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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 Galasiński, Dariusz Gulbrandsen, Pål
Elwyn, Glyn
Durand, Marie Anne
Song, Julia
Aarts, Johanna
Barr, Paul J
Berger, Zackary
Cochran, Nan
Frosch, Dominick
Galasiński, Dariusz
Gulbrandsen, Pål
Authors
Elwyn, Glyn
Durand, Marie Anne
Song, Julia
Aarts, Johanna
Barr, Paul J
Berger, Zackary
Cochran, Nan
Frosch, Dominick
Galasiński, 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
Durand, Marie Anne
Song, Julia
Aarts, Johanna
Barr, Paul J
Berger, Zackary
Cochran, Nan
Frosch, Dominick
Galasiński, 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
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2017-11-06
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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.
Citation
Elwyn, G., Durand, MA., Song, J., Aarts, J., Barr, PJ., Berger, Z., Cochran, N., Frosch, D., Galasiński, 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, 359, pp. 1-7
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Journal article
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en
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© 2017 The Authors. Published by BMJ. This is an open access article available under a Creative Commons licence.
The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1136/bmj.j4891
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0959-8138
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Attribution-NonCommercial-NoDerivs 3.0 United States