INTRODUCTION TO SHARED DECISION MAKING COMMUNICATIONS AND DECISION SUPPORT TECHNOLOGIES IN DIVERSE CULTURAL ENVIRONMENTS

Format Requirements: The format will involve both didactic lecture with hand-outs, case videos and highly interactive group exercises/discussions. The intended audience includes researchers and practitioners interested in the latest advances in shared decision making and in the use of patient-provider communication support technologies such as decision aids. The course will focus on the importance of adapting shared decision making communication models and technologies to the diverse cultures and socio-economic environments that characterize the Asia Pacific Region. In this regard, course learning will be based not only on theory and faculty experience, but also on the experiences of course participants.

Background: This introductory course will first provide a broad overview of the history and current state of shared decision making (SDM) models in health care. SDM is a general approach to decision making that emphasizes the importance of patient-provider communication regarding patient beliefs, values and lifestyles relative to preference sensitive screening and treatment decisions. While research on SDM and attendant technologies such as decision aids is fairly widespread in the West, extension to new regions is relatively recent and therefore, provides both opportunities and challenges to researchers and practitioners.

Consideration of cultural (e.g., individual versus family decision making) and socio-economic (e.g., resource constraint) differences is extremely important in any discussion of the globalization of SDM and attendant technologies.  Thus, a central focus of the course is on cultural and socio-economic targeting and tailoring of SDM communications in increasingly diverse patient populations.  Extensive interactive discussion of alternative approaches will provide participants with tangible tools for adapting pre-existing and/or developing new approaches to SDM in different environments.  A model for real time tailoring based on individual cultural differences will also be introduced. 

Course participants will also learn basic design of patient decision support technology.  Design steps include:  1) deciding on theories and other criteria (e.g., IPDAS) to guide development, 2) determining what components and information to include; and 3) adapting the overall decision support technology in terms of culture and socio-economics to optimize effective communication of the risk and value/lifestyle implications of treatment and screening alternatives.

Critical to the success of the course will be active participation by attendees in group break-outs and general discussions.  Course participants’ professional and/or personal experiences will greatly enhance the applicability of broader principles to the Asia-Pacific context.

By the end of the course, participants will:

1. Appreciate the difference between the extant patient-provider decision models.
2. Understand the elements of the shared decision making model.
3. Know the evidence regarding the benefits as well as the limitations of shared decision making’s impact on medical outcomes.
4. Understand basic steps to consider when designing patient decision support technologies.
5. Understand broader relationships between culture, SDM and patient decision support.
6. Have a practical tool kit for improving the cultural concordance of SDM and decision support communications and technologies.
7. Appreciate the challenges and successes of shared decision making projects in diverse  cultural and socio-economic environments as provided both by course faculty and course participants.
8. Have internalized concrete exemplars of SDM/decision technology cultural targeting and tailoring to use in applying course takeaways.