A Framework and Resources for Shared Decision Making: Opportunities for Improved Physical Therapy Outcomes

Phys Ther. 2018 Dec 1;98(12):1022-1036. doi: 10.1093/ptj/pzy095.


Shared decision making (SDM) is a collaborative approach between clinicians and patients, where the best available evidence is integrated with patients' values and preferences for managing their health problems. Shared decision making may enhance patient-centered care and increase patients' satisfaction, engagement, adherence, and ability to self-manage their conditions. Despite its potential benefits, SDM is underutilized by physical therapists, and frequent mismatches between patients' and therapists' rehabilitation goals have been reported. Physical therapists can use evidence-based strategies, tools, and techniques to address these problems. This paper presents a model for SDM and explains its association with improved patient outcomes and relevance to situations commonly encountered in physical therapy. It describes freely available resources, including health literacy universal precautions, teach-back, motivational interviewing, decision aids, and patient-reported outcome measures that can help physical therapists integrate SDM into their clinical practices. This paper also explains SDM facilitators and barriers, suggests a theoretical framework to address them, and highlights the need for SDM promotion within physical therapy practice, education, administration, and research.

MeSH terms

  • Decision Making*
  • Humans
  • Patient Participation*
  • Patient Satisfaction
  • Patient-Centered Care*
  • Physical Therapists / psychology*
  • Physical Therapy Modalities