Original Publication
Open Access

Critical Synthesis Package: Brief Decision Support Analysis Tool (DSAT-10)

Published: July 21, 2015 | 10.15766/mep_2374-8265.10148

Included in this publication:

  • Critical Analysis of the Brief Decision Support Analysis Tool (DSAT-10).pdf
  • Brief Decision Support Analysis Tool (DSAT-10) English version.pdf
  • Brief Decision Support Analysis Tool (DSAT-10) French version.pdf

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications. It is also part of a discontinued collection that focused on the presentation of health sciences education assessment tools and their reported validity data. 


This Critical Synthesis Package contains: (1) a Critical Analysis of the psychometric properties and application to health sciences education for the Brief Decision Support Analysis Tool (DSAT-10); and (2) copies of the DSAT-10 instrument in both English and French developed by Dawn Stacey, RN, MScN, PhD.

The DSAT-10 instrument is an observational feedback tool for evaluating decisional support interactions between health care workers and patients. The DSAT-10 includes 16 items divided into five domains of: Decision-Making Status; Knowledge of Options, Risks, and Benefits; Values Associated with Outcomes of Options; Support from Others; and Commitment to Act. Raters use the measure by listening to a provider-patient encounter and then complete the DSAT-10 point grid, which has clearly delineated items/points. Definitions of the items are included for clarification and easy reference. Scores range from zero to ten, with higher scores indicating more decisional support being verbalized during the patient-provider interaction. The DSAT-10 was originally utilized to assess nursing student phone conversations with patients, which were taped and reviewed by educators. There is support, however, for use with a variety of learners in a variety of clinical scenarios. Although tools such as the DSAT-10 offer a somewhat schematic and very calculated approach, and physicians in clinical practice have reported that this adds an artificial barrier to genuine patient-centered communication and therefore creates a negative impact on the doctor-patient relationship, the DSAT-10 provides an excellent framework for feedback, and individual learners can be tracked for improvement.

Educational Objectives

  1. To describe the purpose and basic properties of the Brief Decision Support Analysis Tool (DSAT-10), including number of items and scales and psychometric properties;
  2. To describe the application of the DSAT-10 to the field of health sciences education;
  3. To evaluate the relative strengths and weaknesses of the DSAT-10; and
  4. To provide the DSAT-10 and supplemental materials to aid in its administration.

Author Information

  • Lori Wagner, MD, MA: University of Louisville School of Medicine

None to report.

None to report.


  1. Guimond P, Bunn H, O’Conner AM, Jacobsen MJ, Tait VK, Drake ER, Graham ID, Stacey D, Elmslie T. Validation of a tool to assess health practitioners’ decision support and communication skills. Patient Education and Counseling. 2003; 50: 235-245. https://DOI.org/10.1016/S0738-3991(03)00043-0
  2. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977; 33: 159-174. https://DOI.org/10.2307/2529310  
  3. Butow P, Juraskova I, Chang S, Lopez A, Brown R, Bernhard J. Shared decision making coding systems: How do they compare in the oncology context? Patient Education and Counseling. 2010; 78: 261-268. https://DOI.org/10.1016/j.pec.2009.06.009
  4. Brown RF, Butow PN, Juraskova I, Ribi K, Gerber D, Bernhard J, Tattersall MHN. Sharing decisions in breast cancer care: Development of the Decision Analysis System for Oncology (DAS-O). Health Expectations. 2010; 14: 29-37. https://DOI.org/10.1111/j.1369-7625.2010.00613.x  
  5. Elwyn G, Edwards A, Winsing M, Hood K, Atwell C, Grol R. Shared decision making: development of the OPTION scare for measuring patient involvement. Quality and Safety in Health Care. 2003;12:13-99. https://DOI.org/10.1136/qhc.12.2.93
  6. Castorr AH, Thompson KO, Ryan JW, Phillips CY, Prescott PA, Soeken KL. The process of rater training for observational instruments: implications for interrater reliability. Research in Nursing and Health. 1990;13:311-318. https://DOI.org/10.1002/nur.4770130507
  7. Ivers N, Jamtvedt G, Flottorp S, Young JM, Odgaard-Jensen J, French SD, O’Brien MA, Johansen M, Grimshaw J, Oxman AD. Audit and feedback on professional practice and healthcare outcomes (Review). The Cochrane Library. 2012; 6. https://DOI.org/10.1002/14651858.CD000259
  8. Stacey D, Legare F, col NF, Bennett CL, barry MJ, Eden KB, Holmes-Rovner M, Llewellyn- Thomas H, Lyddiatt A, Thomson R, Trevena L, Wu JHC. Decision aids for people facing health treatment or screening decisions (Review). The Cochrane Library. 2014; 1. https://DOI.org/10.1002/14651858.CD001431
  9. Harrision JD, Masya L, Butow P, Solomon M, Young, J, salkeld G, Whelan T. Implementing patient decision support tools: Moving beyond academia? Patient Education and Counseling. 2009; 76: 120-125. https://DOI.org/10.1016/j.pec.2008.12.013  
  10. deVries M, Fagerlin A, Witterman HO, Scherer LD. Combining deliberation and intuition in patient decision support. Patient Education and Counseling. 2013; 91: 154-160. https://DOI.org/10.1016/j.pec.2012.11.016


Wagner L. Critical synthesis package: brief decision support analysis tool (dsat-10). MedEdPORTAL. 2015;11:10148. https://doi.org/10.15766/mep_2374-8265.10148