Article Text
Abstract
Introduction We recently argued that successful implementation of SDM demands precise definition of SDM guiding both the design of interventions and the corresponding choice of outcomes.1 The Six Steps of SDM (figure 1) define its core communicative elements. The SHARE TO CARE training was developed to help physicians achieving them within their encounters. This study investigates how specifically and effectively the training reached this aim.
Methods Sample and design Physicians (N=121) from six departments of a university hospital with videotaped encounters pre and post training.
Intervention The training consists of an interactive online tutorial followed by two personal feedback sessions on videotaped encounters. The online tutorial illustrates all Six Steps, whereas subsequent feedback sessions address individual areas for improvement in each physician’s encounters.
Measurement Items 1–6 of MAPPIN’SDM2 directly mirror the Six Steps. Their implementation is therefore measured using corresponding mean scores. The remaining MAPPIN’SDM items 7–9 are not directly related to the Six Steps.
Statistical analysis Mean scores of items 1–6 and 7–9 were compared pre vs. post using t-tests. Exploratively, improvement of each single item score was analyzed.
Results The Six Steps-related mean score increased significantly (p<.001; Hedges’g=.64), with all particular item scores increasing. No change occurred beyond the Six Steps (p=.97).
Discussion The training specifically improved physicians’ implementation of The Six Steps of SDM. The variety of specialties and settings involved generalizability.
Conclusion The SHARE TO CARE training is specific, effective and widely applicable.
References
Clayman, ML, Scheibler, F, Rueffer, JU, Wehkamp, K, Geiger, F. The Six Steps of SDM: linking theory to practice, measurement and implementation, BMJ EBM 2023; doi:10.1136/bmjebm-2023-112289.
Kasper J, Hoffmann F, Heesen C, Köpke S, Geiger F. Mappin’SDM-the multifocal approach to sharing in shared decision making. PloS One. 2012;7(4): e34849).