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


METHODS
Multi-centre randomized controlled trial.


METHODS
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.


METHODS
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.


METHODS
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.


RESULTS
confidence in these skills and attitudes towards patient-centred communication (Patient Practitioner Orientation Scale (PPOS)).


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.
Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, 4229, Australia, thoffmann@bond.edu.au.
Tammy C
TC
Hoffmann
Sally
S
Bennett
Clare
C
Tomsett
Chris
C
Del Mar
D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D002983:Clinical Competence / Q000592:standards; D003657:Decision Making; D004493:Education; D004504:Education, Medical, Undergraduate / Q000379:methods; D004521:Educational Measurement / Q000379:methods; D055317:Evidence-Based Practice / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D018802:Patient-Centered Care / Q000379:methods / Q000592:standards; D011369:Professional-Patient Relations; D015397:Program Evaluation; D016037:Single-Blind Method; D013337:Students, Medical / Q000523:psychology