Box 1.

Analytical framework for analysing videos

Emergent theme (mechanism)Gross structure informed by model of shared decision making19,20Evidence of activity and interactional competencies (skills used — not mutually exclusive)
Patient preparation and engagement
  • Pre-beginning

  • Preparation and opening

  • GP checks patient understanding of goal setting

  • Patient attends with completed paperwork or refers to it

  • Patient indicates they have discussed goals, for example, with family, friends

  • Both parties establish the agenda

  • GP invites patient to lead

  • Patient initiates discussion about own goals/priorities

Eliciting and legitimising goals
  • Eliciting goals

  • Assessing options

  • GP encourages early identification of patient priority/priorities

  • GP listens attentively without interruption

  • GP supports and validates patient’s view about importance of goal

  • GP picks up and explores cues and clues

  • Patient talks openly about what is important to them and why

  • GP explores patient’s personal circumstances

  • GP explores patient goal(s)

  • GP and patient discuss options for goals

Collaborative action planning
  • Making goals SMART

  • Decision making

  • Summary

  • Evaluation

  • Closure

  • GP invests time in this process

  • GP and patient deliberate together

  • Patient describes own thinking on steps to take to achieve goal

  • Choices discussed by both parties to explore and set goals

  • Pros and cons of options are discussed

  • A SMART goal informed action plan is negotiated

  • GP or patient record agreed goal and current level of attainment

  • SMART = Specific, Measurable, Attainable, Realistic/Relevant, and Time bound.