title: Validating a conceptual model for an inter-professional approach to shared decision making: a mixed methods study.
abstract: OBJECTIVE
  Following increased interest in having inter-professional (IP) health care teams engage patients in decision making, we developed a conceptual model for an IP approach to shared decision making (SDM) in primary care. We assessed the validity of the model with stakeholders in Canada.
  
  
  METHODS
  In 15 individual interviews and 7 group interviews with 79 stakeholders, we asked them to: (1) propose changes to the IP-SDM model; (2) identify barriers and facilitators to the model's implementation in clinical practice; and (3) assess the model using a theory appraisal questionnaire. We performed a thematic analysis of the transcripts and a descriptive analysis of the questionnaires.
  
  
  RESULTS
  Stakeholders suggested placing the patient at its centre; extending the concept of family to include significant others; clarifying outcomes; highlighting the concept of time; merging the micro, meso and macro levels in one figure; and recognizing the influence of the environment and emotions. The most common barriers identified were time constraints, insufficient resources and an imbalance of power among health professionals. The most common facilitators were education and training in inter-professionalism and SDM, motivation to achieve an IP approach to SDM, and mutual knowledge and understanding of disciplinary roles. Most stakeholders considered that the concepts and relationships between the concepts were clear and rated the model as logical, testable, having clear schematic representation, and being relevant to inter-professional collaboration, SDM and primary care.
  
  
  CONCLUSIONS
  Stakeholders validated the new IP-SDM model for primary care settings and proposed few modifications. Future research should assess if the model helps implement SDM in IP clinical practice.
authors.affiliation: Research Center of the Centre Hospitalier Universitaire de Québec, Québec, Canada. france.legare@mfa.ulaval.ca
authors.forename: France
authors.initials: F
authors.lastname: Légaré
authors.forename: Dawn
authors.initials: D
authors.lastname: Stacey
authors.forename: Susie
authors.initials: S
authors.lastname: Gagnon
authors.forename: Sandy
authors.initials: S
authors.lastname: Dunn
authors.forename: Pierre
authors.initials: P
authors.lastname: Pluye
authors.forename: Dominick
authors.initials: D
authors.lastname: Frosch
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kryworuchko
authors.forename: Glyn
authors.initials: G
authors.lastname: Elwyn
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Gagnon
authors.forename: Ian D
authors.initials: ID
authors.lastname: Graham
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002170:Canada; D003657:Decision Making; D004059:Diffusion of Innovation; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011795:Surveys and Questionnaires; D055815:Young Adult