Shared decision-making in PLAB 2

Shared decision-making is one of the clearest markers of strong interpersonal performance in PLAB 2. It means working with the patient to reach a plan that fits both the clinical evidence and their own values and preferences — rather than simply telling them what to do.

What it looks like

1. Explain the options, including doing nothing, in plain language.
2. Set out the benefits and downsides of each in proportion.
3. Explore what matters to the patient — their priorities and concerns.
4. Agree a plan together that fits both the evidence and their values.
5. Check they are comfortable with the decision and safety-net.

Why it scores

Stations such as explaining a statin, discussing anticoagulation, or choosing between management options are really tests of shared decision-making. The candidate who explores the patient’s views and tailors the plan outperforms the one who delivers a correct but one-sided recommendation.

Respect autonomy

A patient with capacity may make a choice you would not — including declining treatment. Respecting that, while ensuring they are properly informed, is part of doing this well.

Common pitfalls

• Presenting only one option, or only your preferred one.
• Overwhelming the patient with figures instead of what matters to them.
• Pressuring rather than partnering.

Practise decision-heavy explanation stations on ZWIP and use the feedback to check you are genuinely sharing the decision, not steering it.