M10

Question 1

Shared Decision-Making (SDM)
in Treatment Planning

Answer 1

• Process in which clinicians and patients work together to make decisions about care
  based on clinical evidence (risks, benefits, outcomes) and patient values and
  preferences

Question 2

• SHARE approach

Answer 2

• Seek your patient’s participation in the decision-making process
• Help your patient explore and compare treatment options (risks, benefits, outcomes, cost, time)
• Assess your patient’s values and preferences
• Reach a decision with your patient
• Evaluate your patient’s decision (check in on patient satisfaction with treatment)

Question 3

pts whose providers listen to them elicit goals and concerns and explain all the options are —x more satifsied with their providers

Answer 3

3-5

Question 4

What is Bad News?

Answer 4

“Any news that drastically and
negatively alters the patient’s
view of his or her future.”
- American Academy of Family
Physicians

Question 5

Four Objectives When Breaking
Bad News

Answer 5

1. Gather information from the patient
2. Transmit the medical information
3. Provide support to the patient
4. Elicit the patient’s collaboration in developing a strategy or treatment plan for the
   future

Question 6

SPIKES
Protocol

Answer 6

Setting
Perception
Invitation
Knowledge
Emotions
Strategy & Summary

Question 7

Set Up the Encounter
Mentally
prepare for the
interaction
(5)

Answer 7

01
Arrange for
privacy
02
Include family
or friends, if the
patient desires
03
Build rapport
04
Limit
interruptions
05

Question 8

Assess the Patient’s Perception
(2)

Answer 8

Use open-ended
questions to determine
the patient’s
understanding
Correct misinformation

Question 9

Obtain the Patient’s Invitation
(2)

Answer 9

Determine how much detail the patient desires
Ask permission to give results to give the patient some control
in the conversation

Question 10

Give Knowledge and Information to the Patient
(4)

Answer 10

Briefly summarize events
leading up to this point
Provide a warning to
lessen the shock
Use plain language, avoid
medical/dental jargon, and
explain technical terms
Provide information in
small chunks, stopping
often to confirm
understanding

Question 11

Addressing the Patient’s
Emotions
(4)

Answer 11

• Stop and address your patient’s emotions as they arise
• Use empathetic statements to recognize your patient’s emotions
• Use validating statements to help the patient realize their feelings are normal
• Ask exploratory/open-ended questions to help understand emotions that are not clear

Question 12

Summary
& Strategy
(4)

Answer 12

Summarize news to facilitate
understanding
Establish a treatment plan with the
patient
Outline next steps
Offer a means of contact if more
questions arise