Form 2 Card survey (clinician)

Evaluation of the SHARE Approach Model

Clinician Card Survey_Clean_3.18.2020

Card survey (clinician)

OMB: 0935-0253

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    1. Clinician Survey



Time of day: _____________________


Satisfaction with discussion


Thinking back to the conversation you just had with your patient, how satisfied are you with the discussion?

Not at all satisfied

1


2


3


4

Extremely satisfied

5


Identification of a decision or problem solving

In the visit today, did any of the following occur? (circle Yes or No)

  1. There was a choice between two or more treatment options: Yes / No

  2. Problem-solving was needed between me and my patient to determine the best care plan: Yes / No


If you answered “no” to both statements, you are finished with this survey.

If you answered “yes”, please answer the last set of questions below.



OPTIONS scale


Strongly agree

1

Agree

2

Disagree

3

Strongly disagree

4

  1. My patient and I identified a health problem and I made it clear that a decision was needed





  1. I asked my patient their preference to take part in the decision (or not)





  1. I discussed different options (including the possibility of doing nothing) with me patient





  1. I discussed advantages, disadvantages and possible outcomes of options with my patient.





  1. I made sure my patient understood the information that I shared.





  1. I described to my patient more than one way to manage the health problem.





  1. I discussed ideas or expectations about managing the health problem with my patient.





  1. I offered different sources of information (e.g., leaflets, websites, contact with other people) to help my patient make the decision.





  1. I gave my patient opportunities to ask questions.






  1. I asked the patient about his/her preferences.





  1. I asked my patient about any concerns or worries about managing the health problem.





  1. My patient and I made a decision;

Or, my patient and I agreed to postpone making a decision





  1. I discussed the possibility of coming back to the decision with my patient.









    1. Audio recording coding scheme


OPTION1220,21

 

Scale Score 

Definition 

The behavior is not observed 

A minimal attempt is made to exhibit the behavior 

The clinician asks the patient about their preferred way of receiving information to assist decision 

The behavior is exhibited to a good standard 

The behavior is observed and executed to a high standard 

 

 

OPTION Item 

The clinician draws attention to an identified problem as one that requires a decision-making process.

 

 

 

 

 

The clinician states that there is more than one way to deal with the identified problem (‘equipoise’).

 

 

 

 

 

The clinician assesses the patient’s preferred approached to receiving information to assist decision making (e.g., discussion, reading printed material, assessing graphical data, using videotapes or other media).

 

 

 

 

 

The clinician lists ‘options’, which can include the choice of ‘no action’.

 

 

 

 

 

The clinician explains the pros and cons of options to the patient (taking ‘no action’ is an option).

 

 

 

 

 

The clinician explores the patient’s expectations (or ideas) about how the problem(s) are to be managed.

 

 

 

 

 

The clinician explores the patient’s concerns (fears) about how problem(s) are to be managed.

 

 

 

 

 

The clinician checks that the patient has understood the information.

 

 

 

 

 

The clinician offers the patient explicit opportunities to ask questions during the decision-making process.

 

 

 

 

 

10 

The clinician elicits the patient’s preferred level of involvement in decision making.

 

 

 

 

 

11 

The clinician indicates the need for a decision making (or deferring) stage.

 

 

 

 

 

12 

The clinician indicates the need to review the decision (or deferment).

 

 

 

 

 


Total Score 0-28

Rescale 0-100





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AuthorElinor Brereton
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