Experiences of Shared Decision-Making Among Resident Physicians in Taiwan

The purpose of this study was to explore the clinical experiences and perceptions regarding three talk model shared decision-making (SDM) practices among different specialty of resident physicians in Taiwan. Resident physicians from a teaching hospital in Southern Taiwan were recruited using purposive sampling. In total, 19 residents participated in one-on-one, in-depth, qualitative, and semi-structured interviews regarding their experiences practicing SDM with their patients. Among these residents, five were from internal medicine, five were from surgery, five were from family medicine, and four were from emergency medicine. The results are as follows: (1) Residents' SDM experiences aligned with all three stages of the three talk model. In the Team Talk stage, they emphasized engaging patients and families, especially in complex cases or when family opinions differed, through a three-way dialogue among physicians, patients, and families. (2) In the Option Talk stage, they prioritized explaining treatment options, including benefits, risks, and lifestyle implications, and encouraging patients and families to express concerns and preferences to support informed decisions. (3) In the Decision Talk stage, they highlighted the importance of in-depth communication to understand patient needs and preferences, summarize and confirm information, and reach a shared consensus. (4) SDM practices differed among specialties due to variations in clinical context and time constraints. Consequently, these findings underscore the need for strategies tailored to each specialty. Tailored SDM training and decision-support tools can bridge the theory-practice gap, strengthen physician-patient relationships, and enhance care quality.