The importance of communication in collaborative decision making: facilitating shared mind and the management of uncertainty.

RATIONALE: Quality medical decision making requires that clinicians and patients incorporate the best available clinical evidence with the patients' values and preferences to develop a mutually agreed upon treatment plan. The interactive process involved in medical decision making is complex and requires patients and clinicians to use both cognitive and communicative skills to reach a shared understanding of the decision. AIMS AND
OBJECTIVES: The purpose of this paper is to present a communication model to help better understand quality medical decision making, and how patient-centered, collaborative communication enhances the decision-making process.
METHODS: We present research on shared mind and cognitive and communicative skills to highlight how they can facilitate the management of uncertainty during the interactive process involved in medical decision making. We provide simple examples about how to frame messages to achieve shared mind and foster uncertainty tolerance.
CONCLUSIONS: Strategies such as providing clear explanations, checking for understanding, eliciting the patient's values, concerns, needs, finding common ground, reaching consensus on a treatment plan, and establishing a mutually acceptable follow-up plan can facilitate collaborative decision making. Future research should explore ways to implement collaborative decision-making processes in existing health care systems.