NGR 5700 Shared Decision Making Paper Assignment Example

NGR 5700 Shared Decision Making Paper Assignment Example

NGR 5700 – Shared Decision-Making Paper Assignment

NGR 5700 DBX-DL01: Decision Making Course

Florida National University

Course Information

Course Number: NGR 5700

Course Title: Decision Making

Course Credits: 3.0000

NGR 5700 Shared Decision Making Paper Assignment Brief

Assignment Instructions Overview

This written assignment requires students to explore the implementation of Shared Decision-Making (SDM) as a routine practice in a chosen healthcare setting, such as a clinic or hospital. The paper must be 6–8 pages in length (excluding the title and reference pages) and follow APA 7th edition formatting. A minimum of 8–10 scholarly references (outside of course readings) is required. Students will compare and contrast at least two SDM models, identify a preferred model for implementation, and detail strategies for integration at organizational, professional, and personal levels. The submission must be in Word format only and must comply with SafeAssign similarity index guidelines (<20%).

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Understanding Assignment Objectives

This assignment aims to deepen your understanding of SDM and its essential role in enhancing patient-provider collaboration. The paper will assess your ability to:

• Describe the significance of SDM in clinical decision-making.
• Evaluate and compare two SDM models.
• Propose implementation strategies specific to your healthcare setting.
• Identify the resources, tools, and staff training needs.
• Address potential challenges and benefits of SDM integration.
• Demonstrate scholarly writing, organization, and APA proficiency.

The Student’s Role

As a graduate nursing student and emerging advanced practice nurse (APN), you are expected to critically appraise SDM theory and apply it to a real-world clinical context. Your role includes:

• Independently researching evidence-based SDM frameworks.
• Using your clinical judgment to tailor SDM models to a practice setting.
• Designing strategic approaches for implementation and training.
• Engaging in reflective analysis of barriers and enablers to SDM adoption.
• Writing a unique, plagiarism-free paper that clearly communicates your ideas.

Competencies Measured

This assignment assesses the following advanced nursing competencies:

• Leadership in systems-based practice through proposing organizational-level changes.
• Evidence-based practice by integrating the latest literature on SDM.
• Collaboration and communication in multidisciplinary care planning.
• Clinical decision-making supported by patient-centered models.
• Professional accountability and advocacy through ethical patient engagement.

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NGR 5700 Shared Decision Making Paper Assignment Example

Introduction

Shared decision-making (SDM) is a collaborative process that allows healthcare providers and patients to make health-related decisions together, integrating clinical evidence and patient preferences. In the context of a hospital surgical unit, where patients often face complex choices regarding surgical interventions, the use of SDM is crucial for promoting informed consent, enhancing patient satisfaction, and improving outcomes. Advanced Practice Nurses (APNs) play a vital role in implementing SDM, acting as patient advocates and clinical leaders. This paper explores the significance of SDM in surgical care, compares two leading SDM models, and outlines a comprehensive strategy to integrate SDM at organizational, professional, and personal levels. It also highlights tools, training resources, challenges, and benefits, offering an evidence-based roadmap to strengthen patient-centered care within surgical settings.

Background and Significance of Shared Decision-Making in Healthcare

SDM represents a paradigm shift from the traditional, paternalistic model of care to one that values and incorporates the patient’s voice in clinical decisions. This approach is especially pertinent in surgical units, where patients may be presented with multiple treatment options, each carrying different risks and benefits. Research shows that SDM leads to better alignment between chosen treatments and patients’ values, which subsequently enhances trust, adherence to treatment, and overall satisfaction with care (Stacey et al., 2017).

From the provider’s perspective, SDM fosters meaningful engagement, reduces decisional conflict, and strengthens the therapeutic alliance (Elwyn et al., 2012). For APNs, SDM is a practice-aligned responsibility that intersects with core competencies such as patient education, advocacy, evidence-based practice, and ethical decision-making (American Association of Nurse Practitioners [AANP], 2020).

The importance of SDM is further emphasized in national healthcare policies and standards. The Institute of Medicine advocates for SDM as a critical element of high-quality care (IOM, 2011), while the Agency for Healthcare Research and Quality (AHRQ) promotes its integration across clinical settings. In surgical environments, where high-stakes decisions are common, SDM ensures that patients are not only informed but also actively involved in choosing interventions that align with their values and goals.

Overview and Comparison of Two Shared Decision-Making Models

The Three-Talk Model

The Three-Talk Model, developed by Elwyn et al. (2017), structures the SDM conversation into three phases: team talk, option talk, and decision talk. This model begins with “team talk,” where clinicians invite the patient to be part of the decision-making process. “Option talk” involves the clinician presenting treatment options using clear, balanced information. Lastly, “decision talk” is the collaborative stage where the provider supports the patient in exploring preferences and making a decision.

This model is particularly useful in time-sensitive environments like surgical units because it is concise, adaptable, and easy to implement during pre-operative consultations. It supports active listening and transparency while maintaining the clinical efficiency often required in hospitals.

The SHARE Approach

Developed by the AHRQ, the SHARE Approach is a five-step process: Seek your patient’s participation, Help your patient explore and compare treatment options, Assess your patient’s values and preferences, Reach a decision with your patient, and Evaluate the decision (AHRQ, 2014). Unlike the Three-Talk Model, the SHARE Approach offers a more detailed and structured framework, including tools for documentation, patient education, and decision aids.

This model is best suited for comprehensive, multidisciplinary discussions involving complex or chronic surgical cases. It allows for greater depth in value clarification and can be extended across multiple encounters. However, it may be time-consuming and less suitable for fast-paced surgical assessments.

Comparison and Suitability for Surgical Units

Both models support the principles of patient-centered care, but their structure and focus differ. The Three-Talk Model is streamlined and pragmatic, aligning well with the high-pressure environment of surgical units. It ensures patients are heard without overwhelming the provider with additional procedural steps. In contrast, the SHARE Approach is ideal for elective or non-urgent surgeries, where time permits deeper value exploration.

Given the urgent and procedural nature of hospital surgical units, the Three-Talk Model emerges as the most practical and effective approach for implementation. It aligns with the workflow, accommodates provider constraints, and fosters meaningful patient engagement without disrupting clinical operations.

Implementation of SDM in the Hospital Surgical Unit

Organizational Level

At the organizational level, implementing SDM requires leadership commitment, policy development, and integration into clinical pathways. Hospital administration must prioritize SDM in strategic goals and allocate resources for training, tools, and staffing. Policies should mandate SDM discussions before all surgical procedures, embedded within electronic health records (EHRs) for documentation and quality tracking (Barry & Edgman-Levitan, 2012).

Standardized protocols for informed consent should be updated to include SDM principles, ensuring patients are presented with multiple treatment options and associated outcomes. Multidisciplinary teams—including surgeons, APNs, anesthetists, and patient educators—should collaborate to implement SDM as part of routine preoperative care.

Professional Level

On the professional level, surgeons and APNs need skill development in communication, cultural competency, and evidence presentation. Training programs should include role-playing, workshops, and use of validated decision aids. Continuing education credits can incentivize participation. Interprofessional collaboration must be encouraged to ensure that SDM is not seen as a sole responsibility of the nurse or surgeon but as a shared task across the care team.

APNs, in particular, should take the lead in coordinating SDM conversations, providing patients with reliable information, and clarifying any doubts prior to surgery. Their holistic approach and longer interaction time with patients make them ideal SDM facilitators.

Personal Level

At a personal level, healthcare providers must embrace a mindset shift from being authoritative decision-makers to facilitators of patient choices. Reflective practice, feedback sessions, and peer review can help clinicians evaluate and improve their SDM conversations. Providers must also remain aware of their biases, ensuring that their recommendations are balanced and not coercive.

Personal accountability includes ensuring that every surgical consultation respects patient autonomy and actively seeks their input. For APNs, personal strategies such as using SDM checklists, attending reflective practice groups, and engaging in peer mentoring can reinforce these behaviors.

Tools, Resources, and Patient Engagement Strategies

To ensure successful SDM integration, both staff and patients require appropriate tools and resources. Decision aids are essential, especially in surgical contexts. These include brochures, videos, online platforms, and printed option grids that outline surgical choices, risks, recovery timelines, and alternative therapies (O’Connor et al., 2009).

EHR templates should prompt providers to record SDM discussions and patient preferences. Visual aids and risk communication tools, such as pictographs or risk calculators, can help patients understand statistical information.

Patient engagement is enhanced through structured pre-operative education sessions led by APNs. These sessions can be group-based or individual and should be culturally sensitive and linguistically appropriate. Offering patients printed questions to bring to consultations encourages active participation.

Training for providers must cover the use of these tools, supported by simulation-based learning, e-learning modules, and mentorship programs. These ensure consistent practice and confidence in facilitating SDM.

Strategies to Build Competency Among APNs and Providers

Competency development should begin with formal SDM training included in APN orientation and ongoing professional development. Key strategies include:

• Simulation-based learning: Role-play scenarios with standardized patients improve communication skills.
• Workshops and seminars: Regular educational sessions provide evidence-based updates and practical guidance.
• Peer mentoring: Pairing experienced APNs with novices helps reinforce SDM in real-time settings.
• Audit and feedback: Reviewing SDM documentation in EHRs and providing feedback helps refine practice.
• Online modules: Self-paced programs accommodate busy schedules and ensure theoretical understanding.

APNs should also be involved in research and quality improvement initiatives related to SDM, promoting a culture of inquiry and evidence-based practice. Certification programs and credentialing that recognize SDM competency can further validate these skills.

Challenges and Benefits of Implementing SDM

Challenges

Despite its benefits, implementing SDM in surgical units presents several challenges. These include:

• Time constraints: Surgical consultations are often brief, making it difficult to engage in extended discussions.
• Provider resistance: Some clinicians may be skeptical of SDM, perceiving it as undermining clinical authority.
• Lack of training: Many providers lack formal education in SDM techniques.
• Documentation issues: Integrating SDM into EHRs without adding to administrative burden is challenging.
• Patient variability: Patients differ in their desire and ability to participate, requiring personalized approaches.

Benefits

Conversely, the benefits are significant:

• Enhanced patient satisfaction: Patients feel heard and respected, increasing trust.
• Improved outcomes: Engaged patients are more likely to adhere to postoperative instructions and report better recovery experiences.
• Reduced decisional regret: Patients who participate in decisions are less likely to experience regret or dissatisfaction.
• Professional growth: APNs develop advanced communication and leadership skills.
• Compliance with standards: SDM supports ethical practice, accreditation requirements, and legal standards for informed consent.

Conclusion

Shared decision-making is a vital practice innovation that enhances surgical care delivery by aligning treatments with patient values and preferences. This paper has explored the importance of SDM, compared two leading models, and proposed a comprehensive strategy to implement the Three-Talk Model within a hospital surgical unit. Implementation at the organizational, professional, and personal levels, supported by tools, training, and ongoing reflection, ensures the sustainability of this patient-centered approach. Though challenges exist, the benefits to both patients and providers make SDM an essential standard of care in modern surgical practice.

References

Agency for Healthcare Research and Quality. (2014). The SHARE approach: A model for shared decisionmaking. https://www.ahrq.gov/health-literacy/professional-training/shared-decision/index.html

American Association of Nurse Practitioners. (2020). Standards of practice for nurse practitioners. https://www.aanp.org/practice/clinical-resources/standards-of-practice

Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making—the pinnacle of patient-centered care. New England Journal of Medicine, 366(9), 780–781. https://doi.org/10.1056/NEJMp1109283

Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., … & Barry, M. (2012). Shared decision making: A model for clinical practice. Journal of General Internal Medicine, 27(10), 1361–1367. https://doi.org/10.1007/s11606-012-2077-6

Elwyn, G., Durand, M. A., Song, J., Aarts, J., Barr, P. J., Berger, Z., … & Frosch, D. L. (2017). A three-talk model for shared decision making: Multistage consultation process. BMJ, 359, j4891. https://doi.org/10.1136/bmj.j4891

Institute of Medicine (US). (2011). Crossing the quality chasm: A new health system for the 21st century. National Academies Press.

O’Connor, A. M., Bennett, C. L., Stacey, D., Barry, M., Col, N. F., Eden, K. B., … & Thomson, R. (2009). Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews, 3(3), CD001431. https://doi.org/10.1002/14651858.CD001431.pub2

Stacey, D., Légaré, F., Lewis, K., Barry, M. J., Bennett, C. L., Eden, K. B., … & Trevena, L. (2017). Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews, 4, CD001431. https://doi.org/10.1002/14651858.CD001431.pub5

Detailed Assessment Instructions for the NGR 5700   Shared Decision Making Paper Assignment

Shared Decision-Making Paper Assignment

The assignment will require you to write a 6-8 page paper formatted using APA 7th edition (this does not include the title or references page). Be sure to review the grading rubric and criteria for the assignment carefully and to include all aspects that are required as part of the assignment grade. It should go without saying that NO two papers should look the same, meaning that the choice of implementation strategies, selection of SDM , the patient and population and specific strategies are unique in every paper AND those papers submitted with numerous similarities will be looked at closely and closely reviewed for any evidence of academic. Students these and all paper assignments need to be original with your own ideas and your individual search of sources and literature to support the paper proposal. Remember the paper must be submitted in a Word formatted APA 7th edition format failure to submit or to submit as a PDF will be returned ungraded. Pay attention when submitting the assignment to SafeAssign that the similarity index is not higher or close to 20% per the Syllabus guidelines.

As an APN working as part of a team, you have been asked by your director to adopt a shared decision-making approach to be used as part of routine practice in your healthcare organization (you may choose if this is a hospital or a clinic setting). This involves describing how shared decision making is implemented from an organizational, professional and personal level to improve the care of patients. What processes are required to implement a successful shared decision-making approach to the current practice environment? Part of this involves determining which SDM of care would be best suited to the selected practice environment and patient population (you are required to describe in- depth at least two different models of SDM comparing and contrasting the two and linking the choice of which model would be best for your practice setting; make sure the description of the practice setting and patients in included in the paper). What is the purpose of SDM, how does it impact patient and provider care? How does SDM help the APN to make decisions in patient care? How does the adoption of the SDM model of care meet the standards of practice for APN/NP?

What resources and training needs would be required both by staff and patients to ensure comprehensive integration of this type of decision making into practice (this needs to be a detailed discussion about specific patient tools and approaches). Additionally, describe specific and detailed strategies that would be implemented to build competency among the APN and provider staff that facilitates adoption of this method. Identify key challenges that you may face in implementing this into the care setting and key benefits to integrating a SDM into care.

Must contain a minimum of 8-10 references not found in your course readings, introduction, summary and be APA formatted.

CRITERION	STRONG	AVERAGE	WEAK
Introduce the overall concepts that will be described in the paper (10 pts)	7-10 pts   Clear and concise introduction of the concepts to be presented in the paper	4-6 pts   Mostly clear but somewhat generic introduction of the concepts to presented in the paper	0-3 pts   Vague, unclear or no introduction of concepts to be presented in the paper
A detailed description of the background and significance of SDM in healthcare and ways it impacts patient and provider care (APN in particular but all levels of care). Description of how	15-21 pts   Detailed and specific background and significance of SDM in healthcare and how it impacts patient and provider clear is thorough and evident. Clear link and description of how the	8-14 pts   Mostly clear but somewhat vague background and significance of SDM in healthcare provided and how it impacts patient and provider is somewhat clear but not specifically evident.	0-7 pts   Vague, unclear, or failure to provide background and significance of SDM in healthcare and how it impacts patient and provider is not clearly evident. Vague or unclear description of

 

SDM meets APN/NP practice standards is described. (21 pts)	SDM meets APN/NP practice standards is described.	Somewhat clear description of how the SDM meets APN/NP practice standards is somewhat described.	how the SDM meets APN/NP practice standards is vaguely or not described.
Detailed description of the processes involved in implementing a shared decision making (SDM) at the organizational, professional and personal level as a way to improve the care of patients. (21 pts)	15-21 pts   Detailed and specific description of how a SDM approach to practice is implemented at the organizational, professional, and personal level of care to improve the care of patients is evident.	8-14 pts   Mostly clear but somewhat vague description of how a SDM approach to practice is implemented at the organizational, professional, and personal level of care to improve the care of patients is somewhat evident.	0-7 pts   Vague and unclear description of how a SDM approach to practice is implemented at the organizational, professional, and personal level of care to improve the care of patients is vague and not clearly evident.
Compare and contrast at least 2 different SDM models of care with the identification of the SDM that would work best in the current practice environment. (21 pts)	15-21 pts   Excellent, specific and detailed comparison and contrast of at least 2 different SDM models with details of how it is used in various practice settings. One of the two described models is prioritized for the selected practice setting and population that serves to clearly link the model with the population.	8-14 pts   Mostly clear but somewhat vague comparison and contrast of at least 2 different SDM models with details of how it is used in various practice settings. One of the two described models is prioritized for the selected practice setting and population that serves to clearly link the model with the population.	0-7 pts   Vague and unclear comparison and contrast of 2 or less SDM models with details of how it is used in various practice settings. One of the two described models may be or is not prioritized for the selected practice setting and population that serves to vaguely or fails to link the model with the population.
Describe and apply resources and tools that will be used to implement SDM models for the selected patient and	15-21 pts   Excellent, detailed and specific description of tools and resources needed to implement the selected SDM model	8-14 pts   Mostly clear but somewhat vague description of tools and resources needed to implement the selected	0-7 pts   Vague and unclear description of tools and resources needed to implement the selected SDM model for the

 

population. Provide	for the select patient	SDM model for the	select patient
sufficient link	population. Strong and	select patient population.	population. Vague
between the tools	clear link is provided	Somewhat strong and	and/or unclear link is
and resources, the	between the tools &	mostly clear link is	provided between the
SDM model chosen	resources, the SDM	provided between the	tools & resources, the
and the patient	model and the patient	tools & resources, the	SDM model and the
population. What will	population. The process	SDM model and the	patient population. The
this process look	is well outlined with	patient population. The	process is either not or
like; justify and	excellent rationale for	process is outlined with	vaguely outlined with
provide the rationale	choice of identified	some rationale for choice	little rationale for choice
for choice of	resources.	of identified resources.	of identified resources.
identified resources.
(21 pts)
Describe strategies that would be implemented to build competency among the APN/providers that facilitates adoption and usage SDM method (21 pts)	15-21 pts   Describe specific and detailed strategies that would be implemented to build competency among the APN/providers that facilitates adoption and usage SDM method. This section is well informed and realistic to the population and care setting.	8-14 pts   Mostly clear but somewhat vague strategies that would be implemented to build competency among the APN/providers that facilitates adoption and usage SDM method. This section is somewhat clear but not exactly realistic to the population and care setting.	0-7 pts   Vague and unclear strategies that would be implemented to build competency among the APN/providers that facilitates adoption and usage SDM method. This section is missing, unclear or extremely vague and not realistic to the population and care setting.
Identify key challenges and benefits that might be encountered when implementing a SDM into the practice setting at the organization, professional and personal levels of care. (21 pts)	15-21 pts   Identifies and specifically outlines the challenges and benefits that might been countered when implementing the selected SDM model in the practice setting at the organizational, professional and personal levels of care.	8-14 pts   Identifies and somewhat specifically outlines the challenges and benefits that might be encountered when implementing the selected SDM model in the practice setting at the organizational, professional and personal levels of care.	0-7 pts   Vague and unclear outlines the challenges and benefits that might be encountered when implementing the selected SDM model in practice setting at the organizational, professional and personal levels of care.

 

Summary – summarize the key points made throughout the paper is a comprehensive manner (10 pts)	7-10 pts   Summarizes the key points made throughout the paper in a succinct but comprehensive manner	4-6 pts   Somewhat summarizes the key points made throughout the paper in a mostly clear but not entirely comprehensive manner	0-3 pts   Vague and unclear summary of the key points made throughout the paper that is not succinct or comprehensive.
Writing Mechanics: Language and direction of the paper follows the assignment outline and is clear and easy to follow. (18 pts)	13-18- pts Demonstrates clarity, conciseness and correctness; writing is free of grammar and spelling errors. The assignment outline was followed and guides the paper content appropriately	7-12 pts   Somewhat concise and clear grammar and spelling used. Guidelines was mostly used to guide the paper content. Some spelling and grammar issues (less than 3-4 errors within paper)	0-6 pts   Many deficiencies in   grammar, spelling, or failure to follow the assignment guidelines. Writing has frequent spelling and grammar errors
APA formatting (paper is formatted per APA 7th edition guidelines including font, level of headings, appropriate number of references, in-text and reference list citations) (18 pts)	13-18- pts   APA formatting is followed throughout the paper with correct citations and includes at least 10 scholarly references that are correctly APA 7th ed. citations.	7-12 pts   APA formatting is mostly followed throughout the paper with mostly correct citations with at least 8 to 9 scholarly references but not required 10 and/or 2-3 incorrect APA 7th ed. referencing or formatting	0-6 pts   Multiple errors in APA formatting throughout the paper identified. Fewer than 8 scholarly references provided in the paper and/or > 3 to 4 errors in APA 7th ed referencing and formatting.
Total: 182 pts

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