Toward the Implementation of Shared Decision-Making in Korean Clinical Practice: Study Protocol for a Foundational Research Project

Shared decision-making (SDM) is an essential component of patient-centered care, yet its implementation in South Korea remains limited due to a persistent physician-centered clinical culture. This project, supported by the Ministry of Health and Welfare, aims to establish a foundation for nationwide SDM implementation by developing a culturally adapted Korean SDM model and creating a framework to support its institutionalization and widespread clinical adoption. This four-year project consists of five interlinked work packages (WPs) organized into two phases, each lasting two years. Using a multi-method approach-comprising nationwide surveys, systematic literature reviews, and psychometric validation studies-we will assess the current landscape (WP1) and develop standardized SDM evaluation tools for primary stakeholders (WP2). A clinical research data management system will be designed and implemented to support data integration and monitoring (WP3). The central component involves developing a Korean SDM conceptual model and corresponding implementation strategies (WP4). Economic evaluations and legal analyses will inform the design of a pilot reimbursement framework to support sustainable system-level integration (WP5). The project is expected to produce the following outcomes: i) an analysis of domestic and international SDM trends; ii) validated SDM assessment tools and guidelines tailored for the Korean context; iii) a standardized and interoperable SDM data management system; iv) a culturally grounded Korean SDM model with evidence-based implementation strategies; and v) policy proposals, including a reimbursement model, to facilitate system-wide adoption. This work will provide the theoretical, empirical, and policy basis required to advance SDM within the Korean healthcare system. By addressing cultural characteristics and structural barriers, the resulting SDM model and policy recommendations are expected to support the sustainable institutionalization of SDM and strengthen patient autonomy and the quality of clinical practice in Korea.