Sharing Decisions with patients makes sense in a lot of cases. It is an expected professional requirement. It is an important outcome of GP Training. However, it is not without difficulties. Some decisions are clear cut; some patients reply with, “What would you do doctor/nurse”. With our usual blend of activities, we move to practising skills which will help us in our consultations with real patients.
Some clinical care is effective care. An autonomous patient may always decline it, but evidence supports the action (e.g. trauma surgery, childhood vaccination). In primary care, most scenarios permit of more than one action. This is called preference sensitive care. Here is where sharing of decisions does and should occur.
Our practical exercises throughout the day are designed to address these issues head on. The exercises are short, structured and aimed at the real world. Whilst we do some skills practice in threes, there is no role play in front of the group and no audio or video recording.