Decision Coaching
A decision coach is a trained healthcare provider who is non-directive and provides support that aims to develop patients'/persons' skills in:
- thinking about the options, pros and cons of options;
- understanding and using evidence-based healthcare information (e.g. decision aids);
- preparing to discuss the decision in a consultation with their practitioner;
- implementing the chosen option.
Coaching is provided face-to-face, using the telephone, or by virtual meeting. It can be used alone or in combination with a patient decision aid or the Ottawa Personal Decision Guide. Training involves learning about decision coaching as an intervention to prepare patients to discuss options with their practitioner and may include the use of decision support tools.
To enhance the quality of decision coaching, there are several resources:
- a script (PDF) for standardizing the way decision coaching is provided to patients/individuals;
- videos demonstrating decision coaching for a health or social decision;
- the Decision Support Analysis Tool (DSAT-10) for evaluating the quality;
- guidance on effective communication skills (PDF);
- the Interprofessional Shared Decision Making model and the Ottawa Decision Support Framework that include decision coaching;
- the Framework for decision coach-mediated shared decision making.
Reviews of several studies showed that when decision coaching was used alone or with a patient decision aid, patients were more knowledgeable and there were no harms. The effect on other outcomes was mixed with some studies showing improvement and other studies showing no difference. Examples of healthcare professionals who have provided decision coaching are nurses, pharmacists, geneticists, health educators, psychologists, and social workers.
References
- Zhao J, Jull J, Finderup J, †Smith M, Kienlin SM, Rahn, AC, Dunn S, Aoki Y, Brown L, Harvey G, Stacey D. Understanding how and under what circumstances decision coaching works for people making healthcare decisions: a realist review. BMC Med Inform Decis Mak. 2022 Oct 8;22(1):265. doi: 10.1186/s12911-022-02007-0.
- Jull J, Kopke S, †Smith M, Carley M, Finderup J, Rahn AC, Boland L, Dunn S, Dwyer AA, Kasper J, Kienlin SM, Légaré F, Lewis KB, †Lyddiatt A, Rutherford C, Zhao J, Rader T, Graham ID, Stacey D. Decision coaching for people making healthcare decisions Cochrane Database Syst Rev. 2021 Nov 8; 11(11):CD013385. doi: 10.1002/14651858.CD013385.pub2.
- Rahn AC, Jull J, Boland L, Finderup J, Loiselle MC, †Smith M, Kopke S, Stacey D. Guidance and /or decision coaching with patient decision aids: Scoping reviews to inform the International Patient Decision Aid Standards (IPDAS). Med Decis Making. 2021 Oct; 41(7):938-953. doi: 10.1177/0272989X21997330.
- Feenstra B, Lawson ML, Harrison D, Boland L, Stacey D. Decision coaching using the Ottawa Family Decision Guide with parents and their children: A field testing study. BMC Med Inform Decis Mak. 2015, 15:5.
- O'Connor AM, Stacey D, Légaré F. Coaching to support patients in making decisions. BMJ. 2008 Feb 2;336(7638):228-9.
- Stacey D, Kryworuchko J, Belkora J, Davison BJ, Durand MA, Eden KB, Hoffman AS, Koerner M, Légaré F, Loiselle MC, Street RL. (2013) Coaching and guidance with patient decision aids: A review of theoretical and empirical evidence. BMC Med Inform Decis Mak. 2013;13 Suppl 2:S11. doi: 10.1186/1472-6947-13-S2-S11.
- Stacey D, Kryworuchko J, Bennett C, Murray MA, Mullan S, Légaré F. Decision coaching to prepare patients for making health decisions: A systematic review of decision coaching in trials of patient decision aids. Med Decis Making. 2012 May-Jun;32(3):E22-33. doi: 10.1177/0272989X12443311.
- Stacey D, Murray MA, Légaré F, Dunn S, Menard P, O'Connor AM. Decision Coaching to Support Shared Decision Making: A framework, evidence, and implications for nursing practice, education, and policy. Worldviews Evid Based Nurs. 2008;5(1):25-35. doi: 10.1111/j.1741-6787.2007.00108.x.
Last modified: 2024-08-21.
