Brief training of student clinicians in shared decision making: A single-blind randomized controlled trial

Hoffmann, Tammy C., Bennett, Sally, Tomsett, Clare and Del Mar, Chris (2014) Brief training of student clinicians in shared decision making: A single-blind randomized controlled trial. Journal of General Internal Medicine, 29 6: 844-849. doi:10.1007/s11606-014-2765-5

Author Hoffmann, Tammy C.
Bennett, Sally
Tomsett, Clare
Del Mar, Chris
Title Brief training of student clinicians in shared decision making: A single-blind randomized controlled trial
Journal name Journal of General Internal Medicine   Check publisher's open access policy
ISSN 0884-8734
Publication date 2014-01-01
Year available 2014
Sub-type Article (original research)
DOI 10.1007/s11606-014-2765-5
Open Access Status DOI
Volume 29
Issue 6
Start page 844
End page 849
Total pages 6
Place of publication New York, NY United States
Publisher Springer New York LLC
Language eng
Abstract BACKGROUND: Shared decision making is a crucial component of evidence-based practice, but a lack of training in the "how to" of it is a major barrier to its uptake. OBJECTIVE: To evaluate the effectiveness of a brief intervention for facilitating shared decision making skills in clinicians and student clinicians. DESIGN: Multi-centre randomized controlled trial. PARTICIPANTS: One hundred and seven medical students, physiotherapy or occupational therapy students undertaking a compulsory course in evidence-based practice as part of their undergraduate or postgraduate degree from two Australian universities. INTERVENTION: The 1-h small-group intervention consisted of facilitated critique of five-step framework, strategies, and pre-recorded modelled role-play. Both groups were provided with a chapter about shared decision making skills. MAIN MEASURES: The primary outcome was skills in shared decision making and communicating evidence [Observing Patient Involvement (OPTION) scale, items from the Assessing Communication about Evidence and Patient Preferences (ACEPP) Tool], rated by a blinded assessor from videorecorded role-plays. Secondary outcomes: confidence in these skills and attitudes towards patient-centred communication (Patient Practitioner Orientation Scale (PPOS)). KEY RESULTS: Of participants, 95 % (102) completed the primary outcome measures. Two weeks post-intervention, intervention group participants scored significantly higher on the OPTION scale (adjusted group difference = 18.9, 95 % CI 12.4 to 25.4), ACEPP items (difference = 0.9, 95 % CI 0.5 to 1.3), confidence measure (difference = 13.1, 95 % CI 8.5 to 17.7), and the PPOS sharing subscale (difference = 0.2, 95 % CI 0.1 to 0.5). There was no significant difference for the PPOS caring subscale. CONCLUSIONS: This brief intervention was effective in improving student clinicians' ability, attitude towards, and confidence in shared decision making facilitation. Following further testing of the longer-term effects of this intervention, incorporation of this brief intervention into evidence-based practice courses and workshops should be considered, so that student clinicians graduate with these important skills, which are typically neglected in clinician training.
Keyword Continuing medical education
Evidence based practice
Shared decision making
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID 1033038
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Health and Rehabilitation Sciences Publications
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