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Establishing development strategies and improvement paths for decision coach competencies in shared decision-making
Shan-Fu Yu1,2,3,4,5, Yi-Chun Lin6, Hsing-Tse Yu7
1Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan.
BMC Medical Informatics and Decision Making
|July 4, 2026
Summary
Professional knowledge is key for decision coaches (DCs) supporting shared decision-making (SDM). This study evaluated DC competencies, finding that knowledge strongly influences other skills, guiding future training strategies.
Area of Science:
- Healthcare Professional Development
- Patient-Centered Care
- Shared Decision-Making (SDM)
Background:
- Decision coaches (DCs) are trained professionals offering non-directive support in health decisions.
- DCs, often nurses, facilitate shared decision-making (SDM) but are not an inherent part of it.
- Core competencies for DCs are crucial, particularly in patient-centered care within nursing education.
Purpose of the Study:
- To evaluate decision coach (DC) competencies within shared decision-making (SDM).
- To examine the accessibility, performance, and interrelationships of DC competency domains.
- To identify critical criteria for enhancing DC training and practice.
Main Methods:
- Mixed-methods study combining literature review and expert consultations.
- Cross-sectional survey of 149 healthcare professionals in Taiwan.
- Accessibility-Performance Analysis (APA) and DEMATEL-based Network Relation Map (NRM) for competency evaluation.
Main Results:
- Professional knowledge (PK) showed directional associations with outcome evaluation (OE), process management (PM), and guidance skills (GS).
- Guidance skills (GS) were highly associated with other competency domains.
- Critical criteria identified include value (PK1), listening skill (GS2), SDM resources (PM3), and practical results (OE3).
Conclusions:
- Professional knowledge is perceived as the most influential competency domain for decision coaches (DCs).
- The integrated APA-NRM approach provides evidence-based prioritization for DC competency development.
- Findings guide practical training strategies for enhancing DC effectiveness in SDM.
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