Table 1.

The observer OPTION 5 Measure- Score Sheet

Item 1: For the health issue being discussed, the clinician draws attention to or confirms that alternate treatment or management options exist or that the need for a decision exists. If the patient rather than the clinician draws attention to the availability of options, the clinician responds by agreeing that the option need deliberation 0 = No effort 1 = Minimal effort 2 = Moderate effort 3 = Skilled effort 4 = Exemplary effort

Item 2: The clinician reassures the patient or re-affirms that the clinician will support the patient to become informed or deliberate about the options. If the patient states that they have sought or obtained information prior to the encounter, the clinician supports such deliberation process 0 = No effort 1 = Minimal effort 2 = Moderate effort 3 = Skilled effort 4 = Exemplary effort

Item 3: The clinician gives information or checks understanding about the options that are considered reasonable (this can include taking no action), to support the patient in comparing alternatives. If the patient requests clarification, the clinician supports the process 0 = No effort 1 = Minimal effort 2 = Moderate effort 3 = Skilled effort 4 = Exemplary effort

Item 4: The clinician makes an effort to elicit the patient’s preferences in response to options that have been described. If the patient declares their preference(s), the clinician is supportive 0 = No effort 1 = Minimal effort 2 = Moderate effort 3 = Skilled effort 4 = Exemplary effort

Item 5: The clinician makes an effort to integrate the patient’s elicited preferences as decisions are made. If the patient indicates how best to integrate their preferences as decisions are made, the clinician makes an effort to do so 0 = No effort 1 = Minimal effort 2 = Moderate effort 3 = Skilled effort 4 = Exemplary effort

Score	Description
0 = No effort	Zero effort observed
1 = Minimal effort	Effort to communicate could be implied or interrupted
2 = Moderate effort	Basic phrases or sentences used
3 = Skilled effort	Substantive phrases or sentences used
4 = Exemplary effort	Clear, accurate communication methods used