Training health professionals in shared decision making: Update of an international environmental scan

Diouf, Ndeye Thiab; Menear, Matthew; Robitaille, Hubert; Guérard, Geneviève Painchaud; Légaré, France

doi:10.1016/j.pec.2016.06.008

Cited by 152 publications

(134 citation statements)

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“…They might also reflect the significant heterogeneity among SDM training programs [39], not only in their content but in their modes of delivery and evaluation of knowledge acquired. In this era of rapidly growing numbers of SDM training programs [40] and national efforts to offer them on the Web platform, the most effective methods of delivery and evaluation urgently need to be standardized.…”

Section: Discussionmentioning

confidence: 99%

Teaching Shared Decision Making to Family Medicine Residents: A Descriptive Study of a Web-Based Tutorial

et al. 2016

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BackgroundDECISION+2, a Web-based tutorial, was designed to train family physicians in shared decision making (SDM) regarding the use of antibiotics for acute respiratory infections (ARIs). It is currently mandatory for second-year family medicine residents at Université Laval, Quebec, Canada. However, little is known about how such tutorials are used, their effect on knowledge scores, or how best to assess resident participation.ObjectiveThe objective of our study was to describe the usage of this Web-based training platform by family medicine residents over time, evaluate its effect on their knowledge scores, and identify what kinds of data are needed for a more comprehensive analysis of usage and knowledge acquisition.MethodsWe identified, collected, and analyzed all available data about participation in and current usage of the tutorial and its before-and-after 10-item knowledge test. Residents were separated into 3 log-in periods (2012-2013, 2013-2014, and 2014-2015) depending on the day of their first connection. We compared residents’ participation rates between entry periods (Cochran-Armitage test), assessed the mean rank of the difference in total scores and category scores between pre- and posttest (Wilcoxon signed-rank test), and compared frequencies of each. Subsequent to analyses, we identified types of data that would have provided a more complete picture of the usage of the program and its effect on knowledge scores.ResultsThe tutorial addresses 3 knowledge categories: diagnosing ARIs, treating ARIs, and SDM regarding the use of antibiotics for treating ARIs. From July 2012 to July 2015, all 387 second-year family medicine residents were eligible to take the Web-based tutorial. Out of the 387 eligible residents, 247 (63.8%) logged in at least once. Their participation rates varied between entry periods, most significantly between the 2012-2013 and 2013-2014 cohorts (P=.006). For the 109 out of 387 (28.2%) residents who completed the tutorial and both tests, total and category scores significantly improved between pre- and posttest (all P values <.001). However, the frequencies of those answering correctly on 2 of the 3 SDM questions did not increase significantly (P>.99, P=.25). Distribution of pre- or posttest total and category scores did not increase between entry periods (all P values >.1). Available data were inadequate for evaluating the associations between the tutorial and its impact on the residents’ scores and therefore could tell us little about its effect on increasing their knowledge.ConclusionResidents’ use of this Web-based tutorial appeared to increase between entry periods following the changes to the SDM program, and the tutorial seemed less effective for increasing SDM knowledge scores than for diagnosis or treatment scores. However, our results also highlight the need to improve data availability before participation in Web-based SDM tutorials can be properly evaluated or knowledge scores improved.

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Section: Discussionmentioning

confidence: 99%

Teaching Shared Decision Making to Family Medicine Residents: A Descriptive Study of a Web-Based Tutorial

et al. 2016

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“…Of the 148, 43 training programmes have been systematically evaluated, but only 37 evaluation reports are available. And few of these studies measured efficacy of the educational program(s) . The programmes vary greatly in what training is delivered, the manner of delivery, and the length of time.…”

Section: Introductionmentioning

confidence: 99%

“…The programmes vary greatly in what training is delivered, the manner of delivery, and the length of time. In addition, the review finds a lack of detail and transparency with regard to the didactic contents . In a recent update of the review, increasing activity in producing SDM trainings is indicated, however, the level of evaluation is still poor and interprofessional approaches to SDM is missing …”

Section: Introductionmentioning

confidence: 99%

Ready for shared decision making: Pretesting a training module for health professionals on sharing decisions with their patients

Kienlin

Nytrøen

Stacey

et al. 2020

Evaluation Clinical Practice

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Introduction While shared decision‐making (SDM) training programmes for health professionals have been developed in several countries, few have been evaluated. In Norway, a comprehensive curriculum, “klar for samvalg” (ready for SDM), for interprofessional health‐care teams was created using generic didactic methods and guidance to tailor training to various contexts. The programmes adapted didactic methods from an evidence‐based German training programmes (doktormitSDM). The overall aim was to evaluate two particular SDM modules on facilitating SDM implementation into clinical practice. Method A descriptive mixed methods study using questionnaires and a focus group guided by the Medical Research Council Complex Interventions Framework. The training was provided as two different applications (module AB [introduction and SDM‐basics] and module ABC [introduction, SDM‐basics and interactive training]) with differing learning objectives, extent of interactivity, and duration (1 vs 2 hours). Groups of participants were recruited consecutively based on requests for health professional SDM training in university/college‐ and hospital‐settings. By a focus group and a self‐administered questionnaire comprehensibility, relevance and acceptance were assessed and qualitative feedback collected after the training. Data passed descriptive and content analysis, respectively. Knowledge was assessed twice using five multiple‐choice items and analysed using paired t‐tests. Results In 11 (six AB and five ABC) training sessions, 357/429 (296 AB and 133 ABC) eligible nurses, physicians and health professional students with varying clinical backgrounds and previous levels of SDM‐knowledge participated. SDM‐knowledge increased from 25‐78% (range pretest) to 85‐95% (range post‐test) (P ≤ .001). The training was rated easy to understand, acceptable and relevant for practice. Findings to improve the education suggest higher emphasis on interprofessional teaching methods. Conclusions The two SDM training modules met the basic requirements for use in a broader SDM implementation strategy and can even improve knowledge.

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“…The authors found a large increase worldwide. However, few programs had been evaluated, most were not tailored to specific clinical areas, and two thirds were multi-professional [2]. The question is: In a subject area where tailoring to the individual person in his context is paramount, do we need to document whether each and every single program works?…”

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confidence: 99%

“…The Qué bec group does an impressive job by keeping an overview of all training programs available, even those not evaluated [2]. Through EACH and AACH I have met wonderful teachers whose teaching methods have not always been the subject of rigorous evaluation.…”

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confidence: 99%

The significance of seconds

Gulbrandsen

2016

Patient Education and Counseling

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Training health professionals in shared decision making: Update of an international environmental scan

Abstract: This update highlights the need to adapt training programs to interprofessional practice and to evaluate them.

Cited by 152 publications

References 28 publications

Teaching Shared Decision Making to Family Medicine Residents: A Descriptive Study of a Web-Based Tutorial

Teaching Shared Decision Making to Family Medicine Residents: A Descriptive Study of a Web-Based Tutorial

Ready for shared decision making: Pretesting a training module for health professionals on sharing decisions with their patients

The significance of seconds

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