SCOPE your life decisions

To paraphrase Shakespeare, “All the world’s a stage and we are players.” I didn’t always see life this way. I just fumbled along with a vague notion that I should have goals and seek ways to accomplish them.

It wasn’t until I was in graduate school that a professor suggested I read the book, The Seven Habits of Highly Effective People. My first reaction was, “What an annoying title!” Trying to be a more effective person struck me as pretentious and nerdy. I wanted to be successful and make it look effortless. I admired the professor, so I read the book anyways. In it, Stephen Covey brilliantly summarizes the lessons he learned from reading almost every published self-help book. More importantly, though, it turned me on to the notion that there is nothing cooler – in a geeky sort of way – than to consciously work at improving your life. I have come to focus professionally on what I see as the core tool for shaping our lives: decision making.

My journey led me to earn a PhD in systems engineering with a specialty in decision and risk analysis. As part of that program, I worked with a group of medical doctors who told me, “We need more of this kind of thinking in health care.”

So for my doctoral dissertation, I studied how people with cancer – whose treatment options include surgery, chemotherapy, hormone therapy, and radiation – actively sort through all the trade-offs to decide on their form of treatment. Leaving such decisions to doctors alone can result in too much or too little treatment relative to what the patient really needs and wants. When you are talking about surgery and chemotherapy for cancer, too much or too little treatment can kill you, or kill your quality of life. I found that after a cancer diagnosis, patients said they got “too much, too little, or conflicting information” and deciding on treatment was daunting.

I asked myself, “Who can we recruit to help patients?” The answer was all around me: college students. So I started a service learning program called the Patient Support Corps in which student interns earn academic credit in exchange for serving patients as personal assistants. I train my students to connect patients with good information, to consolidate all their questions for the doctors; and to accompany them on doctor visits to take notes and recordings so that the patient and family members can review these afterwards.

As part of their training, I teach them to use the SCOPED decision process with patients. SCOPED stands for Situation, Choices, Objectives, People, and Decisions. It’s a checklist of issues to cover when you find yourself at a crossroads. My students use SCOPED to help patients think, talk, read, and write about the options and outcomes. Over time, they started using SCOPED for decisions in their own lives: involving career choices, education, housing, room-mates, and relationships. They convinced me that college students needed more training and tools for decision making because, with rare exceptions, this is not currently part of the high school or college curriculum.

I now teach the SCOPED model to college students cross the country through CAMPUSPEAK’s Decision SCOPE workshop. The workshop is highly experiential and each student works on a decision they are currently facing. Following the workshop, each student receives a SCOPED certification, templates and a mobile app to help them make decisions throughout their life. In the last 12 months, I’ve worked with audience sizes from 50 to 400 and certified over 2,000 students who have given the workshop rave reviews. It’s incredibly gratifying that college students are using SCOPED to improve their life choices.

Don’t leave your opportunities up to chance. Find out how Decision SCOPE can help you make smarter, confident decisions.

Credit // Author: Dr. Jeff Belkora


Dr. Jeff Belkora’s work as the director of the Decision Services Unit at the University of California San Francisco Medical Center has captured national attention. The unit recently won an award from the Mayo Clinic’s Center for Innovation for its “ideas that had the potential to transform for the better the way health care is experienced and delivered.” In his ground breaking work, Jeff has studied patients making the most critical decisions about aggressive medical therapies. He’s discovered that the steps that help a patient make thoughtful, informed decisions about dealing with cancer can be widely applied to others making difficult decisions.

Jeff is a professor at UCSF where he studies and teaches leadership, teamwork, and decision making. He has spoken about his innovative training and decision-making programs to audiences across the globe. He is the author of peer-reviewed journal articles, book chapters and case studies.