title: Physician education on decision-making capacity assessment: Current state and future directions.
abstract: OBJECTIVE
  To examine FPs' training needs for conducting decision-making capacity assessments (DMCAs) and to determine how training materials, based on a DMCA model, can be adapted for use by FPs.
  
  
  METHODS
  A scoping review of the literature and qualitative research methodology (focus groups and structured interviews).
  
  
  METHODS
  Edmonton, Alta.
  
  
  METHODS
  Nine FPs, who practised in various settings, who chose to attend a focus group on DMCAs.
  
  
  METHODS
  A scoping review of the literature to examine the current status of physician education regarding assessment of decision-making capacity, and a focus group and interviews with FPs to ascertain the educational needs of FPs in this area.
  
  
  RESULTS
  Based on the scoping review of the literature, 4 main themes emerged: increasing saliency of DMCAs owing to an aging population, suboptimal DMCA training for physicians, inconsistent approaches to DMCA, and tension between autonomy and protection. The findings of the focus groups and interviews indicate that, while FPs working as independent practitioners or with interprofessional teams are motivated to engage in DMCAs and use the DMCA model for those assessments, several factors impede their conducting DMCAs. The most notable barriers were a lack of education, isolation from interprofessional teams, uneasiness around managing conflict with families, fear of liability, and concerns regarding remuneration.
  
  
  CONCLUSIONS
  This pilot study has helped to inform ways to better train and support FPs in conducting DMCAs. Family physicians are well positioned, with proper training, to effectively conduct DMCAs. To engage FPs in the process, however, the barriers should be addressed.
authors.affiliation: Program Director for the Division of Care of the Elderly and Associate Professor in the Department of Family Medicine at the University of Alberta in Edmonton. Lcharles@ualberta.ca.
authors.forename: Lesley
authors.initials: L
authors.lastname: Charles
authors.affiliation: Division member of the Division of Care of the Elderly and Associate Professor in the Department of Family Medicine at the University of Alberta.
authors.forename: Jasneet
authors.initials: J
authors.lastname: Parmar
authors.affiliation: Assistant Professor in the Department of Occupational Therapy at the University of Alberta.
authors.forename: Suzette
authors.initials: S
authors.lastname: Brémault-Phillips
authors.affiliation: Director of Research for the Division of Care of the Elderly and Professor in the Department of Family Medicine at the University of Alberta.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Dobbs
authors.affiliation: Postdoctoral fellow in the Faculty of Medicine and Dentistry at the University of Alberta.
authors.forename: Lori
authors.initials: L
authors.lastname: Sacrey
authors.affiliation: Research assistant in the Faculty of Rehabilitation Medicine at the University of Alberta.
authors.forename: Bryan
authors.initials: B
authors.lastname: Sluggett
mesh_terms: D000328:Adult; D000416:Alberta; D001291:Attitude of Health Personnel; D003657:Decision Making; D005194:Family Practice / Q000193:education*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010821:Physicians, Family / Q000193:education*; D010865:Pilot Projects; D036301:Qualitative Research