1. Practice-Based Examples: a.

Clinical Scenarios: Provide specific examples of clinical scenarios

where shared decision-making has been effectively facilitated. For instance, describe a case
where a nurse successfully engaged a patient in deciding on a treatment plan or care options.

b. Challenges and Solutions: Discuss any challenges faced in implementing shared decision-making and
how they were overcome. This could include addressing communication barriers, time constraints, or
resistance from either healthcare professionals or patients.

c. Continuous Improvement: Highlight any ongoing initiatives or feedback mechanisms aimed at

improving shared decision-making processes. This could involve regular evaluations, feedback sessions,
or quality improvement projects focused on enhancing patient involvement in decision-making.

2. Observation, Analysis, and Reflection: a. Reflective Practice: Encourage nurses to engage in

reflective practice regarding their experiences with shared decision-making. This could involve
regular debriefing sessions or reflective journals where nurses share insights and lessons
learned.

b. Feedback Loops: Explore whether there are mechanisms in place for gathering feedback from both
patients and healthcare professionals regarding the effectiveness of shared decision-making. Continuous
improvement relies on a feedback loop that informs future practices.

3. Provocative Field Analysis: a. Critical Analysis: Encourage a critical analysis of the organizational
culture and structures that either facilitate or hinder shared decision-making. This could involve
examining power dynamics, communication hierarchies, and the overall attitude toward patient-
centered care.

b. Strategic Recommendations: Based on the analysis, provide strategic recommendations for further
enhancing shared decision-making in the practice environment. This could include suggestions for
additional training, structural adjustments, or cultural shifts within the organization.

In summary, the observation and analysis of shared decision-making in nursing practice should be
comprehensive, incorporating not only the identification of existing processes but also a deep dive into
practical examples, challenges, and opportunities for improvement. Through this process, a nuanced
understanding of the role of leadership and teamwork in managing and sustaining effective change can
be gained.