title: Does training general practitioners result in more shared decision making during consultations?
abstract: We conducted a clustered randomised controlled trial to study the effects of shared decision making (SDM) on patient recovery. This study aims to determine whether GPs trained in SDM and reinforcing patients' treatment expectations showed more trained behaviour during their consultations than untrained GPs.
  
  
  
  We compared 86 consultations conducted by 23 trained GPs with 89 consultations completed by 19 untrained GPs. The primary outcomes were SDM, as measured by the OPTION scale, and positive reinforcement, as measured by global observation. Secondary outcomes were the level of autonomy in decision making and the duration of the consultation.
  
  
  
  Intervention consultations scored significantly higher on most elements of the OPTION scale, and on the autonomy scale; however, they were three minutes longer in duration, and the mean OPTION score of the intervention group remained below average.
  
  
  
  Training GPs resulted in more SDM behaviour and more autonomy for the patient; however, this increase is not attributable to the adoption of a patient perspective. Furthermore, while we aimed to demonstrate that SDM facilitates the reinforcement of patients' positive expectations, the measurement of this behaviour was not reliable.
  
  
  
  In supporting SDM, professionals should give greater attention to patients' treatment expectations.
authors: Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Mailbox 85500, 3508 GA Utrecht, The Netherlands. Electronic address: a.r.j.sanders-vanlennep@umcutrecht.nl.
authors: A R J
authors: AR
authors: Sanders
authors: NIVEL (Netherlands Institute for Health Services Research), Mailbox 1568, 3500 BN Utrecht, The Netherlands; Faculty of Social and Behavioural Science, Utrecht University, Postbus 80140, 3508 TC Utrecht, The Netherlands.
authors: J M
authors: JM
authors: Bensing
authors: Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Mailbox 85500, 3508 GA Utrecht, The Netherlands.
authors: M A L U
authors: MA
authors: Essed
authors: NIVEL (Netherlands Institute for Health Services Research), Mailbox 1568, 3500 BN Utrecht, The Netherlands.
authors: T
authors: T
authors: Magnée
authors: Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Mailbox 85500, 3508 GA Utrecht, The Netherlands.
authors: N J
authors: NJ
authors: de Wit
authors: NIVEL (Netherlands Institute for Health Services Research), Mailbox 1568, 3500 BN Utrecht, The Netherlands; Groningen University, University Medical Centre Groningen, Dept. of General Practice Groningen A. Deusinglaan 1, 9712 CP Groningen, The Netherlands.
authors: P F M
authors: PF
authors: Verhaak
mesh_terms: D000328:Adult; D003142:Communication; D003657:Decision Making; D004521:Educational Measurement; D005260:Female; D058005:General Practitioners / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D063868:Patient Outcome Assessment; D010358:Patient Participation / Q000379:methods*; D012017:Referral and Consultation / Q000458:organization & administration*
keywords: Medical education; Patient participation; Patient-oriented outcomes; Primary health care; Shared decision-making