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The purpose of this paper is to increase awareness of shared decision making, the initial aim of the study was to understand how psychiatrists-in-training defined themselves as unique among physicians with an eye on how professional identity might shape approach to care. The second aim was to use those definitions and descriptions related to professional identity and tailor a brief training module to promote awareness of the shared decision making model.

The authors do this by first conducting focus groups to ascertain how psychiatric residents characterize their professional identity and unique disciplinary characteristics. The authors then designed a brief training session that exploits the relationship between how they define themselves as physicians and how they approach clinical decision making with patients.

Three major themes that emerged from the focus group data: the central role of societal and treatment contexts in shaping their professional identity and approaches to care, a professional identity characterized by a great sense of pride, and a strong commitment to systematic decision-making processes in practice. While the assessment of the training module is preliminary and lacks rigor for any generalizability or statements of causality, responses likely affirm the training tailored around professional identity as a possible vehicle for effective exposure to the concept of shared decision making and served as a useful avenue for self-reflection about needed changes to more fully embrace the practice.

More inquiry may be needed into the association between trust, relationship longevity and power and paternalism, as a way to bring greater insight into the adoption of shared decision making. Future research will have to investigate whether or not including identity-related content is empirically connected to successful training on shared decision making. Likewise, future research should also look at the reciprocal impact of effectively using shared decision making on the affirmation of professional identity among psychiatrists, and indeed all who embrace patient-centered care.

This is the one of the first papers to investigate issues of professional identity among psychiatry residents, and also among the first papers to consider the relationship between professional identity and use of shared decision making.

The purpose of this paper is to analyse the accounts of Swedish cardiologists concerning patient involvement in consultations for atrial fibrillation (AF). The questions were: how cardiologists handle and provide scope for patient involvement in medical consultations regarding AF treatment and how cardiologists describe their familiarity with shared decision-making.

A descriptive study was designed. Ten interviews with cardiologists at four Swedish hospitals were held, and a qualitative content analysis was performed on the collected data.

The analysis shows cardiologists’ accounts of persuasive practice, protective practice, professional role and medical craftsmanship when it comes to patient involvement and shared decision-making. The term “shared decision-making” implies a concept of not only making one decision but also ensuring that it is finalised with a satisfactory agreement between both parties involved, the patient as well as the cardiologist. In order for the idea of patient involvement to be fulfilled, the two parties involved must have equal power, which can never actually be guaranteed.

Methodologically, this paper reflects the special contribution that can be made by the research design of descriptive qualitative content analysis (Krippendorff, 2004) to reveal and understand cardiologists’ perspectives on patient involvement and participation in medical consultation and shared decision-making. The utility of this kind of analysis is to find what cardiologists said and how they arrived at their understanding about patient involvement. Accordingly, there is no quantification in this type of research.

Cardiologists should prioritise patient involvement and participation in decision-making regarding AF treatment decisions in consultations when trying to meet the request of patient involvement.

Theoretically, the authors have learned that the patient involvement and shared decision-making requires the ability to see patients as active participants in the medical consultation process.

Describes the practices, thoughts, and feelings of shared‐governance principals as they confront the challenges of school restructuring. The focus is on the principals’ perspective on shared governance and democratic schooling; the challenges of becoming involved in collaborative decision making with teachers, parents, and students; and the principals’ own professional growth as they strove to become “one among equals” with their colleagues. The data discussed here were drawn from a qualitative study of principals in nine schools affiliated with Glickman’s League of Professional Schools in Georgia. A protocol of open‐ended interview questions designed by the researchers, according to general guidelines for grounded theory inquiry, provided principals with the opportunity to identify and describe in detail their perspective on shared governance leadership in schools. Inductive analysis of the data generated a description of the implementation of shared governance that includes five salient themes: meanings, becoming involved, letting go of power, supportive processes, and supportive structures. Discusses findings in terms of the relevant empirical and theoretical literature.

Two decades of research have identified a robust effect: Members of decision-making groups mention and repeat shared information that all members know more so than unshared information that a single member knows. This chapter explores the idea that processes related to member status both affect and explain information exchange in decision-making groups. First, we offer five propositions that identify information sharing patterns and their implications for high- and low-status group members. Second, we highlight three theoretical explanations for the group preference for shared information and examine how well each theory accounts for the proposed member status processes.

In terms of the role of myth in decision making, this paper focuses on the way myth obfuscates critical issues related to shared governance in higher education. The result of that obfuscation is a minimization of the realities that work against shared governance by favoring an untenable view based on an idealistic and unattainable vision of shared governance. First, however, a critique of myth is in order to demonstrate not only that myth is no more than ordinary interpretation but also that it is insufficiently based on rationality and can become a dangerous instrument in the hands of policy makers.

The purpose of this paper is to understand how women with a diagnosis of schizophrenia or bipolar disorder approach medication decision making in pregnancy.

The study was co-produced by university academics and charity-based researchers. Semi-structured interviews were conducted by three peer researchers who have used anti-psychotic medication and were of child bearing age. Participants were women with children under five, who had taken anti-psychotic medication in the 12 months before pregnancy. In total, 12 women were recruited through social media and snowball techniques. Data were analyzed following a three-stage process.

The accounts highlighted decisional uncertainty, with medication decisions situated among multiple sources of influence from self and others. Women retained strong feelings of personal ownership for their decisions, whilst also seeking out clinical opinion and accepting they had constrained choices. Two styles of decision making emerged: shared and independent. Shared decision making involved open discussion, active permission seeking, negotiation and coercion. Independent women-led decision making was not always congruent with medical opinion, increasing pressure on women and impacting pregnancy experiences. A common sense self-regulation model explaining management of health threats resonated with women’s accounts.

Women should be helped to manage decisional conflict and the emotional impact of decision making including long term feelings of guilt. Women experienced interactions with clinicians as lacking opportunities for enhanced support except in specialist perinatal services. This is an area that should be considered in staff training, supervision, appraisal and organization review.

This paper uses data collected in a co-produced research study including peer researchers.

The ability to make good decisions is the defining attribute of a high performance organization. The challenge is to ensure that good decision‐making practices permeate the entire organization. As organizations grow, employees make decisions in an increasingly complex, ambiguous, and uncertain environment. Formal practices enable employees to make decisions that are meaningful to the firm's stakeholders and guide their behaviours to align with the strategic intent of the firm as well as its values and norms.

Through case studies and consultancy work the author has developed an approach to focus on management decision making and improved effectiveness.

This paper describes a diagnostic tool which helps companies understand how well their management systems support decision making and where CEOs should invest to focus leadership time and attention. The decision‐making scorecard and tools help CEOs design effectiveness management systems and focus its use to drive their specific business agenda.

With formal decision‐making practice in place, CEOs rely on delegation and control practices to ensure that employees make decisions in line with the organization's vision and values. Using the described approach, CEOs and employees focus their attention on the relevant control levers and use their time for interaction and learning rather than control. Furthermore they successfully apply more relevant decision‐making practices than before, and have abandoned extensive and expensive performance management projects in favour of more differentiated and focused initiatives that support their immediate goals with a direct impact. The tools have been used to ensure that the next strategic move delivers the expected value. In summary, good decision‐making practices translate the CEOs' power and responsibility into higher performance, growth and lower risk.

The purpose of this study was to describe mental health professionals’ experiences of changes in attitudes towards, and knowledge about, users of mental health-care recovery and decisional participation in clinical practice after an educational intervention.

Users of mental health care want to participate in decisions regarding their own mental health care. Shared decision-making as a method is coherent with recovery orientation in mental health services and results in better-informed patients and fewer conflicts regarding decisions. A qualitative intervention study was designed to evaluate changes in attitudes and knowledge about mental health recovery in Sweden. Nine participants were interviewed, and the data were analysed by content analysis.

Three categories were generated from the analysis: Increased theoretical knowledge, changing attitudes about practical approaches and the significance of social factors in recovery.

When shared decision-making is to be implemented in mental health, professionals need to gain knowledge about recovery and need to adopt changed roles as health professionals. Educational interventions therefore seem necessary if such changes are to happen.

The purpose of this study is to describe participation in decision-making among service users with severe mental illness.

Service users want to participate in decision-making and in the planning of their care. There are widely known methods, such as shared decision-making, that could be used to facilitate service user participation. Three focus group interviews were conducted with the participation of 14 persons with mental illness and/or substance abuse who were service users at two Swedish Homes for Care and Residence (HVB). Data were analyzed by qualitative content analysis.

Two themes emerged: service users’ involvement in decisions is hampered by the professionals’ approach and adequate information and experience of participation means greater empowerment.

Although it is known that service users would like to have more influence, and that methods like shared decision-making are recommended to empower service users and improve the decision process, research on these matters is limited.

This study reveals that there is a need of more systematic decisional support, such as shared decision-making, so that service users can be seen as important persons not only in guidelines and policy documents but also in clinical practice.

The findings indicate that service users do not participate in decisions systematically, although policies, guidelines and laws providing that service users should be offered an active part in decision-making with regard to their care and treatment.

Although it is known that service users would like to have more influence, and that methods like shared decision-making are recommended to empower service users and improve their decision process, research on these matters is limited. The findings indicate that service users do not participate in decisions systematically, even though policies, guidelines and laws are in place stipulating that service users should be offered an active part in decision-making with regard to their own care and treatment. The results of this project bring improvement opportunities to light.

A core premise of the paper is that participative, democratic organizational forms have a direct effect on openness. A key proposition is that organizational forms that promote inclusion, transparency and shared decision-making more broadly as part of their structure and culture would enhance greater openness. However, democratic forms are not a panacea when it comes to openness, there are inherent paradoxes, leading to inevitable tradeoffs that democratic organizations must manage.

The theoretical framework in the study explores the interaction between open strategy making and organizational democracy. This paper reviews the literature on open strategy and organizational democracy and presents propositions linking openness and elements of democratic organizations.

Open strategy requires a level of inclusion and transparency not typically associated with hierarchical organizations. This paper proposed that an organizational context where there are institutionalized processes that promote both transparency and inclusiveness, shared decision-making and a supportive organizational culture would promote openness. At the same time, these organizations need to manage key paradoxes associated with organizational democracy to benefit from its positive effect on openness. The idea is not that hierarchies cannot be open; they may simply need to be more creative and work harder at providing the scaffolding for participation.

This is a conceptual paper and we cannot make any claims of causality. It is also possible to refine the framework by adding or eliminating some of the conceptual variables.

Opening up the strategy process to non-traditional stakeholders can improve the strategy formation process. Non-traditional stakeholders can bring new insight, and be motivated and prepared for strategy implementation when they are part of the strategy formation process. Organizations need to focus on creating a climate that supports openness by emphasizing structural forms that promote openness. Sharing decision-making, profits and creating a democratic culture are important for successful openness. In addition, organizations need to manage the tradeoffs that arise as they link organizational democracy to openness.

This paper discusses the link between open strategy and organizational democracy. The research sheds light on how organizational forms, specifically structure affects openness, as well as the limits to structure and openness.