Teaching clinicians shared decision making and risk communication online: an evaluation study

Abstract

ObjectivesTo describe the development and initial evaluation of a brief e-learning course as a means of teaching shared decision making and risk communication skills to clinicians of all specialties.DesignComparison pre-course and post-course of scores in subjective confidence and objective knowledge about shared decision making and risk communication.SettingOnline and open to all specialties and levels of clinical experience, including students.ParticipantsThe course is freely available online and all who started the course from September 2018 to May 2020 were invited to participate in the evaluation study.InterventionThe self-guided e-learning course is made up of four modules and takes approximately 2 hours to complete. It is hosted on the website of the Winton Centre for Risk Communication and the UK’s National Health Service e-learning platform.Main outcome measuresPre-course and post-course confidence in performing shared decision making (as measured by a 10-item scale adapted from the OPTION tool; total score range 10–50), and objective knowledge about basic principles of shared decision making and risk communication, as measured by performance on four knowledge questions and three calculations. At course commencement, a single item from the Berlin Numeracy Test, and the eight-item Subjective Numeracy Test were also asked.ResultsOf 366 unique participants who consented and commenced the course, 210 completed all modules and the final post-course test. Participants’ mean age was 38.1 years, 69% were in current clinical practice and had a mean of 10.5 years of clinical practice. Numeracy was relatively low, with 50.7% correctly answering the Berlin Numeracy Test item pre-course. Participants who completed the course showed a significant improvement in their confidence by a mean summed score of 3.7 units (95% CI 2.9 to 4.6, p<0.0001) from a mean pre-course of 37.4 (SD 6.1) to post-course of 41.1 (SD 6.9). There was an increase in the proportion of correct answers for most knowledge questions (p<0.0001, p=0.013 for two directly compared), although no improvement in most skill questions that involved numbers (eg, calculating relative risks). Participants with higher numeracy appeared to show higher skill and confidence on most questions.ConclusionsThis online, free e-learning course was successful in increasing participants’ confidence in, and some aspects of knowledge about, shared decision making and risk communication. It also highlighted the need for improvements in clinicians’ numerical skills as a vital part of training. We suggest that the course is used in combination with practical face-to-face experience and more intensive numerical skills training.

The Association Between Patients' eHealth Literacy and Satisfaction With Shared Decision-making and Well-being: Multicenter Cross-sectional Study

“…Another German study noted that the regular use of eHealth services facilitated the decision-making process for patients with cancer and their families [ 40 ]. Other studies have reported that the internet and web-based courses are fundamental in improving patients’ communication skills with medical personnel [ 3 , 41 ], reducing their overall medical expenses [ 42 ], and increasing their confidence and knowledge to be involved in decision-making [ 43 ]. In addition, we found that patients who reported being very satisfied with SDM (satisfied with all five dimensions of the SSDM) obtained a similar mean score on the eHEALS ( Multimedia Appendix 3 ).…”

Shared decision making between older people with multimorbidity and GPs: a qualitative study

“…This could be a key message in training programmes. An up-to-date systematic review of studies evaluating the effectiveness of recently developed shared decision-making training is warranted (91)(92)(93).…”

A Brief Shared Decision-Making Intervention for Acute Respiratory Infections on Antibiotic Dispensing Rates in Primary Care: A Cluster Randomized Trial

“…For example, a 2-hour interactive e-learning course on shared decision making (which has a version for GPs) appears to improve clinicians' shared decisionmaking confidence and knowledge, but behavioral effects are not yet tested. 23…”