Core Competencies for Shared Decision Making Training Programs: Insights From an International, Interdisciplinary Working Group

Abstract

Shared decision making is now making inroads in health care professionals’ continuing education curriculum, but there is no consensus on what core competencies are required by clinicians for effectively involving patients in health-related decisions. Ready-made programs for training clinicians in shared decision making are in high demand, but existing programs vary widely in their theoretical foundations, length, and content. An international, interdisciplinary group of 25 individuals met in 2012 to discuss theoretical approaches to making health-related decisions, compare notes on existing programs, take stock of stakeholders concerns, and deliberate on core competencies. This article summarizes the results of those discussions. Some participants believed that existing models already provide a sufficient conceptual basis for developing and implementing shared decision making competency-based training programs on a wide scale. Others argued that this would be premature as there is still no consensus on the definition of shared decision making or sufficient evidence to recommend specific competencies for implementing shared decision making. However, all participants agreed that there were 2 broad types of competencies that clinicians need for implementing shared decision making: relational competencies and risk communication competencies. Further multidisciplinary research could broaden and deepen our understanding of core competencies for shared decision making training.

Shared decision making: Concepts, evidence, and practice

“…Indeed skills training for residents as well as specialists is starting to bud, but mostly so in Western countries such as North-Western Europe, Canada, the US, and Australia [67]. Elsewhere, some groups are active in this field, but the efforts seem incidental so far [68].…”

Is Shared Decision Making a Utopian Dream or an Achievable Goal?

“…Discussion continues about whether broader or narrower definitions should prevail and what precise skills SDM requires of physicians [21,22]. Some argue that patients do not necessarily want to share decisions-they want the doctor to make the decision for them [23].…”

A Qualitative Analysis of Attending Physicians' Use of Shared Decision-Making: Implications for Resident Education

“…6 Despite the widespread promotion of SDM, implementation remains challenging, and there is no consensus on how to teach and foster SDM skills in trainees. [7][8][9] Prior studies across multiple specialties have demonstrated that interventions to teach SDM skills can be both necessary and effective. [10][11][12][13][14] However, for SDM to be integrated into routine clinical care, those skills need to be taught and modeled routinely during training.…”