Framework for teaching and learning informed shared decision making

Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada V5Z 4E3.
BMJ Clinical Research (Impact Factor: 14.09). 10/1999; 319(7212):766-71.
Source: PubMed


Competencies for the practice of informed shared decision making by physicians and patients are proposed. The competencies are a framework for teaching, learning, practice, and research. Challenges to putting informed shared decision making into practice are perceived lack of time, physicians' predisposition and skill, and patients' inexperience with making decisions about treatment.

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    • "To implement shared decision making in clinical practice, there are implications for training, which can be tackled by simulated learning, whether with colleagues or with trained actors (Towle and Godolphin 1999;Elwyn et al, 1999). In such cases, brief patient decision-support tools can be used (Elwyn et al, 2010a). "

    No preview · Article · Jan 2016 · British journal of nursing (Mark Allen Publishing)
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    • "But other definitions exist (e.g. [3] [10]) and the most common way of measuring patient perceptions of SDM is using a modification of the Degner et al. Control Preferences Scale [11] [12]. "
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    ABSTRACT: Objective This study aims to develop a conceptual model of patient-defined SDM, and understand what leads patients to label a specific, decision-making process as shared. Methods Qualitative interviews were conducted with 23 primary care patients following a recent appointment. Patients were asked about the meaning of SDM and about specific decisions that they labeled as shared. Interviews were coded using qualitative content analysis. Results Patients’ conceptual definition of SDM included four components of an interactive exchange prior to making the decision: both doctor and patient share information, both are open-minded and respectful, patient self-advocacy, and a personalized physician recommendation. Additionally, a long-term trusting relationship helps foster SDM. In contrast, when asked about a specific decision labeled as shared, patients described a range of interactions with the only commonality being that the two parties came to a mutually agreed-upon decision. Conclusion There is no one-size-fits all process that leads patients to label a decision as shared. Rather, the outcome of “agreement” may be more important than the actual decision-making process for patients to label a decision as shared. Practice Implications Studies are needed to better understand how longitudinal communication between patient and physicians and patient self-advocacy behaviors affect patient perceptions of SDM.
    Full-text · Article · Sep 2014 · Patient Education and Counseling
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    • "To improve search sensitivity, we added variants with the word “medical” (“shared medical decision making”, “informed medical decision making”). We also studied combinations of those two phrases (“informed and shared decision making”, “informed shared decision making” [4]). "
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    ABSTRACT: Background Shared Decision Making (SDM) is increasingly advocated as a model for medical decision making. However, there is still low use of SDM in clinical practice. High impact factor journals might represent an efficient way for its dissemination. We aimed to identify and characterize publication trends of SDM in 15 high impact medical journals. Methods We selected the 15 general and internal medicine journals with the highest impact factor publishing original articles, letters and editorials. We retrieved publications from 1996 to 2011 through the full-text search function on each journal website and abstracted bibliometric data. We included publications of any type containing the phrase “shared decision making” or five other variants in their abstract or full text. These were referred to as SDM publications. A polynomial Poisson regression model with logarithmic link function was used to assess the evolution across the period of the number of SDM publications according to publication characteristics. Results We identified 1285 SDM publications out of 229,179 publications in 15 journals from 1996 to 2011. The absolute number of SDM publications by journal ranged from 2 to 273 over 16 years. SDM publications increased both in absolute and relative numbers per year, from 46 (0.32% relative to all publications from the 15 journals) in 1996 to 165 (1.17%) in 2011. This growth was exponential (P < 0.01). We found fewer research publications (465, 36.2% of all SDM publications) than non-research publications, which included non-systematic reviews, letters, and editorials. The increase of research publications across time was linear. Full-text search retrieved ten times more SDM publications than a similar PubMed search (1285 vs. 119 respectively). Conclusion This review in full-text showed that SDM publications increased exponentially in major medical journals from 1996 to 2011. This growth might reflect an increased dissemination of the SDM concept to the medical community.
    Full-text · Article · Aug 2014 · BMC Medical Informatics and Decision Making
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