Decision-Making Models in Nursing: A Comparative Overview
This paper examines three major clinical decision-making models used by physicians and patients to achieve optimal health outcomes: the paternalistic model, informed decision-making, and shared decision-making. For each model, the paper outlines its core benefits, inherent limitations, and the clinical situations in which it is most appropriately applied. The analysis concludes that shared decision-making offers the greatest potential for lasting positive change, as it balances clinician expertise with patient autonomy and fosters mutual responsibility in treatment planning. The discussion draws on peer-reviewed literature across healthcare ethics and clinical communication.
- Introduction to Clinical Decision-Making: Overview of models for optimal patient outcomes
- The Paternalistic Model: Physician-led model: benefits, limits, best uses
- Informed Decision-Making: Patient knowledge, consent, and partnership benefits
- Shared Decision-Making: Mutual two-way model with strongest change potential
- Conclusion: Shared decision-making as most effective overall model
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What makes this paper effective
- The paper uses a clear parallel structure to evaluate each decision-making model — presenting benefits, limitations, and best-use scenarios for every model — making comparison easy for the reader.
- Each model is grounded in peer-reviewed citations, lending academic credibility to claims about clinical advantages and drawbacks.
- The paper closes with a reasoned conclusion, arguing that shared decision-making is the most effective model, which gives the comparative analysis a clear argumentative direction rather than leaving it purely descriptive.
Key academic technique demonstrated
This paper demonstrates comparative analytical writing: rather than treating each model in isolation, it evaluates all three against consistent criteria (benefits, limitations, applicable situations). This technique allows the writer to build toward a defensible conclusion without simply summarizing sources.
Structure breakdown
The paper consists of a brief framing introduction followed by three body paragraphs — one per model — each following the same internal structure. A reference list in APA format closes the paper. This tight, symmetrical organization suits a short comparative essay and makes the argument easy to follow at the undergraduate level.
Introduction to Clinical Decision-Making
There are various decision-making models that physicians and patients use to reach optimal solutions regarding the best possible patient outcomes. The three primary models — paternalistic, informed, and shared decision-making — each carry distinct advantages, limitations, and appropriate clinical applications.
The Paternalistic Model
The paternalistic model has its own set of pros and cons. Its benefits include the flow of expert information from physician to patient, a focus on community-wide outcomes rather than any single individual, and a clinician acting as a guardian who prioritizes the patient's health interests (Ayodele, 2016). Because the outcomes of one patient can affect the perceived image of the healthcare field, the model encourages decisions that serve the broader good.
The pitfalls of this model include heavy dependency on the physician and medical staff, one-way information flow, and the clinician making the final decision with little or no input from the patient — a dynamic that can cause dissatisfaction. Nevertheless, the paternalistic model can be particularly justified in emergencies where the patient is in critical condition and may be unaware of the severity or urgency of the situation.
Informed Decision-Making
The informed decision-making model comprises various benefits, including heightened self-confidence for both patient and physician, greater satisfaction with the care provided, increased patient knowledge, and reduced worry and conflict about the final decision — since there is a shared partnership and distributed responsibility in the process (Paterick, Paterick, & Paterick, 2020).
The limitations include a time-consuming process, the potential for information overload that the patient may not be capable of processing carefully, and uncertainty about consistently favorable patient outcomes. Situations in which informed consent is most appropriately practiced include cases involving a child, a parent, or a family member in a medical procedure, where clarity about roles and understanding is especially important.
Conclusion
Among the three models examined, shared decision-making offers the greatest potential for lasting, positive change by integrating the perspectives of both clinicians and patients into the treatment process. While each model has appropriate applications depending on clinical context, shared decision-making best supports patient autonomy, satisfaction, and informed risk management.
References
Ankolekar, A., Dekker, A., Fijten, R., & Berlanga, A. (2018). The benefits and challenges of using patient decision aids to support shared decision-making in health care. JCO Clinical Cancer Informatics, 2, 1–10.
Ayodele, J. A. (2016). The realities surrounding the applicability of medical paternalism in Nigeria. Global Journal of Social Sciences, 14, 55–61. http://dx.doi.org/10.4314/gjss.v15i1.6
Paterick, Z. R., Paterick, T. E., & Paterick, B. B. (2020). Medical informed choice: Understanding the element of time to meet the standard of care for valid informed consent. Postgraduate Medical Journal, 96, 708–710.
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