The development of incorpoRATE: A measure of physicians’ willingness to incorporate shared decision making into practice

Berkowitz, Julia; Martínez‐Camblor, Pablo; Stevens, Gabrielle; Elwyn, Glyn

doi:10.1016/j.pec.2021.02.040

Cited by 9 publications

(5 citation statements)

References 77 publications

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“…Using an attitude measure with evidence of validity, we found that willingness to engage in SDM among family medicine residents varies greatly. 36 Six months after our educational intervention (SDM-FM), we found a small improvement in the willingness of residents to engage in SDM. 37 At a practical level, these findings suggest educators should view SDM as a skill for continual development during medical school and residency training, and they should not rely on one-off interventions such as a lecture or workshop.…”

Section: • How Patient Circumstances Influence Decision Making (Eg St...mentioning

confidence: 75%

What should educators teach to improve preventive health care?

et al. 2022

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Critical thinking encompasses a broad set of skills and dispositions, including cognitive skills (such as analysis, inference, and self regulation); approaches to specific questions or problems (orderliness, diligence, and Key points Many flawed assumptions or beliefs persist about the value of preventive health care interventions. It is essential to promote critical thinking to improve learning outcomes and clinical decision making. The Prevention in Practice series of articles in Canadian Family Physician is a resource for educators who want guidance on what to teach medical students or residents. Key questions and learning objectives can be developed for themes arising from this series of articles.

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Section: • How Patient Circumstances Influence Decision Making (Eg St...mentioning

confidence: 75%

What should educators teach to improve preventive health care?

et al. 2022

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“…Another study analyzing surgical decision-making did show that surgeons did favor SDM in cases of limited evidence for a given treatment plan, when multiple treatment options exist, and if treatment options impact on patients’ lifestyle [ 39 ]. A recently published pilot study on the use of “incorpoRATE” as a measure of the physicians’ willingness to incorporate SDM into practice did show that physicians felt less comfortable acting on informed patient choices when there was known incongruence with their own recommendations [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

A prospective study of shared decision-making in brain tumor surgery

2022

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Purpose Shared decision-making (SDM) is a key tenet of personalized care and is becoming an essential component of informed consent in an increasing number of countries. The aim of this study is to analyze patient and healthcare staff satisfaction with the SDM process before and after SDM was officially introduced as the standard of care. Decision grids are important tools in the SDM process, and we developed them for three different types of intracranial tumors. Methods This prospective study was conducted in a high-volume neuro-oncological center on all consecutive eligible patients undergoing consideration of treatment for intracranial glioma and metastases. Twenty-two patients participated before and 74 after the introduction of SDM. Six and 5 staff members respectively participated in the analysis before and after team training and the introduction of SDM. The main outcome was patient and healthcare staff satisfaction with the SDM process. Results Patients reported high satisfaction with the SDM process before (mean CollaboRATE score 26 of 27 points) and after (mean CollaboRATE score 26.3 of 27 points, p = 0.23) the introduction of SDM. Interestingly, staff attitude toward SDM improved significantly from 61.68 before to 90.95% after the introduction of SDM (p-value < 0.001). Decision grids that were developed for three different types of intracranial tumors are presented. Conclusions Team training in SDM and the introduction of techniques into daily practice can increase staff satisfaction with the SDM process. High levels of patient satisfaction were observed before, with a non-significant increase after the introduction of SDM. Decision grids are an important tool to facilitate the conveyance and understanding of complex information and to achieve SDM in daily clinical practice.

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“…Health care professionals will also fill out a questionnaire based on items from the incorpoRATE, a brief and broadly applicable measure of physicians' willingness to incorporate SDM into practice. 33…”

Section: Physicians' Willingness To Incorporate Sdmmentioning

confidence: 99%

Effectiveness and implementation of SHared decision-making supported by OUTcome information among patients with breast cancer, stroke and advanced kidney disease: SHOUT study protocol of multiple interrupted time series

et al. 2022

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IntroductionWithin the value-based healthcare framework, outcome data can be used to inform patients about (treatment) options, and empower them to make shared decisions with their health care professional. To facilitate shared decision-making (SDM) supported by outcome data, a multicomponent intervention has been designed, including patient decision aids on the organisation of post-treatment surveillance (breast cancer); discharge location (stroke) and treatment modality (advanced kidney disease), and training on SDM for health care professionals. The SHared decision-making supported by OUTcome information (SHOUT) study will examine the effectiveness of the intervention and its implementation in clinical practice.Methods and analysisMultiple interrupted time series will be used to stepwise implement the intervention. Patients diagnosed with either breast cancer (N=630), stroke (N=630) or advanced kidney disease (N=473) will be included. Measurements will be performed at baseline, three (stroke), six and twelve (breast cancer and advanced kidney disease) months. Trends on outcomes will be measured over a period of 20 months. The primary outcome will be patients’ perceived level of involvement in decision-making. Secondary outcomes regarding effectiveness will include patient-reported SDM, decisional conflict, role in decision-making, knowledge, quality of life, preferred and chosen care, satisfaction with the intervention, healthcare utilisation and health outcomes. Outcomes regarding implementation will include the implementation rate and a questionnaire on the health care professionals’ perspective on the implementation process.Ethics and disseminationThe Medical research Ethics Committees United in Nieuwegein, the Netherlands, has confirmed that the Medical Research Involving Human Subjects Act does not apply to this study. Bureau Onderzoek & Innovatie of Santeon, the Netherlands, approved this study. The results will contribute to insight in and knowledge on the use of outcome data for SDM, and can stimulate sustainable implementation of SDM.Trial registration numberNL8374, NL8375 and NL8376.

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The development of incorpoRATE: A measure of physicians’ willingness to incorporate shared decision making into practice

Cited by 9 publications

References 77 publications

What should educators teach to improve preventive health care?

What should educators teach to improve preventive health care?

A prospective study of shared decision-making in brain tumor surgery

Effectiveness and implementation of SHared decision-making supported by OUTcome information among patients with breast cancer, stroke and advanced kidney disease: SHOUT study protocol of multiple interrupted time series

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