Development of the IcanSDM scale to assess primary care clinicians’ ability to adopt shared decision-making

Giguère, Anik; Bogza, Laura-Mihaela; Coudert, Laëtitia; Carmichael, Pierre-Hugues; Renaud, Jean‐Sébastien; Légaré, France; Lindig, Anja; Voyer, Philippe

doi:10.1101/2020.07.01.20144204

Cited by 4 publications

(6 citation statements)

References 36 publications

(56 reference statements)

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“…Of all the studies, 69% (36/52) were published between 2019 and 2021 [ 9 , 32 - 68 ]. Furthermore, 58% (30/52) were located in Canada [ 7 , 8 , 10 - 12 , 23 - 25 , 28 , 31 , 35 , 38 - 41 , 44 - 51 , 53 , 54 , 56 , 60 , 63 , 65 , 67 ] and the rest in the United States (n=6), the United Kingdom (n=4), Australia (n=2) [ 30 , 34 ], Iran (n=2) [ 55 , 64 ], Argentina (n=1) [ 52 ], Indonesia (n=1) [ 32 ], Germany (n=1) [ 58 ], Sweden (n=1) [ 21 ], the Netherlands (n=1) [ 59 ], and Burkina Faso (n=1) [ 37 ]. In addition, two multicountry studies were reported: 1 from Brazil-China-France-Japan-Mali [ 68 ] and 1 from Canada-Vietnam [ 19 ] ( Table 1 ; Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…( Table 2 ). In most studies, participants in CPD activities consisted of interprofessional groups (30/52, 60%) [ 7 , 9 - 11 , 19 , 21 , 27 , 28 , 31 , 35 , 37 , 41 , 43 , 44 , 46 , 47 , 50 , 51 , 53 , 55 - 61 , 63 , 64 , 66 - 68 ]. Professions included nurses (5/52, 10%) [ 26 , 29 , 30 , 48 , 54 ], physicians (4/52, 8%) [ 38 , 39 , 49 , 52 ], social workers or other health professionals, namely occupational therapists, physiotherapists, dietitians, behavioral counselors, nutritionists, health researchers (4/52, 8%) [ 23 - 25 , 34 , 36 ], specialist physicians (3/52, 6%) [ 32 , 40 , 65 ], and pharmacists (2/52, 4%) [ 22 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…The questionnaire was administered in four languages: French (14/52, 27%) or English (28/52, 54%) [ 8 - 11 , 19 , 21 - 24 , 26 - 32 , 34 - 37 , 39 - 51 , 53 - 55 , 57 , 59 - 68 ], Spanish (1/52, 2%) [ 52 ] and Dutch (1/52, 2%) [ 58 ]. The median number of CPD activities targeting behavior change per study was 1 and varied between 1 and 9 CPD activities per study.…”

Section: Resultsmentioning

confidence: 99%

“…The median number of CPD activities targeting behavior change per study was 1 and varied between 1 and 9 CPD activities per study. One-quarter (11/52, 21%) of the studies used CPD-REACTION to measure behavioral change intention but were not linked to a specific CPD activity [ 21 , 22 , 29 , 31 , 38 , 40 , 45 , 46 , 51 , 53 , 59 ] ( Table 1 ). The most common format for CPD activities was web-based or e-learning based (34/52, 65%).…”

Section: Resultsmentioning

confidence: 99%

“…The evaluations targeted 39 different clinical behaviors [ 7 - 12 , 19 - 70 ]. Thematic analysis showed that 7 (18%) out of the 39 pertained to shared decision-making [ 9 , 35 , 50 , 54 , 56 , 64 , 67 ] and 5 pertained to decision aids or toolkit implementation [ 53 , 60 , 61 , 63 , 66 ] ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

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Use of the CPD-REACTION Questionnaire to Evaluate Continuing Professional Development Activities for Health Professionals: Systematic Review

Ayivi-Vinz¹,

Kanyinga²,

Bergeron³

et al. 2022

JMIR Med Educ

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Background Continuing professional development (CPD) is essential for physicians to maintain and enhance their knowledge, competence, skills, and performance. Web-based CPD plays an essential role. However, validated theory–informed measures of their impact are lacking. The CPD-REACTION questionnaire is a validated theory–informed tool that evaluates the impact of CPD activities on clinicians’ behavioral intentions. Objective We aimed to review the use of the CPD-REACTION questionnaire, which measures the impact of CPD activities on health professionals’ intentions to change clinical behavior. We examined CPD activity characteristics, ranges of intention, mean scores, score distributions, and psychometric properties. Methods We conducted a systematic review informed by the Cochrane review methodology. We searched 8 databases from January 1, 2014, to April 20, 2021. Gray literature was identified using Google Scholar and Research Gate. Eligibility criteria included all health care professionals, any study design, and participants’ completion of the CPD-REACTION questionnaire either before, after, or before and after a CPD activity. Study selection, data extraction, and study quality evaluation were independently performed by 2 reviewers. We extracted data on characteristics of studies, the CPD activity (eg, targeted clinical behavior and format), and CPD-REACTION use. We used the Mixed Methods Appraisal Tool to evaluate the methodological quality of the studies. Data extracted were analyzed using descriptive statistics and the Student t test (2-tailed) for bivariate analysis. The results are presented as a narrative synthesis reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results Overall, 65 citations were eligible and referred to 52 primary studies. The number of primary studies reporting the use of CPD-REACTION has increased continuously since 2014 from 1 to 16 publications per year (2021). It is available in English, French, Spanish, and Dutch. Most of the studies were conducted in Canada (30/52, 58%). Furthermore, 40 different clinical behaviors were identified. The most common CPD format was e-learning (34/52, 65%). The original version of the CPD-REACTION questionnaire was used in 31 of 52 studies, and an adapted version in 18 of 52 studies. In addition, 31% (16/52) of the studies measured both the pre- and postintervention scores. In 22 studies, CPD providers were university-based. Most studies targeted interprofessional groups of health professionals (31/52, 60%). Conclusions The use of CPD-REACTION has increased rapidly and across a wide range of clinical behaviors and formats, including a web-based format. Further research should investigate the most effective way to adapt the CPD-REACTION questionnaire to a variety of clinical behaviors and contexts. Trial Registration PROSPERO CRD42018116492; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=116492

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Use of the CPD-REACTION Questionnaire to Evaluate Continuing Professional Development Activities for Health Professionals: Systematic Review

Ayivi-Vinz¹,

Kanyinga²,

Bergeron³

et al. 2022

JMIR Med Educ

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Translation and psychometric evaluation of the German version of the IcanSDM measure – a cross-sectional study among healthcare professionals

Lindig

Hahlweg

Christalle

et al. 2021

BMC Health Serv Res

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Background Shared decision-making (SDM) between patients and healthcare professionals (HCPs) is a key component of patient-centred care. To implement SDM in clinical practice and to evaluate its effects, it is helpful to know about HCPs’ perception of SDM barriers. The measure IcanSDM was developed in Canada and assesses the perception of SDM barriers. To our knowledge, no equivalent measure exists in German. Therefore, the aim of this study was to translate and adapt the IcanSDM measure to be used by a German speaking population and evaluate its psychometric properties. Methods This is a cross-sectional psychometric study based on a secondary analysis of baseline data from a SDM implementation study. The original 8-item IcanSDM was translated into German using a team translation protocol. We assessed comprehensibility via cognitive interviews with n = 11 HCPs. Based on results of cognitive interviews, the translated IcanSDM version was revised. Two hundred forty-two HCPs filled out the measure. Psychometric analysis included acceptance (completion rate), item characteristics (response distribution, skewness, item difficulties, corrected item-total correlations, inter-item correlations), factorial structure (confirmatory factor analysis (CFA), model fit), and internal consistency (Cronbach’s α). Results We translated and adapted the German IcanSDM successfully except for item 8, which had to be revised after the cognitive interviews. Completion rate was 98%. Skewness of the items ranged between −.797 and 1.25, item difficulties ranged between 21.63 and 70.85, corrected item-total-correlations ranged between .200 and .475, inter-item correlations ranged between .005 and .412. Different models based on CFA results did not provide a valid factorial structure. Cronbach’s α ranged between .563 and .651 for different factor models. Conclusion We provide the first German measure for assessing perception of SDM barriers by HCPs. The German IcanSDM is a brief measure with good acceptance. However, we found unsatisfying psychometric properties, which were comparable to results of the original scale. In a next step, the IcanSDM should be further developed and modified and predictive validity should be evaluated.

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Evaluation of a program for routine implementation of shared decision-making in cancer care: results of a stepped wedge cluster randomized trial

et al. 2021

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Background Shared decision-making (SDM) is preferred by many patients in cancer care. However, despite scientific evidence and promotion by health policy makers, SDM implementation in routine health care lags behind. This study aimed to evaluate an empirically and theoretically grounded implementation program for SDM in cancer care. Methods In a stepped wedge design, three departments of a comprehensive cancer center sequentially received the implementation program in a randomized order. It included six components: training for health care professionals (HCPs), individual coaching for physicians, patient activation intervention, patient information material/decision aids, revision of quality management documents, and reflection on multidisciplinary team meetings (MDTMs). Outcome evaluation comprised four measurement waves. The primary endpoint was patient-reported SDM uptake using the 9-item Shared Decision Making Questionnaire. Several secondary implementation outcomes were assessed. A mixed-methods process evaluation was conducted to evaluate reach and fidelity. Data were analyzed using mixed linear models, qualitative content analysis, and descriptive statistics. Results A total of 2,128 patient questionnaires, 559 questionnaires from 408 HCPs, 132 audio recordings of clinical encounters, and 842 case discussions from 66 MDTMs were evaluated. There was no statistically significant improvement in the primary endpoint SDM uptake. Patients in the intervention condition were more likely to experience shared or patient-lead decision-making than in the control condition (d=0.24). HCPs in the intervention condition reported more knowledge about SDM than in the control condition (d = 0.50). In MDTMs the quality of psycho-social information was lower in the intervention than in the control condition (d = − 0.48). Further secondary outcomes did not differ statistically significantly between conditions. All components were implemented in all departments, but reach was limited (e.g., training of 44% of eligible HCPs) and several adaptations occurred (e.g., reduced dose of coaching). Conclusions The process evaluation provides possible explanations for the lack of statistically significant effects in the primary and most of the secondary outcomes. Low reach and adaptations, particularly in dose, may explain the results. Other or more intensive approaches are needed for successful department-wide implementation of SDM in routine cancer care. Further research is needed to understand factors influencing implementation of SDM in cancer care. Trial registration clinicaltrials.gov, NCT03393351, registered 8 January 2018.

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Development of the IcanSDM scale to assess primary care clinicians’ ability to adopt shared decision-making

Cited by 4 publications

References 36 publications

Use of the CPD-REACTION Questionnaire to Evaluate Continuing Professional Development Activities for Health Professionals: Systematic Review

Use of the CPD-REACTION Questionnaire to Evaluate Continuing Professional Development Activities for Health Professionals: Systematic Review

Translation and psychometric evaluation of the German version of the IcanSDM measure – a cross-sectional study among healthcare professionals

Evaluation of a program for routine implementation of shared decision-making in cancer care: results of a stepped wedge cluster randomized trial

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