Article Text

Download PDFPDF
242 Specificity of effects of the share to care training for physicians – a pre-post trial
  1. Anja Schuldt-Joswig1,
  2. Margarethe Gregersen1,
  3. Claudia Hacke1,
  4. Christina Gesine Sommer1,
  5. Constanze Stolz-Klingenberg1,
  6. Christine Wagner-Ullrich1,
  7. Olga Kopoleva1,
  8. Gerhard Koch1,
  9. Jens Ulrich Rueffer2,
  10. Fueloep Scheibler1,
  11. Marla L Clayman3,4,
  12. Friedemann Geiger1,5
  1. 1National Competency Center for Shared Decision Making, University Hospital Schleswig-Holstein, Kiel, Germany
  2. 2TakePart Media and Science GmbH, Cologne, Germany
  3. 3Center for Health Organization and Implementation Research (CHOIR), US Department of Veterans Affairs, Bedford, Massachusetts, USA
  4. 4Department of Population and Quantitative Health Sciences, UMASS Chan School of Medicine, Worcester, Massachusetts, USA
  5. 5Medical School Hamburg, Hamburg, Germany


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.


  1. 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.

  2. 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).

Abstract 242 Figure 1

The Six Steps of SDM with example sentences (from Clayman et al., 2023)

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.