Purpose: Training health professionals in shared decision making (SDM) is necessary to implement SDM in clinical practice. We identified and critically appraised training programs in SDM for health professionals.
Method: Data sources included experts in SDM; organizations and individuals involved in training healthcare professionals, including members of our research team; and systematic reviews of SDM. We favoured sensitivity over specificity and included any training program or stand-alone educational activity in SDM for any healthcare professional (pre- or post-licensure) in any language. Pairs of reviewers independently extracted data on the programs’ characteristics (program name, objectives and duration; author contact information; program creation date; country of origin; languages in which the program was available; sources that informed the program; target population; clinical context; learning activities; elements of SDM covered; and evaluation methods). We computed the frequency counts of each of the programs’ characteristics. The programs’ developers validated our data extraction.
Result: We found 55 programs created between 1996 and 2011 in 15 countries, produced in 9 languages. We extracted data from 21 articles, 19 PowerPoint presentations, 22 short descriptions or syllabi, 11 training manuals, and 3 DVDs. The three most frequently identified clinical contexts were cancer (n=9), palliative care (n=5) and prenatal screening (n=3). Thirteen programs only targeted pre-licensure health professionals, 32 only targeted licensed professionals, and 7 targeted both. Most programs targeted physicians, including residents (n=28), or targeted nurses (n=12). Programs’ duration ranged from 15 minutes to 12 weeks. Teaching methods included large group sessions (n=16), small group sessions (n=35), auto-tutorials (n=15), the dissemination of printed educational material (n=22), audit and feedback (n=24), case discussions (n=38) and simulations (n=33). Seventy-two percent of programs covered all essential elements of SDM, and 14 programs reported on their evaluation of the following outcomes: satisfaction of trainees (n=10), knowledge and skills in SDM (n=6), SDM behaviour (n=5) and patient health outcomes (n=6).
Conclusion: Programs training health professionals to deliver SDM are being steadily introduced into practice world-wide. These programs vary in how and what they deliver. There is sparse evidence of their effectiveness on health professionals’ SDM behaviour and on patient outcomes. We suggest the need to agree on the competencies required for professionals to practice SDM and measures to evaluate the impact of professionals’ practice of SDM.
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