What does SMART stand for in goal setting, and provide a nurse coaching example?

• A. Specific, Measurable, Achievable, Relevant, Time-bound; e.g., walk 30 minutes, 5 days/week for 6 weeks, tracked in a journal.
• B. Simple, Measurable, Attainable, Realistic, Timed; e.g., exercise daily for a week.
• C. Strategic, Motivated, Action-oriented, Realistic, Timed; e.g., join a gym and start immediately.
• D. Specific, Measurable, Adaptable, Relevant, Timely; e.g., lose weight gradually over a year.

Answer: (B)

In SMART goal setting, goals are kept clear, trackable, doable, sensible, and time-bound. In this version, SMART stands for Simple, Measurable, Attainable, Realistic, Timed.

Simple means the goal should be straightforward so the patient can act on it without confusion. Measurable ensures there’s a concrete way to track progress (numbers, frequency, duration, or a date). Attainable (or Achievable) checks that the goal is within the patient’s current abilities and resources, avoiding setting them up for frustration. Realistic aligns the goal with the patient’s values, daily life, and potential barriers, so it’s something they can incorporate. Timed adds a specific deadline or timeframe to create accountability and a plan for follow-up.

Example: A patient looking to improve activity and blood pressure management might set: walk briskly for 15 minutes, five days a week, for four weeks, and log each session in a simple notebook. This is simple and clear, measurable (time, frequency), attainable and realistic for many beginners, and time-bound (four-week timeframe). If barriers arise, you adjust the plan (e.g., shorten duration or number of days) while preserving the SMART framework and schedule a check-in to review progress.