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Training physicians to use an encounter decision aid in routine gynecology: Impact on knowledge, attitudes, and intentions

Johanna W.M. Aarts, Rachel Thompson, Tina C Foster, Glyn Elwyn

Abstract


Rationale, aims and objectives: Efforts to improve shared decision-making through the implementation of decision aids are unlikely to be successful without accompanying training for the health professionals that care for patients. This study aimed to evaluate the immediate impact of training gynecologists and residents to use an encounter decision aid (Option Grid TM decision aid) to facilitate shared decision-making in routine gynecology.

Methods: In February 2015, participants completed anonymous surveys before and after being introduced to the concepts of shared decision-making and encounter decision aids and after viewing videos illustrating effective and ineffective decision aid use. A non-participant observer took field notes during these training activities and a subsequent group discussion and role play.

Results: Eleven of the 16 physicians invited to the training participated. Participants expressed significantly more positive attitudes toward using decision aids after the training activities than before, but their negative attitudes were unchanged over time. After, participants demonstrated knowledge of optimal decision aid use, expressed fairly strong decision aid use intentions and generally recommended wider implementation of the training activities. Strengths and weaknesses spanning both content and delivery of the training session were identified.

Conclusion: Given the importance of attitudes, knowledge and intentions to successful behavior change, our findings are encouraging. Forthcoming data on physicians’ shared decision-making behaviors will shed further light on the sufficiency of the training for generating significant and sustained behavior change.

Keywords


Attitude, behavioural change, competencies, decision aids, gynaecology, implementation, intentions, patient communication, patient partnership, person-centered healthcare, residents, shared decision-making, training

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References


Fay, M., Grande, S.W., Donnelly, K. & Elwyn, G. (2016). Using Option Grids: Steps toward shared decision-making for neonatal circumcision. Patient Education and Counseling 99 (2) 236-242.

Elwyn, G., Pickles, T., Edwards, A., Kinsey, K., Brain, K., Newcombe, R.G., Firth, J., Marrin, K., Nye, A. & Wood, F. (2016). Supporting shared decision making using an Option Grid for osteoarthritis of the knee in an interface musculoskeletal clinic: A stepped wedge trial. Patient Education and Counseling 99 (4) 571-577.

Mullan, R.J., Montori, V.M., Shah, N.D., Christianson, T.J.H., Bryant, S.C., Guyatt, G.H., Perestelo-Perez, L.I., Stroebel, R.J., Yawn, B.P., Yapuncich, V., Breslin, M.A., Pencile, L. & Smith, S.A. (2009). The diabetes mellitus medication choice decision aid: A randomized trial. Archives of Internal Medicine 169 (17) 1560-1568.

Weymiller, A.J., Montori, V.M., Jones, L.A., Gafni, A., Guyatt, G.H., Bryant, S.C., Christianson, T.J., Mullan, R. & Smith, S.A. (2007). Helping patients with type 2 diabetes mellitus make treatment decisions: statin choice randomized trial. Archives of Internal Medicine 167 (10) 1076-1082.

Branda, M.E., LeBlanc, A., Shah, N.D., Tiedje, K., Ruud, K., Van Houten, H., Pencille, L., Kurland, M., Yawn, B. & Montori, V.M. (2013). Shared decision making for patients with type 2 diabetes: A randomized trial in primary care. BMC Health Services Research 13, 301.

Hess, E.P., Knoedler, M.A., Shah, N.D., Kline, J.A., Breslin, M., Branda, M.E., Pencille, L.J., Asplin, B.R., Nestler, D.M., Sadosty, A.T., Stiell, I.G., Ting, H.H. & Montori, V.M. (2012). The Chest Pain Choice decision aid: A randomized trial. Circulation, Cardiovascular Quality and Outcomes 5 (3) 251-259.

Montori, V.M., Shah, N.D., Pencille, L.J., Branda, M.E., Van Houten, H.K., Swiglo, B.A., Kesman, R.L., Tulledge-Scheitel, S.M., Jaeger, T.M., Johnson, R.E., Bartel, G.A., Melton, L.D. 3rd. & Wermers, R.A. (2011). Use of a decision aid to improve treatment decisions in osteoporosis: The osteoporosis choice randomized trial. American Journal of Medicine 124 (6) 549-556.

Légaré, F., Ratté, S., Gravel, K. & Graham, I.D. (2008). Barriers and facilitators to implementing shared decision-making in clinical practice: Update of a systematic review of health professionals’ perceptions. Patient Education and Counseling 73 (3) 526-535.

Berkhof, M., van Rijssen, H.J., Schellart, A.J.M., Anema, J.R. & van der Beek, A.J. (2011). Effective training strategies for teaching communication skills to physicians: An overview of systematic reviews. Patient Education and Counseling 84 (2) 152-162.




DOI: http://dx.doi.org/10.5750/ejpch.v7i1.1590

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