TY - JOUR
T1 - A three-talk model for shared decision making
T2 - Multistage consultation process
AU - Elwyn, Glyn
AU - Durand, Marie Anne
AU - Song, Julia
AU - Aarts, Johanna
AU - Barr, Paul J.
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
AU - Trevena, Lyndal
AU - Witteman, Holly O.
AU - Van Der Weijden, Trudy
N1 - Publisher Copyright:
© Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to.
PY - 2017
Y1 - 2017
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85033221134&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85033221134&partnerID=8YFLogxK
U2 - 10.1136/bmj.j4891
DO - 10.1136/bmj.j4891
M3 - Article
C2 - 29109079
AN - SCOPUS:85033221134
SN - 0959-8146
VL - 359
JO - BMJ (Online)
JF - BMJ (Online)
M1 - S7
ER -