Summarizing the Purposeful SDM Schema, a problem-based model of SDM.: Presenter(s): Ian Hargraves, Mayo Clinic, United States

SDM has been conceptualized in several ways throughout its development, with each orientation furthering research and SDM practice in new and fruitful directions. Recently, a new perspective on SDM was formed by asking “What problem is SDM the solution to?” and proposing as a response “The problem that the patient is experiencing” and that SDM’s purpose is to help patients and clinicians figure out how best respond to that problem. This perspective led to the development of the Purposeful SDM schema, opened up new research questions, insights into SDM, approaches to SDM education, and directions for intervention development. We sought to summarize the key Findings: of work drawing on the Purposeful SDM schema. This body of work has shown that: There are several distinctly different types of problems that require patients and clinicians to make decisions together. (PEC 2019) Each of those problems utilize fundamentally different SDM Methods: of working out how to respond to the problem (weighing, negotiation, problem-solving, insight-development). (PEC 2019) Generalized models of involving patients in making decisions do not account for necessary problem-specific variation in deliberative method (PEC 2020) Each SDM method conceives of, and utilizes, key SDM terms (e.g. option, preference, involvement etc.) in different ways. (PEC 2020) Current SDM observer measures only detect the use of 1 of 4 SDM Methods: (PEC 2021) Change in SDM method is discernable in clinical encounters (Forthcoming) The method of weighing pros/cons/preferences is not the most common form of SDM (Forthcoming) The Purposeful SDM model has usefully distinguished different kinds of SDM that correspond with different types of patient problems. The schema’s conceptual framework is consistent with empirical findings. Purposeful SDM schema provides an additional perspective that can be used to advance SDM research and practice in new directions.