Shared Decision Making Training Through Practice

Shared Decision Making Training Is Really a Listening Workout

A physician lays out two treatment options, clearly and correctly, then asks, “Any questions?” The patient says no. Later, in the parking lot, she calls her sister and says she has no idea which one to pick.

If you run a clinical skills course, a residency program, or a patient experience team, you have probably seen this gap. Shared decision making training often teaches the steps on paper, but the real skill is staying curious about what matters to the patient while the clock runs. That takes practice, and most programs do not have enough room for it.

If you are looking for a way to add that practice, see how Empathable PX lets clinicians rehearse these conversations with a virtual patient and get feedback tied to what they actually said. Visit the Empathable PX page to learn more or ask about a no-cost pilot.

Shared decisions begin with questions, not options

Inviting a patient into a decision means asking what they care about, what worries them, and what they already understand. Many clinicians know this and still slip into explaining, because explaining feels efficient and safe.

The habit has to be practiced to change.

Knowing the steps is not the same as doing them

A learner can recite the stages of a shared decision and still talk for four minutes before the patient speaks. Information is easy to deliver. Real invitation is harder, especially when time is short and the clinician has a strong opinion.

That is why we treat communication as a skill built through reps, not a one-time lecture.

Low-stakes practice lets learners try a different approach

With a virtual patient, a learner can run the same conversation twice: once the way they usually do it, and once with more questions up front. There is no audience and no grade, so they can experiment and notice the difference.

Sessions take about five minutes and run on any device. A faculty member does not need to be present, and a standardized patient does not need to be booked.

Feedback should show where the patient was invited in, and where they were not

After each conversation in Empathable PX, the virtual patient tells a coach how it felt from the patient’s side of the bed. The learner receives a narrative summary and a breakdown across the six HCAHPS patient communication skills, scored on 32 criteria and tied to specific lines.

An illustrative example of what a learner might read: “You described both options well, but you never asked what mattered most to me. I felt like the choice was already made.” That is something a clinician can act on in the next rep.

What we’re not doing

We are not telling clinicians which option to recommend, and we are not suggesting every decision should be handed to the patient. Shared decision making means the patient’s values are part of the conversation. It does not mean the clinician steps back from their expertise.

Nor are we replacing standardized patients. Virtual patients add practice between live sessions, so the time with a standardized patient can go further.

Build toward the harder decisions

Proficiency is a good score, then a good score at increasing difficulty, then holding it over time. Begin with a simple, preference-sensitive choice. Then move to a patient who is anxious, rushed, or holding back what they really think.

Add reps to the time you already have

Empathable PX is built for everyone who talks to patients, with role-specific scenarios. No-cost pilots are available for hospitals and schools under a research grant, with setup within a week. If your shared decision making training needs more repetitions, a demo is an easy place to begin.

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