Shared Decision-Making Challenge

The CardioSmart Challenge for FITs

Use an existing CardioSmart tool with 3-5 patients and submit an essay about your experience to the CardioSmart team. If your narrative effectively shows Shared Decision-Making in action, you could be 1 of 3 winners.

When we say shared decision-making (SDM) as a cardiology community, we mean:

A care team member opens the discussion about the health condition and introduces treatment options. The potential risks and benefits of the options are shared with the patient using a decision aid when available. The clinician invites the patient’s informed care preferences, goals, values, and lived experience to arrive at a shared treatment plan.

Numerous studies have shown that shared decision-making improves patients' satisfaction with, and involvement in, their health care. SDM also improves accurate risk perceptions of possible benefits and harms among patients; increases the likelihood that patients' choices are more consistent with their informed values; and enhances communication between patients and their clinicians.

To further encourage care teams to engage their patients in SDM, the Center for Medicare and Medicaid Services (the federal agency that provides health coverage to more than 160 million people) requires an SDM interaction for certain patients before placing an implantable cardioverter defibrillator or a left atrial appendage closure device. It is also considering an SDM interaction for carotid stenosis. ACC clinical guidance documents are increasingly including recommendations for shared decision-making as well.

SDM is critical in helping patients make appropriate medical decisions, and ACC leadership remains highly supportive of SDM. As a new generation of cardiologists, you can help us lead the way with this important approach to providing quality care.

The Reward

CardioSmart/Patient Voice Team will select the Top 3 essays as winners.
These fellows will:

Be featured in Cardiology magazine
Receive free registration at ACC.24 annual meeting in Atlanta being held April 6-8
Present your narrative at the Program Directors and Graduate Medical Educators Symposium and the Health Equity Hub at ACC.24

The Timeline

Nov. 15: Challenge launches
Jan. 15: Deadline for fellows to submit write-ups to CardioSmart team
Jan. 16-Feb. 25: CardioSmart team reviews all submissions
Feb. 26: Winners announced

Detailed Instructions

1. Fellows choose from three CardioSmart tools to use with 3-5 patients:

Challenge Tools

AFib and High Risk for Stroke

If you are living with atrial fibrillation and have High Risk for Stroke, use this decision aid to decide between no treatment and treatment with blood thinners (warfarin vs. DOACs).
Drug Options for Patients With Heart Failure

If you have heart failure with reduced ejection fraction and are trying to decide which medicine to take to stop the renin-angiotensin hormone pathway, use this four-page decision aid to better understand your options.
Aspirin and Heart Disease

When should you take daily aspirin? Download the file to print the infographic.
Digital download only

show more tools

2. Fellows submit a narrative in MS Word (750 words or less) to the CardioSmart Team (astephen@acc.org) demonstrating that they engaged in a shared decision-making conversation using the tool with their patients. Narratives should include the following:

Basic information including:
- Gender/age/ethnicity/condition of patients
- Geographic area of clinician and patient
- Decision aid or infographic used with patient
- Setting (virtual vs. in-office)
Did this tool help to facilitate your decision-making conversation with your patients?
How long did this process take/how long did you spend with each patient?
What went well during this process?
What challenges did you face?
What would you improve/what would make this process easier (for clinician and patient)?
What decision was made? If not, why not?

3. The CardioSmart Team will use a four-part grading rubric (see below) to select the winners:

Demonstrates an understanding of the 5 steps of shared decision-making
Explains how shared decision-making enriched the clinician-patient relationship
Addresses social determinants of health and their impact on patient decision making
Expresses how the challenge intersects with at least one of the ACGME Competencies:

Patient care and procedural skills
Medical knowledge
Practice-based learning and improvement
Interpersonal and communication skills
Professionalism
Systems-based practice

4. CardioSmart/Patient Voice Team and Dr. Megan Coylewright – the CardioSmart Editor – will review all submissions and select the top three winners.

Let us know you’re participating by using #CardioSmart, #SharedDecisionMaking, or #CardioSmartChallenge on X.