A blended learning for general practitioners and nurses on skills to support shared decision-making with patients about palliative cancer treatment: A one-group pre-posttest study

Hoek, Danique W. Bos – van den; Smets, Ellen M. A.; Ali, Rania; Baas-Thijssen, Monique C.M.; Bomhof-Roordink, Hanna; Helsper, Charles W.; Stacey, Dawn; Tange, Dorien; Laarhoven, H.W.M. van

doi:10.1016/j.pec.2023.107712

Cited by 5 publications

(10 citation statements)

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“…This innovative, experimental study demonstrated that cancer patients and survivors (i.e., APs) did not differentiate trained from untrained HCPs when evaluating SDM support. Although trained observers established a medium effect of the training on SDM support behavior of HCPs, 21 this effect was apparently not sufficiently large to be perceived by APs or it was not meaningful enough to them. In line, we found low correlations between assessments of trained observers and APs.…”

Section: Discussionmentioning

confidence: 93%

“…We previously conducted standardized patient assessments (SPAs) before and after a training program on SDM support for GPs and nurses. 21 The video-recorded SPAs were assessed by trained observers to evaluate the trainings’ effectiveness. In the current innovative, experimental study design, video recordings ( n = 32) of SPAs of GPs ( n = 8) and nurses ( n = 8) conducted before (SPA T0) and after (SPA T2) the training were assessed by at least 4 cancer patients or survivors ( n = 132); each participant watched 1 SPA.…”

Section: Methodsmentioning

confidence: 99%

“…In addition, the intraclass correlations between APs’ assessments were calculated with 1-way random-effects models as each SPA was assessed by a different set of raters. 40 Also, correlations between APs’ assessments and trained observers’ assessments from the previous study 21 were calculated. Next, HCP discipline and its interaction with training status (HCP discipline × before/after training) were added to the LMMs to examine possible differences between GPs and nurses.…”

Section: Methodsmentioning

confidence: 99%

“…Research shows that training can strengthen SDM support knowledge and skills of HCPs. 18 – 21 We previously evaluated a training program in SDM support for GPs and nurses by having expert observers assess video-recorded simulated consultations conducted before and after the training. These observers established a medium-sized significant improvement in SDM support behavior after training.…”

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confidence: 99%

“…These observers established a medium-sized significant improvement in SDM support behavior after training. 21 Former research, however, has shown that patients and trained observers evaluate the SDM behavior of clinicians differently. 22 , 23 This stresses the necessity of exploring patient perspectives.…”

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confidence: 99%

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Through the Eyes of Patients: The Effect of Training General Practitioners and Nurses on Perceived Shared Decision-Making Support

Bos – van den Hoek,

Smets,

Ali

et al. 2023

Med Decis Making

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Purpose To examine the effects of training general practitioners and nurses in shared decision-making (SDM) support as perceived by cancer patients and survivors. Design An innovative, experimental design was adopted that included analogue patients (APs), that is, people who have or have had cancer and who imagine themselves in the position of the actor-patient presented in a video. Each AP assessed a video-recorded simulated consultation of a health care professional (HCP) conducted before or after an SDM support training program. The primary outcome was the APs’ perceived SDM support with 13 self-developed items reflecting the perceived patient benefit of SDM support as well as the perceived HCP support behavior. Secondary outcomes included an overall rating of SDM support, AP-reported extent of SDM (CollaboRATE), satisfaction with the communication (Patient Satisfaction Questionnaire), conversation appreciation and helpfulness, as well as decision-making satisfaction and confidence (visual analog scale, 0–100). In addition, patient and HCP characteristics associated with AP-perceived SDM support were examined. Results APs ( n = 131) did not significantly differentiate trained from untrained HCPs in their perceptions of SDM support nor in secondary outcomes. Agreement between APs’ perceptions was poor. The higher the perceived comparability of the consultation with APs’ previous personal experiences, the higher their rating of SDM support. Limitations We used a nonvalidated primary outcome and an innovative study design that should be tested in future work. Conclusions Despite the limitations of the study design, the training seemed to not affect cancer patients’ and survivors’ perceived SDM support. Implications The clinical relevance of the training on SDM support needs to be established. The variation in APs’ assessments suggests patients differ in their perception of SDM support, stressing the importance of patient-tailored SDM support. Highlights Cancer patients and survivors did not significantly differentiate trained from untrained HCPs when evaluating SDM support, and agreement between their perceptions was poor. The clinical relevance of training GPs and nurses in SDM support needs to be established. Patient-tailored SDM support may be recommended, given the variation in APs’ assessments and their possible diverging perceptions of SDM support. This innovative study design (having patients watch and assess videos of simulated consultations made in the context of training evaluation) needs to be further developed.

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Section: Discussionmentioning

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Through the Eyes of Patients: The Effect of Training General Practitioners and Nurses on Perceived Shared Decision-Making Support

Bos – van den Hoek,

Smets,

Ali

et al. 2023

Med Decis Making

Self Cite

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Shared decision making in rural general practices: a qualitative exploration of older rural South Australians’ perceived involvement in clinical consultations with doctors

Hamiduzzaman,

Siddiquee,

Gaffney

et al. 2024

Global Health Journal

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Prospectively investigating the impact of AI on shared decision-making in post kidney transplant care (PRIMA-AI): protocol for a longitudinal qualitative study among patients, their support persons and treating physicians at a tertiary care centre

Sassi,

Eickmann,

Roller

et al. 2024

BMJ Open

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IntroductionAs healthcare is shifting from a paternalistic to a patient-centred approach, medical decision making becomes more collaborative involving patients, their support persons (SPs) and physicians. Implementing shared decision-making (SDM) into clinical practice can be challenging and becomes even more complex with the introduction of artificial intelligence (AI) as a potential actant in the communicative network. Although there is more empirical research on patients’ and physicians’ perceptions of AI, little is known about the impact of AI on SDM. This study will help to fill this gap. To the best of our knowledge, this is the first systematic empirical investigation to prospectively assess the views of patients, their SPs and physicians on how AI affects SDM in physician–patient communication after kidney transplantation. Using a transdisciplinary approach, this study will explore the role and impact of an AI-decision support system (DSS) designed to assist with medical decision making in the clinical encounter.Methods and analysisThis is a plan to roll out a 2 year, longitudinal qualitative interview study in a German kidney transplant centre. Semi-structured interviews with patients, SPs and physicians will be conducted at baseline and in 3-, 6-, 12- and 24-month follow-up. A total of 50 patient–SP dyads and their treating physicians will be recruited at baseline. Assuming a dropout rate of 20% per year, it is anticipated that 30 patient–SP dyads will be included in the last follow-up with the aim of achieving data saturation. Interviews will be audio-recorded and transcribed verbatim. Transcripts will be analysed using framework analysis. Participants will be asked to report on their (a) communication experiences and preferences, (b) views on the influence of the AI-based DSS on the normative foundations of the use of AI in medical decision-making, focusing on agency along with trustworthiness, transparency and responsibility and (c) perceptions of the use of the AI-based DSS, as well as barriers and facilitators to its implementation into routine care.Ethics and disseminationApproval has been granted by the local ethics committee of Charité—Universitätsmedizin Berlin (EA1/177/23 on 08 August 2023). This research will be conducted in accordance with the principles of the Declaration of Helsinki (1996). The study findings will be used to develop communication guidance for physicians on how to introduce and sustainably implement AI-assisted SDM. The study results will also be used to develop lay language patient information on AI-assisted SDM. A broad dissemination strategy will help communicate the results of this research to a variety of target groups, including scientific and non-scientific audiences, to allow for a more informed discourse among different actors from policy, science and society on the role and impact of AI in physician–patient communication.

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A blended learning for general practitioners and nurses on skills to support shared decision-making with patients about palliative cancer treatment: A one-group pre-posttest study

Cited by 5 publications

References 59 publications

Through the Eyes of Patients: The Effect of Training General Practitioners and Nurses on Perceived Shared Decision-Making Support

Through the Eyes of Patients: The Effect of Training General Practitioners and Nurses on Perceived Shared Decision-Making Support

Shared decision making in rural general practices: a qualitative exploration of older rural South Australians’ perceived involvement in clinical consultations with doctors

Prospectively investigating the impact of AI on shared decision-making in post kidney transplant care (PRIMA-AI): protocol for a longitudinal qualitative study among patients, their support persons and treating physicians at a tertiary care centre

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