Teaching argumentation theory to doctors

2012 ◽  
Vol 1 (1) ◽  
pp. 66-80 ◽  
Author(s):  
Sara Rubinelli ◽  
Claudia Zanini
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Health Professionals ◽  
Decision Model ◽  
Critical Discussion ◽  
Argumentation Theory ◽  
Shared Decision ◽  
Ideal Model ◽  
Points Of View ◽  
Interpretative Model

This paper supports the need for health professionals to be trained in argumentation theory, by illustrating the challenges that they face in interacting with patients and according to the different models of consultation that patients prefer. While there is no ideal model of consultation that can be promoted universally, the ability to construct arguments in support of health professionals’ points of view, as well as the ability to engage in critical discussion with patients, translate in essential skills for reaching patients’ agreement when communication develops through the interpretative model or the informed decision model or, eventually, shared decision-making.

scholarly journals Using argumentation theory to identify the challenges of shared decision-making when the doctor and the patient have a difference of opinion

2012 ◽  
Vol 1 (2) ◽  
pp. 26 ◽  
Author(s):  
Claudia A. Zanini ◽  
Sara Rubinelli
Keyword(s):  
Decision Making ◽  
Dispute Resolution ◽  
Shared Decision Making ◽  
Communication Skills ◽  
Critical Discussion ◽  
Argumentation Theory ◽  
Shared Decision ◽  
Ideal Model ◽  
Difference Of Opinion ◽  
The Ideal

This paper aims to identify the challenges in the implementation of shared decision-making (SDM) when the doctor and the patient have a difference of opinion. It analyses the preconditions of the resolution of this difference of opinion by using an analytical and normative framework known in the field of argumentation theory as the ideal model of critical discussion. This analysis highlights the communication skills and attitudes that both doctors and patients must apply in a dispute resolution-oriented communication. Questions arise over the methods of empowerment of doctors and patients in these skills and attitudes as the preconditions of SDM. Overall, the paper highlights aspects in which research is needed to design appropriate programmes of training, education and support in order to equip doctors and patients with the means to successfully engage in shared decision-making.

scholarly journals Evaluation of the Use of Shared Decision Making in Breast Cancer: International Survey

2021 ◽  
Vol 18 (4) ◽  
pp. 2128
Author(s):  
Marta Maes-Carballo ◽  
Manuel Martín-Díaz ◽  
Luciano Mignini ◽  
Khalid Saeed Khan ◽  
Rubén Trigueros ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Professionals ◽  
Cross Sectional Study ◽  
Shared Decision ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Professional Societies ◽  
New Policies

Objectives: To assess shared decision-making (SDM) knowledge, attitude and application among health professionals involved in breast cancer (BC) treatment. Materials and Methods: A cross-sectional study based on an online questionnaire, sent by several professional societies to health professionals involved in BC management. There were 26 questions which combined demographic and professional data with some items measured on a Likert-type scale. Results: The participation (459/541; 84.84%) and completion (443/459; 96.51%) rates were high. Participants strongly agreed or agreed in 69.57% (16/23) of their responses. The majority stated that they knew of SDM (mean 4.43 (4.36–4.55)) and were in favour of its implementation (mean 4.58 (4.51–4.64)). They highlighted that SDM practice was not adequate due to lack of resources (3.46 (3.37–3.55)) and agreed on policies that improved its implementation (3.96 (3.88–4.04)). The main advantage of SDM for participants was patient satisfaction (38%), and the main disadvantage was the patients’ paucity of knowledge to understand their disease (24%). The main obstacle indicated was the lack of time and resources (40%). Conclusions: New policies must be designed for adequate training of professionals in integrating SDM in clinical practice, preparing them to use SDM with adequate resources and time provided.

scholarly journals Mental health professionals’ experiences with shared decision-making for patients with psychotic disorders: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Espen W. Haugom ◽  
Bjørn Stensrud ◽  
Gro Beston ◽  
Torleif Ruud ◽  
Anne S. Landheim
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Shared Decision Making ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Psychotic Disorders ◽  
Successful Implementation ◽  
Practical Training ◽  
Shared Decision ◽  
Antipsychotic Medications

Abstract Background Shared decision-making (SDM) is a process whereby clinicians and patients work together to select treatments based on both the patient’s preferences and clinical evidence. Although patients with psychotic disorders want to participate more in decisions regarding their care, they have limited opportunities to do so because of various barriers. Knowing about health professionals’ experiences with SDM is important toward achieving successful implementation. The study aim was to describe and explore health professionals’ SDM experiences with patients with psychotic disorders. Methods Three focus group interviews were conducted, with a total of 18 health professionals who work at one of three Norwegian community mental health centres where patients with psychotic disorders are treated. We applied a descriptive and exploratory approach using qualitative content analysis. Results Health professionals primarily understand the SDM concept to mean giving patients information and presenting them with a choice between different antipsychotic medications. Among the barriers to SDM, they emphasized that patients with psychosis have a limited understanding of their health situation and that time is needed to build trust and alliances. Health professionals mainly understand patients with psychotic disorders as a group with limited abilities to make their own decisions. They also described the concept of SDM with little consideration of presenting different treatment options. Psychological or social interventions were often presented as complementary to antipsychotic medications, rather than as an alternative to them. Conclusion Health professionals’ understanding of SDM is inconsistent with the definition commonly used in the literature. They consider patients with psychotic disorders to have limited abilities to participate in decisions regarding their own treatment. These findings suggest that health professionals need more theoretical and practical training in SDM.

scholarly journals Institutional constraints on strategic maneuvering in shared medical decision-making

2012 ◽  
Vol 1 (1) ◽  
pp. 19-32 ◽  
Author(s):  
A. Francisca Snoeck Henkemans ◽  
Dima Mohammed
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Medical Decision Making ◽  
Critical Discussion ◽  
Medical Decision ◽  
Institutional Constraints ◽  
Treatment Preferences ◽  
Shared Decision ◽  
Basic Principles ◽  
The Ideal

In this paper it is first investigated to what extent the institutional goal and basic principles of shared decision making are compatible with the aim and rules for critical discussion. Next, some techniques that doctors may use to present their own treatment preferences strategically in a shared decision making process are discussed and evaluated both from the perspective of the ideal of shared decision making and from that of critical discussion.

A pragma-dialectical perspective on obstacles to shared decision-making

2018 ◽  
Vol 7 (2) ◽  
pp. 161-176 ◽  
Author(s):  
Roosmaryn Pilgram ◽  
Francisca Snoeck Henkemans
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Critical Discussion ◽  
Medical Decision ◽  
Shared Decision ◽  
Systematic Account ◽  
Dialectical Theory ◽  
Different Types ◽  
Argumentative Discussion ◽  
Dialectical Perspective

Abstract Shared medical decision-making has been analyzed as a particular kind of argumentative discussion. In the pragma-dialectical argumentation theory, different types of conditions and rules are formulated for the ideal of a reasonable argumentative discussion. In this paper, we shall first show how making use of the distinctions made in the pragma-dialectical theory between different types of conditions for reasonable discussion can help to give a more systematic account of the obstacles that need to be overcome for shared decision-making to be successful. Next, by referring to the rules for critical discussion, we shall provide a more detailed explanation than can be found in the literature on health communication of why certain types of conduct of the participants in the medical encounter can be analyzed as obstacles to the goal of shared decision-making.

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