Motivational interviewing and shared decision making in primary care

Sonntag, Ulrike; Wiesner, Julia; Fahrenkrog, Sandra; Renneberg, Babette; Braun, Vittoria; Heintze, Christoph

doi:10.1016/j.pec.2011.07.026

Cited by 28 publications

(41 citation statements)

References 22 publications

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“…In addition to the overall low level of SDM, this study showed that a higher level of SDM was significantly correlated to the female sex of the therapist, which is in agreement with the results of Sonntag et al 41 The study of Roter and colleagues 43 on general practice may help to explain the finding that female therapists involved their patients more in the …”

Section: Discussionsupporting

confidence: 91%

Implementation of Shared Decision Making in Physical Therapy: Observed Level of Involvement and Patient Preference

et al. 2013

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Shared decision making was not applied; although patients preferred to share decisions or at least provide their opinion about the treatment, physical therapists did not often recognize this factor. The participating physical therapists were more likely to make decisions in the best interest of their patients; that is, these therapists tended to apply a paternalistic approach rather than involving the patient.

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Section: Discussionsupporting

confidence: 91%

Implementation of Shared Decision Making in Physical Therapy: Observed Level of Involvement and Patient Preference

et al. 2013

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“…28 However, when their actual skills in shared decision making are measured, they are often poor. 29 Clinician communication skills do not necessarily improve with time or experience, 30 further highlighting the need for specific training in these skills.…”

Section: Discussionmentioning

confidence: 99%

Brief Training of Student Clinicians in Shared Decision Making: A Single-Blind Randomized Controlled Trial

et al. 2014

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BACKGROUND: Shared decision making is a crucial component of evidence-based practice, but a lack of training in the "how to" of it is a major barrier to its uptake. OBJECTIVE: To evaluate the effectiveness of a brief intervention for facilitating shared decision making skills in clinicians and student clinicians. DESIGN: Multi-centre randomized controlled trial. PARTICIPANTS: One hundred and seven medical students, physiotherapy or occupational therapy students undertaking a compulsory course in evidence-based practice as part of their undergraduate or postgraduate degree from two Australian universities. INTERVENTION:The 1-h small-group intervention consisted of facilitated critique of five-step framework, strategies, and pre-recorded modelled role-play. Both groups were provided with a chapter about shared decision making skills. MAIN MEASURES: The primary outcome was skills in shared decision making and communicating evidence [Observing Patient Involvement (OPTION) scale, items from the Assessing Communication about Evidence and Patient Preferences (ACEPP) Tool], rated by a blinded assessor from videorecorded role-plays. Secondary outcomes: confidence in these skills and attitudes towards patient-centred communication (Patient Practitioner Orientation Scale (PPOS)). KEY RESULTS: Of participants, 95 % (102) completed the primary outcome measures. Two weeks post-intervention, intervention group participants scored significantly higher on the OPTION scale (adjusted group difference=18.9, 95 % CI 12.4 to 25.4), ACEPP items (difference=0.9, 95 % CI 0.5 to 1.3), confidence measure (difference=13.1, 95 % CI 8.5 to 17.7), and the PPOS sharing subscale (difference=0.2, 95 % CI 0.1 to 0.5). There was no significant difference for the PPOS caring subscale. CONCLUSIONS: This brief intervention was effective in improving student clinicians' ability, attitude towards, and confidence in shared decision making facilitation.Following further testing of the longer-term effects of this intervention, incorporation of this brief intervention into evidence-based practice courses and workshops should be considered, so that student clinicians graduate with these important skills, which are typically neglected in clinician training. INTRODUCTIONWhile various definitions abound, the core tenets of shared decision making include: a two-way exchange of information between the patient and clinician, discussion and deliberation of the possible options and their outcomes, and the clinician and patient both participating in the decision making process and arriving at a decision. 1 Successful evidence-based practice requires clinicians to incorporate patient values and preferences and utilise shared decision making. 2 Indeed, shared decision making can be viewed as a prerequisite to evidencebased practice. 3 However, shared decision making has not been routinely adopted by health professionals. There are barriers to its implementation. 4 One barrier is simply the lack of teaching clinicians the "how to". Recent commentaries about shared de...

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“…Sources: Hargraves et al, 55 Nicolai et al, 58 Brezis et al, 75 Tsulukidze et al, 76 Barr et al, 77 Almario et al, 78 Little et al, 79 and Krupat et al 80 is useful for teamwork and communication skills, 83 can elicit authentic physician behaviours, 84 and is effective to teach and evaluate clinicians' competence for difficult conversations. 85,86 Simulation exercises demonstrate clinicians' variability for identical cases in the process of relationship building 87 and allow exploring strategies for collaboration and counseling-what physicians say, how they say it and why.…”

Section: Tools and Simulation-based Training To Promote Sdmmentioning

confidence: 99%

Meaningful shared decision‐making: complex process demanding cognitive and emotional skills

Stalnikowicz

Brezis

2020

Evaluation Clinical Practice

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Background Shared decision‐making (SDM) takes place when clinicians help patient identify best course of action in the context of their preferences. Methods The aim of this paper is a narrative review of the literature with special focus on the humanistic dimensions of SDM. Results We show that SDM is largely underused in practice, because of many barriers such as time constraints and poor skills. Conclusions We suggest that listening and empathy are key challenges in communicating uncertainty, which require emotional intelligence and trust building skills. To promote implementation, we propose the development of tools, simulation‐based training and the design of improved measures for SDM quality. While essential for patients, we believe that SDM may restore meaning in healthcare.

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Motivational interviewing and shared decision making in primary care

Cited by 28 publications

References 22 publications

Implementation of Shared Decision Making in Physical Therapy: Observed Level of Involvement and Patient Preference

Implementation of Shared Decision Making in Physical Therapy: Observed Level of Involvement and Patient Preference

Brief Training of Student Clinicians in Shared Decision Making: A Single-Blind Randomized Controlled Trial

Meaningful shared decision‐making: complex process demanding cognitive and emotional skills

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