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245 Shared decision making curricula in medical schools: European approaches and experiences
  1. Kevin Selby1,
  2. Marie-Anne Durand1,
  3. Christian Von Plessen1,
  4. Alexandre Gouveia1,
  5. Angelique Timmerman2,
  6. Trudy Vander Weijden2,
  7. Pieter Van Bostraeten3,
  8. Jasmien Jaeken3,
  9. Lien Mertens3,
  10. Mieke Vermandere3,
  11. Martin Härter4
  1. 1Center for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
  2. 2Maastricht University, Netherlands
  3. 3KU Leuven, Belgium
  4. 4Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany

Abstract

Introduction Shared decision making (SDM) is an essential competency for medical students. Training can improve medical students’ skills, confidence, and attitudes regarding SDM.1 Multiple approaches appear to be effective. Uncertainty remains regarding key components of SDM teaching, duration and appropriate implementation in diverse settings.

Presentations Belgium: A realist review was conducted to understand how educational SDM interventions affect SDM competency development in medical students, under which circumstances and why. We built an initial program theory based on a scoping literature search and expert interviews. We found professional identity formation and integrated skills development (e.g. communication skills) as important mechanisms. Finally, this theory was tested in a systematic literature search.

Germany We established in 2012 a SDM curriculum in medicine (iMED) and in 2021 for dentistry (iMED DENT). It consists of a lecture and two workshops with simulated patients in small groups (10 students/group). An observer-rated, objective structured clinical examination (OSCE) has been developed to measure learning progress.

Switzerland We collected medical student evaluations at baseline with role-plays (spring 2019) and after implementing standardized patients (spring 2023). In 2019, 78/112 (70%) felt the module definitely allowed them to do a SDM consultation and 78/112 (70%) were strongly satisfied. In 2023, the results were 118/130 (91%) and 114/130 (88%), respectively.

Netherlands A longitudinal educational design-based SDM curriculum was developed for Family Medicine residency based on identified educational needs,2 integrating workshops for both trainees and supervisors, using clinical situations to develop SDM competencies and supervisor didactic skills. The curriculum was piloted and evaluated at two sites using the Kirkpatrick evaluation model: learning experiences, effect on competency development, clinical performance and workplace learning.

Conclusion Given difficulties in conducting multisite studies complying with institutional constraints, comparing approaches, experiences and empirical results is essential to replicate successful educational interventions.

Reference

  1. Durand MA, DiMilia PR, Song J, Yen RW, Barr PJ. Shared decision making embedded in the undergraduate medical curriculum: a scoping review. PLOS ONE 2018;13(11):e0207012. https://doi.org/10.1371/journal.pone.0207012

  2. Baghus A, Giroldi E, Timmerman A, Schmitz E, Erkan F, Röhlinger D, Pieterse D, Dielissen P, Kramer A, Rietmeijer C, Muris J, van der Weijden T. Identifying residents’ educational needs to optimising postgraduate medical education about shared decision-making. PEC 2022;105(10):3086–3095. https://doi.org/10.1016/j.pec.2022.06.016

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