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200 Effectiveness of individual feedback and coaching on shared decision-making consultations in oncology care: a pre-post study
  1. Loes J Peters1,2,
  2. Haske Van Veenendaal3,4,
  3. Dirk T Ubbink1
  1. 1Department of Surgery, Amsterdam UMC, Amsterdam, the Netherlands
  2. 2Dutch Association of Medical Specialists, Utrecht, the Netherlands
  3. 3Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
  4. 4Dutch Federation of Cancer Patients Organizations, Utrecht, the Netherlands

Abstract

Introduction Although training clinicians effectively improves their SDM skills, this usually is time- consuming. Therefore, the effectiveness of an individual digital training program, tailored to the clinicians’ daily practice was investigated.

Methods In this pre-post study, oncology clinicians audio-taped one decision-making process to measure their baseline SDM-skills. Subsequently, they were offered the intervention: E-learnings, feedback reports, a self-assessment, defining 1–3 personal learning questions, and face-to-face digital coaching. Afterwards, clinicians audio-taped one or two more decision-making processes to estimate the effect of the intervention. Primary outcome was the level of SDM, using the OPTION-5 instrument. As secondary outcomes, patients rated their perceived involvement in the decision-making process (using the SDM-Q9 and iSHARE questionnaires) and the consultation duration was registered.

Results In total, 10 medical specialists, 8 nurse specialists, 2 physician-assistants and 2 nurses from 10 different hospitals in the Netherlands participated. Mean OPTION-scores improved significantly from 43.9% to 59.3% percent (mean difference: 15.5%, p=0.002). Nine clinicians audio-taped a third consultation after four weeks. Their OPTION-score retained over time (56.1% to 58.3%, mean difference: 2.2%, p=0.677). SDM-Q9- and iSHARE-scores did not differ significantly between the pre- and post-measurements (p=0.90 and 0.79, respectively). Mean baseline duration of consultations was 35:22 min:sec, compared to 38:52 after the intervention (difference: 3:30, p=0.43). After another 4 weeks consultation duration slightly decreased (n=9; 39:54 compared to 33:24, difference 06:30, p=0.49).

Discussion This digital training program seems to improve SDM without patients noticing it.

Conclusions This individual SDM training program improved the SDM skills of oncology clinicians, which is sustained over time.

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