Professional Conversation discussion points- Question 1

What interpersonal skills are required to support shared decision making?

Definition of Empathy

The ability to understand other people's feelings, suffering and their behaviours. Empathy is a significant link to compassion. It enables people to connection an emotional level by sharing their feelings and experiences Vilella and Reddivari, 2023).

Active listening definition

Form of listening used to gain a deeper understanding of the message and context. It uses behaviour and attitudes, enabling interest in what one speaker is saying and ensures the individual feels respect and empathy.

What are communication skills?

Help to facilitate a mutual understanding between two individuals (Grover et al., 2020)

Definition of emotional intelligence

The ability to understand react to the way people feel to make good judgements and avoid/solve problems (Cambridge University Press, 2025)

Definition of Integrity and Honesty

Acting honestly, ethically and within moral principles when providing care meaning that care provisions are effective (Marshall and Austin, 2020)

How does empathy support shared decision making?

• Enables women to feel safe- more able to express their thoughts and feelings (Moudatsou et al., 2020)

• Enabled a person centred approach (Moudatsou et al., 2020)

• Helps women to build a rapport with the professional, meaning they are more likely to engage in care and informed decision making.

How does Active listening support shared-decision making?

o   This is an essential part of communication skills- Communication skills help to facilitate a mutual understanding between two individuals (Grover et al., 2020).

o   Enables personalised care as ensures that women feel heard (Moudatsou et al., 2020)

o   Ockenden report women should be provided with accurate and contemporaneous evidence-based information as this will ensure they can participate in decision making and informed-choices about their care. (Ockenden, 2022).

o   Active listening helps to facilitate this as it means that women’s choices and preferences will be heard, empowering women to be part of the informed decision-making process.

How does Emotional Intelligence support shared decision making?

o   The recognition of emotions in yourself and others meaning that effective communication can be provided and is paramount in the provision of empathetic care (Reis Da Silva, 2024).

o   EI is essential in the formation of a positive patient-professional relationship, as it means that a trusting rapport will be built between the patient and the professional

How does integrity and honesty support shared decision making?

o   This is part of Accountability and responsibility. Midwives are responsible for their actions and should take into account how these will impact the woman, her family and her baby (Marshall and Austin, 2020).

o   Professionals should always act in the best interests of those they are caring for. (Nursing and Midwifery Council, 2018).

Definition of civility and respect?

Showing kindness and compassion towards others, creating a positive and respectful working environment for everyone. (NHS England, 2025).

Definition of MDT Working skills?

Skills required to work well together as a team. Involves effective communication, civility and respect and mutual respect. Also requires the recognition of conflict and applying the effective skills to resolve these.

What is mutual collaboration?

o working together with other professionals to achieve common goals and results.   

• Having relationships that are collaborative and supportive ensures that individuals are more satisfied in their work and are less likely to experience bullying and harassment.

Impact of mutual collaboration in supporting shared decision making?

o   Bullying and harassment has a direct correlation with patient outcomes, meaning if it is prevalent patients are more likely to have poorer outcomes (NHS England, 2023).

o   This makes the MDT communication more effective meaning that patients will be the centre of the care and will be fully informed to make an informed decision about all aspects of care.

Definition of conflict resolution?

o   Aims to resolve the disagreement or conflict with positive outcomes that satisfy all individuals involves.

How does conflict resolution support shared decision making?

o   Can promote team building, critical thinking and alternative resolutions (Ronquillo et al., 2023).

How does civility and respect support shared decision making?

o   This creates a compassionate and inclusive culture for everyone and prevents poor mental health.

How does MDT working skills support shared decision making?

o   Means that professionals will spend less time relaying repeated information to others, so more time will be spent giving direct patient care (NHS Institute for Innovation and Improvement, 2008) This enhances collaboration and efficiency, leading to better patient outcomes through a coordinated approach.

What interpersonal skills are required to support shared decision making?

• Empathy

• Active Listening

• Emotional Intelligence

• Integrity and honesty

What team working skills are required to support shared decision making?

• Civility and respect

• MDT working skills

• Understanding of shared roles and responsibilities

• Mutual colloboration

• Conflict resolution

What are the ethical issues that you would need to consider when facilitating informed choice?

• Ethics- including Edward’ Levels of Ethics 1996

  • Judgement

  • Rules

  • Principles

  • Utilitarianism

  • Deontology

  • Cultural Sensitivity

What is ethics?

This is about the exploration of values and beliefs, to clarify what people understand and feel in a certain situation. Values and beliefs are often influenced by a person’s lifestyle and upbringing (Marshall and Austin, 2020).

How does Edward’s Levels of Ethics (1996) enable the facilitation of informed decision making?

Enables the clear structure of ethical issues so that these barriers can be identified and overcome.

What are the 4 sections of Edward’s Levels of Ethics (1996)?

Judgement

Rules

Principles

Ethical Theories

Judgement definition?

Personal beliefs and biases created by an individual, which are not evidence-based (Marshall and Austin, 2020). Often based off of personal bias.

How does judgement impact informed decision making?

o   This could include being judgemental of the woman’s decision, which could be demonstrated in their personal actions, creating a barrier between the woman and the midwife leading to ineffective communication.

o   Could mean that not all information is shared with the woman or that information is posed in a way that could lead to unintentional coercion of the woman’s choice, because of the individuals past experiences within a similar situation.

Example of how judgement could impact on informed decision making?

o   E.G. A woman who has a learning disability comes into the care of the midwife. The midwife sees that she has a learning disability so assumes that she is unable to decide for herself and that she does not have capacity. This would be the midwife creating a judgement about the woman with the disability.

How are these ethical issues of judgement overcome?

Educating midwives about conditions, so that they can support women to make an informed decision.

using things such as Easy-read format, translators, having longer appointments and providing written information in Braille.

What are rules (Edward’s levels of Ethics 1996)?

These are what guide a midwife’s practice and controls their actions (Marshall and Austin, 2020).

How do rules Impact informed decision making?

-  Although there are rules not all of the women’s choices will follow these.

• Ensuring that all women are fully informed of all information, for example, using informed decision-making tools such as BRAINS, ensures they have all of the information required to make this decision. Ensuring documentation, I contemporaneous helps to overcome the ethical issue of these rules and prevents any possible litigation.

What are the principles of ethical practice?

Autonomy

Non-maleficence

Beneficence

Justice

What do the principles of ethical practice mean?

§  Mean that other people’s rights are respected, no harm is caused, the provision of compassion is provided, and positive action outweighs the risks. It also ensures that everyone is treated fairly and that all women have the same level of options, no matter their race or ethnicity.

Linking the principles of ethical practice to the MENTAL HEALTH ACT 2012:

-   Although there are ethical principles, the woman’s autonomy is to be respected even if this goes against these principles. All decisions made on behalf of the woman are to be made in their best interests and should only be made in cases where a woman has been determined as not having capacity by 2 registered doctors, as per The Mental Health Act 2012.

What are the ethical theories that impact midwifery practice?

Utilitarianism

Deontology

What is Utilitarianism?

Not everyone will be happy with the choice that is made on their behalf; therefore, choices should be made as the greatest benefit for the greatest number.

What is Deontology?

Practitioners have a duty of care to multiple people, i.e. women and fetus. They have to consider their duties to everyone to decide under this theory.

How does deontology impact on informed decision making?

o   These conflict in duties can make dilemmas in deciding the best course of action.

What is the importance of cultural sensitivity in informed decision making?

Having cultural sensitivity is an important part of midwifery care, you need to show respect to the woman’s personal and religious beliefs.