Objective To explore how patients and physicians describe attitudes and behaviours that facilitate shared decision making.Background Studies have described physician behaviours in shared decision making, explored decision aids for informing patients and queried whether patients and physicians want to share decisions. Little attention has been paid to patientsÕ behaviors that facilitate shared decision making or to the influence of patients and physicians on each other during this process.
BACKGROUND: Systems of undergraduate medical education and patient care can create barriers to fostering caring attitudes.
OBJECTIVE:The aim of this study is to survey associate deans and curriculum leaders about teaching and assessment of caring attitudes in their medical schools.
PARTICIPANTS:The participants of this study include 134 leaders of medical education in the USA and Canada.
METHODS
RESULTS:We received 73 responses from 134 medical schools. Most respondents believed that their schools strongly emphasized caring attitudes. At the same time, 35% thought caring attitudes were emphasized less than scientific knowledge. Frequently used methods to teach caring attitudes included small-group discussion and didactics in the preclinical years, role modeling and mentoring in the clinical years, and skills training with feedback throughout all years. Barriers to fostering caring attitudes included time and productivity pressures and lack of faculty development. Respondents with supportive learning environments were more likely to screen applicants' caring attitudes, encourage collaborative learning, give humanism awards to faculty, and provide faculty development that emphasized teaching of caring attitudes.
CONCLUSIONS:The majority of educational leaders value caring attitudes, but overall, educational systems inconsistently foster them. Schools may facilitate caring learning environments by providing faculty development and support, by assessing students and applicants for caring attitudes, and by encouraging collaboration.
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