Exercise #10
Promoting Shared Decision-Making in Multicultural Health Communication
Authors: Prof. Karmen Erjavec and Sabina Krsnik, MBA
35–40 minutes
Description
A nurse is explaining a treatment plan to a patient from another cultural background who speaks limited knowledge of the national language. The patient nods frequently but seems uncertain. In their culture, family members usually participate in health decisions. This exercise reinforces your understanding of shared decision-making in multicultural healthcare through 10 multiple-choice questions on core SDM principles, cultural barriers, and communication strategies.
Methodological Guide
Objectives
Understand the importance of shared decision-making (SDM) in multicultural healthcare settings. Identify barriers that hinder SDM across diverse patient populations. Apply culturally sensitive communication strategies to promote participation and trust. Strengthen collaboration between healthcare professionals and patients through mutual respect and understanding.
Expected Outcomes
After completing this exercise, students will be able to: Explain the concept and benefits of shared decision-making. Recognise the impact of culture and communication barriers on SDM. Apply empathy and active listening to build trust with multicultural patients. Facilitate participatory healthcare decisions respectfully and effectively.
Exercise Procedure
Stage 1: Introduction—overview of SDM principles and examples from multicultural healthcare. Stage 2: Interactive discussion—identifying communication barriers and culturally responsive strategies. Stage 3: Interactive Quiz (10 questions)—students select the correct answers related to SDM and intercultural competence. Stage 4: Reflection and feedback—analysing why certain responses represent effective communication.
Mode of Implementation
Individual and group work.
Role of the Teacher
Introduce SDM principles and clarify differences between paternalistic, informed, and shared approaches. Guide discussion on communication barriers and cultural challenges. Facilitate the interactive quiz and encourage reasoning behind answers. Provide examples of culturally sensitive phrasing. Summarise lessons learned and highlight ethical implications.
Theoretical Basis
This exercise builds on Section 9.4 (Commitment to Dialogue and Collaboration) of the handbook and established theories of shared decision-making (Charles, Gafni, and Whelan, 1997; Elwyn, Frosch, and Rollnick, 2012). Shared decision-making (SDM) is a cooperative and ethical communication process that balances clinical expertise with patient values and cultural beliefs. It requires mutual respect, clear information exchange, and culturally sensitive dialogue to ensure understanding and trust. In multicultural healthcare settings, effective SDM depends on recognising and overcoming language, cultural, and hierarchical barriers through empathy, active listening, and adaptation of communication strategies. By applying these principles, healthcare professionals promote inclusiveness, respect for autonomy, and culturally appropriate collaboration in clinical decision-making.
Practical Application
Students practise recognising and overcoming barriers to SDM through analysis of examples and reflection. The final quiz reinforces understanding of core principles: patient involvement, empathy, cultural sensitivity, and clear communication strategies.
Knowledge Transfer
Students will: Identify key elements of SDM and their relevance in multicultural care. Recognise barriers (language, hierarchy, cultural beliefs) and learn strategies to overcome them. Understand the link between empathy, trust, and decision-making participation. Develop the ability to assess and adapt communication to patient needs and literacy levels. Strengthen awareness of ethical and cultural dimensions of shared decision-making.
Reinforcement & Reflection
How can healthcare providers balance professional authority with patient autonomy? What communication strategies best ensure patient understanding? How can family members influence or support shared decisions? How does culture shape trust and participation in clinical dialogue?
Required Resources
Computer or digital platform for interaction. Paper and pencil.
Assessment / Evaluation
Formative assessment: observation of student participation during discussion and quiz justification. Self-assessment: students reflect on their confidence in applying SDM principles. Interactive quiz: Immediate formative feedback on students’ understanding of shared decision-making principles.
Practical Tips
Use real-life or case-based examples from healthcare settings. Encourage inclusion of family roles in culturally diverse decision-making. Reinforce empathy, clarity, and respect for autonomy. Discuss ethical challenges (e.g., differing cultural expectations of authority).
Discussion Topics
How can shared decision-making improve patient satisfaction and outcomes? What strategies can overcome cultural resistance to patient participation? How can healthcare providers foster trust when patients defer to family or tradition?
Stage 1 — Shared decision-making analysis
Read the scenario and respond in the three fields below. Scenario: A nurse is explaining a treatment plan to a patient from another cultural background who speaks limited knowledge of the national language. The patient nods frequently but seems uncertain. In their culture, family members usually participate in health decisions. Aim for 100–150 words in total across the three fields.
- Two main barriers to shared decision-making
- One concrete strategy to overcome each barrier
- Building trust and encouraging patient participation
Stage 1 — Shared decision-making analysis
Read the scenario and respond in the three fields below. Scenario: A nurse is explaining a treatment plan to a patient from another cultural background who speaks limited knowledge of the national language. The patient nods frequently but seems uncertain. In their culture, family members usually participate in health decisions. Aim for 100–150 words in total across the three fields.
- Two main barriers to shared decision-making
- One concrete strategy to overcome each barrier
- Building trust and encouraging patient participation
Further Resources
Charles, C., Gafni, A., & Whelan, T. (1997). Shared decision-making in the medical encounter. Elwyn, G., Frosch, D., & Rollnick, S. (2012). Dual equipoise and shared decision-making. Elwyn, G., et al. (2017). A three-talk model for shared decision making: Multistage consultation process. BMJ, 359, j4891. Scholl, I., Zill, J. M., Härter, M., & Dirmaier, J. (2014). An integrative model of patient-centeredness—A systematic review. Patient Education and Counseling, 96(1), 57–68.
Additional Remarks
This final exercise integrates all previous communication competencies. It highlights empathy, collaboration, and respect as cornerstones of culturally responsive healthcare. The combination of reflection and a comprehensive quiz ensures knowledge consolidation and readiness for real-world application.