Humanistic communication in the evaluation of shared decision making: A systematic review

Marleen Kunneman, Michael R. Gionfriddo, Freddy J.K. Toloza, Fania R. Gärtner, Gabriela Spencer-Bonilla, Ian G. Hargraves, Patricia J. Erwin, Victor M. Montori

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations


Objective: To assess the extent to which evaluations of shared decision making (SDM) assess the extent and quality of humanistic communication (i.e., respect, compassion, empathy). Methods: We systematically searched Web of Science and Scopus for prospective studies published between 2012 and February 2018 that evaluated SDM in actual clinical decisions using validated SDM measures. Two reviewers working independently and in duplicate extracted all statements from eligible studies and all items from SDM measurement instruments that referred to humanistic patient-clinician communication. Results: Of the 154 eligible studies, 14 (9%) included ≥1 statements regarding humanistic communication, either in framing the study (N = 2), measuring impact (e.g., empathy, respect, interpersonal skills; N = 9), as patients’/clinicians’ accounts of SDM (N = 2), in interpreting study results (N = 3), and in discussing implications of study findings (N = 3). Of the 192 items within the 11 SDM measurement instruments deployed in the included studies, 7 (3.6%) items assessed humanistic communication. Conclusion: Assessments of the quality of SDM focus narrowly on SDM technique and rarely assess humanistic aspects of patient-clinician communication. Practice implications: Considering SDM as merely a technique may reduce SDM's patient-centeredness and undermine its’ contribution to patient care.

Original languageEnglish (US)
Pages (from-to)452-466
Number of pages15
JournalPatient Education and Counseling
Issue number3
StatePublished - Mar 2019


  • Communication
  • Humanism
  • Patient involvement
  • Shared decision making

ASJC Scopus subject areas

  • Medicine(all)


Dive into the research topics of 'Humanistic communication in the evaluation of shared decision making: A systematic review'. Together they form a unique fingerprint.

Cite this