Shared Decision Making: A Model for Clinical Practice
They propose that achieving SDM depends on tasks that help confer agency, where agency refers to the capacity of
individuals to act independently and to make their own free choices.27,28 SDM aims to confer agency by 1) providing information and 2) supporting the decision making process…
They describe three key steps of SDM for clinical practice, namely: choice talk, option talk
and decision talk, where the
clinician supports deliberation throughout the process (Fig. 1 and Boxes 1, 2 and 3). Choice talk refers
to the step of making sure that patients know that reasonable options are available.
Glyn Elwyn, PhD1,2, Dominick Frosch, PhD3,4, Richard Thomson, MD5,
Natalie Joseph-Williams, MSc1, Amy Lloyd, PhD1, Paul Kinnersley, MD1, Emma Cording, MB BCh1,Dave Tomson, BM BCh6, Carole Dodd, MSc7, Stephen Rollnick, PhD1, Adrian Edwards, PhD1, and Michael Barry, MD8,9
1Cochrane Institute of
Primary Care and Public Health, Neuadd Meirionydd, Cardiff University, Cardiff,
UK; 2The Dartmouth Center for Health
Care Delivery Science, Dartmouth College, New Hampshire, NH,
USA; 3Department of Health Services Research, Palo
Alto Medical
Foundation Research Institute, Palo Alto, CA, USA; 4Department of Medicine, University of California, Los Angeles,
Los Angeles, CA, USA;
5Institute of Health and
Society, Newcastle University, Newcastle upon Tyne, UK; 6Collingwood Health Group, New York Surgery, North Shields,
UK; 7Clinical Governance & Risk department,
Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; 8General
Medicine Division, Massachusetts General Hospital, Boston, MA,
USA; 9Informed Medical Decisions Foundation,
Boston, MA, USA.
Received August 22, 2011
Revised January 3, 2012
Accepted April 3, 2012
Published online May 23, 2012
JGIM
1361
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