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

Abstract

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.

Ready for SDM: evaluating a train-the-trainer program to facilitate implementation of SDM training in Norway

“…MAPPIN'SDM is founded on the criteria of evidence-based patient information [15,16] and, in a recent systematic review comparing measurement instruments, has been found to most comprehensively cover the essential elements of SDM [17]. Using a generic pedagogic approach [18], the Ready for SDM metacurriculum also relies on a set of "active components" used to change behaviour of HCPs, so-called behaviour change techniques (BCTs) [19]. BCTs are observable and replicable and can be used individually or in combination with other BCTs from a comprehensive taxonomy of 93 techniques [19].…”

“…The individual training modules within our meta-curriculum Ready for SDM currently present in different stages of evaluation [18,[21][22][23][24].…”

“…One module of our meta-curriculum, Ready for SDM INTERPROF, is using an interprofessional approach to facilitate translation of SDM into practice by improving knowledge and attitudes and thereby, changing the culture of communication in health care environments. This interactive 2-h classroom educational module has passed extensive qualitative evaluation [18] and in a cluster randomized study proved efficacious regarding knowledge gain and acquisition of communication competencies [25]. It is currently in frequent demand by hospital trusts, is recommended by the Ministry of Health, and may soon play an important role in Norwegian national strategies to implement SDM in health care [18,25].…”

Editorial introduction: Decision making, reasoning, context, and perspective

“…[18][19][20] The edition concludes with a number of papers proposing innovative methods for implementing and evaluating the impact of PCC and SDM. [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Again, the core concepts of PCC and SDM are explored across a very diverse set of contexts. It would of course be misleading to present this edition as the "conclusion" of the debate commenced in our previous thematic issue on this subject.…”

“…The edition concludes with a number of papers proposing innovative methods for implementing and evaluating the impact of PCC and SDM . Again, the core concepts of PCC and SDM are explored across a very diverse set of contexts.…”