Realistic Medicine

The 6-step DECIDE model is recommended as a guide to shared decision making discussions in Scotland. It gives some examples of what we can say at each step and highlights key phrases you can adapt to different people and situations.

Choosing language carefully when having shared decision making conversations helps support clear, unambiguous communication that people and their families can understand.

Give evidence-based facts not opinions or descriptions:

• Use a consistent ‘denominator’ – ideally 100. Say ‘5 in every 100’ rather than 1 in 20.
• Share balanced information about what could happen (benefits and risks or complications)
• Neutral information is unbiased so easier to understand and use. Avoid gain/positive or loss/negative framing such as ‘best v worse’ case scenarios.
• Explain ‘absolute’ not ‘relative’ risks. Absolute risk gives the likelihood of an event happening in a given group of people over a specific period of time.
• Use relevant decision aids like pictograms, if available.

The box below has some helpful tips:

To support staff in learning how to have meaningful shared decision making conversations a toolkit has been developed for tutors.

This toolkit contains all the resources needed for experienced facilitators to run interactive, shared decision making workshops.