title: PCI Choice: Cardiovascular clinicians' perceptions of shared decision making in stable coronary artery disease.
abstract: Describe cardiovascular clinicians' perceptions of Shared Decision Making following use of a decision aid (DA) for stable coronary artery disease (CAD) "PCI Choice", in a randomized controlled trial.
  
  
  
  We conducted a semi-structured qualitative interview study with cardiologists and physician extenders (n=13) after using PCI Choice in practice. Interviews were transcribed then coded. Codes were organized into salient themes. Final themes were determined by consensus with all authors.
  
  
  
  Most clinicians (70%) had no prior knowledge of SDM or DAs. Mixed views about the role of the DA in the visit were related to misconceptions of how patient education differed from SDM. Qualitative assessment of clinician perceptions generated three themes: 1) Gaps exist in clinician knowledge around SDM; 2) Clinicians are often uncomfortable with modifying baseline practice; and 3) Clinicians express interest in using DAs after initial exposure within a research setting.
  
  
  
  Use of DAs by clinicians during clinic visits may improve understanding of SDM. Initial use is marked by a reluctance to modify established practice patterns.
  
  
  
  As clinicians explore new approaches to benefit their patients, there is an opportunity for DAs that provide clinician instruction on core elements of SDM to lead to enhanced SDM in clinical practice.
authors.affiliation: The Preference Laboratory, The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, USA; Section of Cardiovascular Medicine, Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Lebanon, USA. Electronic address: Megan.Coylewright@Dartmouth.edu.
authors.forename: Megan
authors.initials: M
authors.lastname: Coylewright
authors.affiliation: Section of Cardiovascular Medicine, Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Lebanon, USA.
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: O'Neill
authors.affiliation: Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Dick
authors.affiliation: The Preference Laboratory, The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, USA.
authors.forename: Stuart W
authors.initials: SW
authors.lastname: Grande
mesh_terms: D000328:Adult; D000368:Aged; D060050:Angina, Stable; D001291:Attitude of Health Personnel; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D010465:Perception; D010820:Physicians / Q000523:psychology*; D036301:Qualitative Research; D016032:Randomized Controlled Trials as Topic
keywords: Decision aid; Patient preference; Percutaneous coronary intervention; Shared decision making; Stable angina; Stable coronary artery disease