Dariusz; Gulbrandsen, Pål; Han, Paul K.J.; Härter, Martin; Kinnersley, Paul; Lloyd, Amy; Mishra, Manish; Perestelo-Perez, Lilisbeth; Scholl, Isabelle; Tomori, Kounosuke; Trevena, Lyndal; Witteman, Holly O.; Van Der Weijden, Trudy.

In: BMJ (Online), Vol. 359, S7, 2017.

Research output: Contribution to journalArticle

Elwyn, G, Durand, MA, Song, J, Aarts, J, Barr, PJ, Berger, Z, Cochran, N, Frosch, D, Galasiski, D, Gulbrandsen, P, Han, PKJ, Härter, M, Kinnersley, P, Lloyd, A, Mishra, M, Perestelo-Perez, L, Scholl, I, Tomori, K, Trevena, L, Witteman, HO & Van Der Weijden, T 2017, 'A three-talk model for shared decision making: Multistage consultation process', BMJ (Online), vol. 359, S7. https://doi.org/10.1136/bmj.j4891
Elwyn, Glyn ; Durand, Marie Anne ; Song, Julia ; Aarts, Johanna ; Barr, Paul J. ; Berger, Zackary ; Cochran, Nan ; Frosch, Dominick ; Galasiski, Dariusz ; Gulbrandsen, Pål ; Han, Paul K.J. ; Härter, Martin ; Kinnersley, Paul ; Lloyd, Amy ; Mishra, Manish ; Perestelo-Perez, Lilisbeth ; Scholl, Isabelle ; Tomori, Kounosuke ; Trevena, Lyndal ; Witteman, Holly O. ; Van Der Weijden, Trudy. / A three-talk model for shared decision making : Multistage consultation process. In: BMJ (Online). 2017 ; Vol. 359.
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AU - Berger, Zackary

AU - Cochran, Nan

AU - Frosch, Dominick

AU - Galasiski, Dariusz

AU - Gulbrandsen, Pål

AU - Han, Paul K.J.

AU - Härter, Martin

AU - Kinnersley, Paul

AU - Lloyd, Amy

AU - Mishra, Manish

AU - Perestelo-Perez, Lilisbeth

AU - Scholl, Isabelle

AU - Tomori, Kounosuke

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AU - Van Der Weijden, Trudy

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