University of Edinburgh
 

Informed Choice from Theory into Practice

Presented on Tuesday 2 March 2010

Developing resources for informed choice

Gwen Carr, Alys Young

The two-pronged approach

  • Informed choice
    - Issues-driven understanding
    - Context-driven understanding
  • Consideration of the interplay of the two in the practical job of actually producing the guidance documents

Translating research into product

  • Consistency of form and strucure with the subject matter
    - Non-presciptive
    - Reflect IC as process and (potential) outcome
  • Tensions between
    - The 'how to'
    - The exploratory
    - The definitional
  • Diversity of consumers

Parent document

Challenges:

  • Make the idea of informed choice accessible and intelligible
  • Make it concrete and helpful
  • Provide a resource that was skills building as much as knowledge building
  • Huge variation in parents' strengths, needs and capacities
  • Provide a flexiblly usable resource
  • What does informed choice mean?
  • Underpinning issues in parent terms
  • Case studies
  • Examples followed by
    - Things to think about,
    - ideas for putting it into practice,
    - further resources to go to

  • What to expect from services who offer an informed choice approach
  • Key questions to ask
  • Parent overall checklist - what to expect from professionals offering an IC approach

Parent version underpinning issues

  • Every family is different
  • I know my family and child best
  • I need more than information to make a choice
  • Do I really have a choice in every situation?
  • It seems like the professionals think one choice is better
  • I don't feel comfortable and confident about making choices
  • It's OK to change my mind
  • It's not readily available but I still want to know about it
  • Not everything I've been told about is available
  • It's available, but can I use it?
  • Would learning a new skill help me to make choices for my child?

Definition, case study, reflection approach

  • Enabled huge diversity in examples and situations to be reflected
  • Introduces new ideas and new knowledge in non-didactic way
  • Engages parents in 'like me' 'not like me' discussion with no judgements
  • Introduces thinking and doing tools
  • Access at different levels is possible

Products

  • How to use
  • Underpinning issues
  • What parents and professionals told us
  • Practical examples
  • Resources
  • Principles

Professional document

  • Elaborates underpinning issues
  • Then applies them to selected areas of practice
    Appointments, Audiology, Communication, Family to Family Support, Information, Multi-agency working, Service structure and organisation, Training, Transport

Definition

"Informed Choice means that families can make knowledgeable decisions which reflect their own cultures, values and views. This should be based on full access to comprehensive, unbiased and evidence-based information about the full range of options."

An Informed Choice approach to service provision is one in which:

  • Service providers adopt open and flexible policies that effectively endorse a range of possibilities;
  • Services and professionals make no value judgements about one option over another and this stance is reflected in their strategic decision-making and resourcing;
  • Families are supported to reach decisions in ways that are sensitive to their individual strengths, resources, needs and experience;
  • An informed choice is not seen as a one-off decision but as an ongoing process.

Concluding points

  • Coordinated application of theoretical and empirical techniques
  • Significance of looking beyond the field
  • Research-based flexible and responsive 'tools'
  • Informed choice is a process not an end
  • As an orientation to practice is of relevance way beyond communication choices
  • Can (should?) inform the very structuring, resourcing and organisation of services
  • Difficult challenge to notions of 'expert' knowledge and behaviour
  • What is reponsible execution of professional expertise within a framework of informed choice?
  • Tunes into the overall parent journey - not just about how to make decisions.