BackgroundDecision coaching is non-directive support delivered by a healthcare provider to help patients prepare to actively participate in making a health decision. 'Healthcare providers' are considered to be all people who are engaged in actions whose primary intent is to protect and improve health (e.g. nurses, doctors, pharmacists, social workers, health support workers such as peer health workers).Little is known about the e ectiveness of decision coaching.
ObjectivesTo determine the e ects of decision coaching (I) for people facing healthcare decisions for themselves or a family member (P) compared to (C) usual care or evidence-based intervention only, on outcomes (O) related to preparation for decision making, decisional needs and potential adverse e ects.
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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