What is agenda setting in the clinical encounter? Consensus from literature review and expert consultation.

Abstract

OBJECTIVE: To establish consensus on the core domains of agenda setting in consultations. METHODS: We reviewed the healthcare literature and, using a modified Delphi technique to embrace both patient and clinician perspectives, conducted an iterative online survey, with 30 experts in health communication. Participants described agenda setting and rated the importance of proposed domains. Consensus was determined where the group median was ≥5 on a 7-point Likert-like response scale, and the interquartile range fell to within one point on this scale. RESULTS: Relevant publications were identified in three overlapping bodies of healthcare literature. Survey respondents considered that agenda setting involved a process whereby patients and clinicians establish a joint focus for both their conversation and their working relationship. Consensus was obtained on six core domains: identifying patient talk topics, identifying clinician talk topics, agreement of shared priorities, establishing conversational focus, collaboration and engagement. New terminology--agenda mapping and agenda navigation--is proposed. CONCLUSION: We identified core agenda setting domains that embraced patient and clinician perspectives. PRACTICE IMPLICATIONS: An integrated conceptualization of agenda setting may now be used by researchers and educators in both clinician and patient focused interventions.