PS4-19 EVALUATING A WORKSHOP TO DEVELOP SHARED DECISION MAKING AND DECISION COACHING SKILLS AMONGST PEDIATRIC HEALTHCARE PROFESSIONALS

Wednesday, October 21, 2015
Grand Ballroom EH (Hyatt Regency St. Louis at the Arch)
Poster Board # PS4-19

Margaret L. Lawson, MD, MSc, FRCP1, Allyson L. Shephard, RN, MScN1, Jennifer Kryworuchko, PhD, RN, CNCC(C)2, Laura Boland, MSc, PhD(c)3, Janet Jull, OT, PhD1 and Dawn Stacey, RN, PhD, CON (C)4, (1)Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada, (2)University of Saskatchewan College of Nursing, Saskatoon, SK, Canada, (3)University of Ottawa, Institute of Population Health, Ottawa, ON, Canada, (4)University of Ottawa, Ottawa, ON, Canada
Purpose: The aim was to evaluate an evidence-based interdisciplinary workshop to train healthcare professionals (HCPs) in SDM and decision coaching with children and their families. Decision coaching by trained HCP is individualized non-directive guidance that helps people make informed, values-based decisions. 

Methods: Retrospective pre-/post study. HCPs from an acute care tertiary pediatric hospital and its sister outpatient rehabilitation and treatment centre were invited to participate. Participants completed an online tutorial (Ottawa Decision Support Tutorial) and then attended a 2-3 hour skill-building workshop. The tutorial, a series of 10 modules and a case study, introduces the concept of decision support. The workshop provides foundational knowledge about SDM and decision coaching followed by opportunities to practise decision coaching using simulated clinical encounters, audit and feedback.  Each workshop was customized to include clinically relevant evidence and examples based on participants’ discipline and area of work.  Participants rated the workshop on a 5-point Likert scale with higher scores reflecting greater self-efficacy and satisfaction. Self-efficacy was evaluated through a pre-post questionnaire and continuing medical education evaluation forms were used to evaluate satisfaction.

Results: Ten workshops were conducted from 2012-2015 with149 HCPs participating in one workshop each: 20% physicians,19% social workers, 17% therapists (occupational therapists, physical therapists, speech language pathologists), 15% registered nurses, 7% behavioural consultants, 4% educators, and 16% “other” (dietitians, psychologists, administrators). Post workshop evaluations were completed by 70% of participants. Satisfaction was high for facilitators’ expertise and interaction with the audience, achieving learning objectives, information presented, relevance to clinical practice, evidence base, quality of audiovisual aids, and use of case-based methods (range 4.4±0.6 (SD) to 4.8±0.4). Participants rated their self-efficacy as significantly increased with greater confidence to: explore decisions and help clarify values/preferences (pre 3.0±0.8, post 4.1±0.6, p<0.001), identify decision-making needs and plan next steps (pre 3.0±0.8, post 4.1±0.6, p<0.001), and evaluate SDM between clinicians and patients (pre 2.5±0.9, post 3.8±0.8, p<0.001).

Conclusion: One hundred and forty-nine HCPs from multiple disciplines completed the online tutorial and participated in the skill-building workshops as part of a hospital-wide project to implement an SDM program. This workshop was an acceptable way to train HCPs and increase their self-efficacy in SDM and decision coaching, an intervention that helps children and their families to make informed, values-based decisions about their health.

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