Objectives To revise an existing three-talk model for learning how to achieve shared decision making, and to consult with relevant stakeholders to update and obtain wider engagement. Design Multistage consultation process. Setting Key informant group, communities of interest, and survey of clinical specialties. Participants 19 key informants, 153 member responses from multiple communities of interest, and 316 responses to an online survey from medically qualified clinicians from six specialties. Results After extended consultation over three iterations, we revised the three-talk model by making changes to one talk category, adding the need to elicit patient goals, providing a clear set of tasks for each talk category, and adding suggested scripts to illustrate each step. A new three-talk model of shared decision making is proposed, based on “team talk,” “option talk,” and “decision talk,” to depict a process of collaboration and deliberation. Team talk places emphasis on the need to provide support to patients when they are made aware of choices, and to elicit their goals as a means of guiding decision making processes. Option talk refers to the task of comparing alternatives, using risk communication principles. Decision talk refers to the task of arriving at decisions that reflect the informed preferences of patients, guided by the experience and expertise of health professionals. Conclusions The revised three-talk model of shared decision making depicts conversational steps, initiated by providing support when introducing options, followed by strategies to compare and discuss trade-offs, before deliberation based on informed preferences.

Over the course of March 2020, the everyday life of most people changed from normal to extraordinary around the globe. By the beginning of March, there had been serious outbreaks of COVID-19 in a limited number of countries, such as China, South Korea, Iran and Italy, while many others experienced a lull before the storm. People in unaffected countries understood that the Corona SARS CoV-2 virus might reach their shores at one point; the question was when and how hard it would hit. By the end of March, many governments had ordered drastic measures. Schools and university campuses were shut down. Shops, restaurants and companies were closed. People in many different jobs were asked to work from home, and many were in quarantines.

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