--- title: "Shared decison making three-talk model. | Sutter Health" description: "Revised 3-talk model of shared dec making: provide support when introducing options, compare & discuss tradeoffs, decide based on informed preferences." url: "https://www.sutterhealth.org/research/publications/shared-decison-making-three-talk-model-1055312442" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Shared decison making three-talk model. # A three-talk model for shared decision making: multistage consultation process. Elwyn G, Durand MA, Song J, Aarts J, Barr PJ, Berger Z, Cochran N, Frosch D, Galasinski 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. _BMJ. 2017 Nov 6;359:j4891. doi: 10.1136/bmj.j4891._ 2017-11-06 ## 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. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/29109079) ## Research topics - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Having and being a personal physician: vision of the Pisacano scholars.](https://www.sutterhealth.org/research/publications/having-and-being-a-personal-physician-1055312594) DeVoe JE, Lesser LI. J Am Board Fam Med 24(4):463-8. doi: 10.3122/jabfm.2011.04.100293. 2011 Aug 01 - Publication ### [Capsule commentary on O'Malley et al., overcoming challenges to teamwork in patient-centered medical homes: a qualitative study.](https://www.sutterhealth.org/research/publications/comment-omalley-et-al-teamwk-challenges-pcmhs-1055312918) Tai-Seale M. J Gen Intern Med. 30(2):239. doi: 10.1007/s11606-014-3128-y. 2015 Feb 01 - Publication ### [Comparison of outpatient satisfaction survey scores for Asian physicians and non-Hispanic white physicians.](https://www.sutterhealth.org/research/publications/outpt-satisfaction-survey-scores-asian-vs-nhw-mds-1055312501) Garcia LC, Chung S, Liao L, Altamirano J, Fassiotto M, Maldonado B, Heidenreich P, Palaniappan L. JAMA Netw Open. 2(2):e190027. doi: 10.1001/jamanetworkopen.2019.0027. 2019 Feb 01 - Publication ### [Measuring professionalism in medicine and nursing: results of a European survey.](https://www.sutterhealth.org/research/publications/measuring-professionalism-in-medicine-and-nursing-1055312797) Lombarts KM, Plochg T, Thompson CA, Arah OA; DUQuE Project Consortium. PLoS One. 9(5):e97069. doi: 10.1371/journal.pone.0097069. eCollection 2014. 2014 May 21 - Publication ### [Overcoming challenges to adoption of shared medical appointments.](https://www.sutterhealth.org/research/publications/challenges-to-adoption-of-shared-medical-appts-1055312762) McCuistion MH, Stults CD, Dohan D, Frosch DL, Hung DY, Tai-Seale M. Popul Health Manag. 17(2):100-5. doi: 10.1089/pop.2013.0035. Epub 2013 Oct 24. 2014 Apr 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/shared-decison-making-three-talk-model-1055312442#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Shared decison making three-talk model."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/shared-decison-making-three-talk-model-1055312442#medicalscholarlyarticle","name":"A three-talk model for shared decision making: multistage consultation process.","headline":"Shared decison making three-talk model.","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.","description":"Revised 3-talk model of shared dec making: provide support when introducing options, compare & discuss tradeoffs, decide based on informed preferences.","keywords":["Health Services"],"datePublished":"2017-11-06","url":"https://www.sutterhealth.org/research/publications/shared-decison-making-three-talk-model-1055312442","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"29109079"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1136/bmj.j4891"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/29109079/","https://doi.org/10.1136/bmj.j4891"],"isPartOf":{"@type":"Periodical","name":"BMJ"},"author":[{"@type":"Person","name":"Elwyn G"},{"@type":"Person","name":"Durand MA"},{"@type":"Person","name":"Song J"},{"@type":"Person","name":"Aarts J"},{"@type":"Person","name":"Barr PJ"},{"@type":"Person","name":"Berger Z"},{"@type":"Person","name":"Cochran N"},{"@type":"Person","name":"Frosch D"},{"@type":"Person","name":"Galasinski D"},{"@type":"Person","name":"Gulbrandsen P"},{"@type":"Person","name":"Han PKJ"},{"@type":"Person","name":"Härter M"},{"@type":"Person","name":"Kinnersley P"},{"@type":"Person","name":"Lloyd A"},{"@type":"Person","name":"Mishra M"},{"@type":"Person","name":"Perestelo-Perez L"},{"@type":"Person","name":"Scholl I"},{"@type":"Person","name":"Tomori K"},{"@type":"Person","name":"Trevena L"},{"@type":"Person","name":"Witteman HO"},{"@type":"Person","name":"Van der Weijden T"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Health Services","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Services%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/shared-decison-making-three-talk-model-1055312442","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/shared-decison-making-three-talk-model-1055312442#breadcrumblist"}}} ```