We describe three key steps of SDM for clinical practice, namely: choice talk, option talk and decision talk,where the clinician supports deliberation throughout the process (Fig. 1 and Boxes 1, 2 and 3). Choice talk refers to the step of making sure that patients know that reasonable options are available. Option talk refers to providing more detailed information about options and decision talk refers to supporting the work of considering preferences and deciding what is best. The model outlines a step-wise process, although it is important to recognize that the model is not prescriptive clinical interactions are by necessity fluid. Decision support tools provide crucial inputs into this process.