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Table 2 Decision Making Conceptual Models to Inform Decision Coaching and/or Guidance

From: Coaching and guidance with patient decision aids: A review of theoretical and empirical evidence

Conceptual Model Goal Provided by SDM /Coaching or Guidance Process Implemented and/or evaluated in
IP-SDM Model (coaching) To assist two or more health professionals to achieve shared decision making with the patient Health professional trained to support the patient’s involvement in SDM 1) Making explicit that a decision needs to be made, 2) Exchanging information (including the use of PtDAs), 3) Clarifying values/preferences, 4) Determining feasibility of options, 5) Reaching a choice, and 6) Implementing the chosen option. Primary care (CA, US); Intensive care (CA, US); Nephrology (CA); Homecare (CA)
Framework for Decision Coach Mediated SDM (coaching) To achieve higher quality decisions Health professional a) Assessing patients’ decisional conflict and related modifiable deficits in knowledge, values clarity and support; b) Tailoring decision support to meet patients’ needs by facilitating access to PtDAs and/or providing evidence-based information, verifying understanding, clarifying values, building skills in deliberation, communication and accessing support; c) Monitoring and facilitating patients’ progress in decision making; and d) Screening for factors influencing decision implementation, including patients’ motivation and self-efficacy, and other potential barriers impeding implementation. Primary care call centre (CA, US, Chile); Cancer care (AU, UK, Japan); End of life care (CA); Various decisions in training of graduate students (CA)
FAST (coaching) To improve participation in specialty or chronic care consultations Students/trainees, peer navigators, allied health professionals To help patients after they have reviewed a PtDA (or education materials in the absence of a PtDA) to formulate issues that they will subsequently analyze with their practitioner(s). Orthopaedics (US, UK); Chronic care, (US, UK); Cancer care (US, UK)
Ottawa Decision Support Framework (guidance) To address modifiable decisional needs contributing to decisional conflict Incorporated as steps in PtDAs Structures the process of decision making by making explicit a set of steps and encouraging patients to communicate their informed preferences with others involved in the decision (e.g., practitioner, family, friends) Large variety of decisions (AU, CA, US, Japan, UK)
  1. AU = Australia; CA = Canada; US = United States; UK = United Kingdom; SDM = shared decision making