Hi Pam,
I am currently involved in a large scale service implementation study
called MAGIC (Making Good Decisions in Collaboration). The project is aimed at
making Shared Decision Making (SDM) the norm and covers a wide range of areas
including obstetrics. We have been successful in implementing a midwife led
approach to a VBAC clinic whereby the midwife identifies the women who have had
one previous caesarean with no other obstetric risk factors and a “shared
decision making” consultation ensues. We use the Ottawa decision guide and an information
leaflet that we developed specifically for purpose, as a basis for the
consultation. We are in the process of widening this to include other
preference sensitive decisions such as prenatal screening, ECV and choice of
place of birth but we hope to create an overall culture of shared decision
making within women’s services.
As part of the project we offer workshops that aim to equip midwives,
nurses, clinicians etc. with the skills to participate in a shared decision
making consultation. This is broken down into three components “Option talk
– Choices talk – Preference/Decision talk”. The fundamental
aim of SDM is to elicit a discussion with the women regarding their values and
what is important to them as individuals rather than what we think is
important. Unfortunately the project is still at the pilot stage and I have
very little to offer you in way of further information regarding the project at
this point but I can send you the document that we use for the workshops if you
think this would be useful. There is quite a bit of literature around SDM and I
would advise that you try a literature search including the term “shared
decision making”. I can also recommend the following book that may offer
insight into the concept of SDM and in particular chapter 17 discusses
implementation in clinical practice Elwyn G & Edwards A (Ed) 2009 Shared
Decision Making in Health Care – Achieving evidence based patient choice.
Oxford University Press. The Ottawa site offers a range of decision aids
that you may also find useful: http://decisionaid.ohri.ca/decguide.html
I hope this helps a little.
Regards
Claire
Claire
Leader
Senior Research
Midwife
Team Lead
Reproductive Health
Research Midwives'
Office, Level 6, Leazes Wing, Royal Victoria Infirmary, Newcastle Upon Tyne.
NE1 4LP
Tel: 0191 2820439
From:
A forum for discussion on midwifery and reproductive health research.
[mailto:[log in to unmask]] On
Behalf Of Pamela Harnden
Sent: 25 February 2011 00:47
To:
[log in to unmask]
Subject: Discussing Consultation
styles
Hi everyone,
I am trying to develop some educational guidelines for student midwives
and education video's based around effective consultation style.
I believe that traditionally student midwives have 'learnt' their
consultation style from working alongside and observing their mentors in the
practice area. I am just not sure that this is always an effective way of
students 'modelling' their future interaction and partnerships with
women.
I have read 'The Inner Consultation' by Roger Neighbour but this is
largely written for GP's. I really like certain aspects of his book especially
where he discusses 'two heads' the 'organiser' and the 'responder', there are
also many other valuable parts of the book which could be applied to midwifery.
I have attempted to make a search of PubMed using keywords,
consultation, midwifery, teaching, students without much success. Can anyone
suggest any further keywords or does anyone have any literature on the subject?
many thanks
--
Honorary Research
Fellow & Research Assistant Melbourne
University
