A shared decision-making communications workshop improves internal medicine resident skill, risk-benefit education, and counseling attitude

Fred Amell, Caroline Park, Pooja Sheth, Glyn Elwyn, Darlene LeFrancois

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: We assessed the impact of a workshop on first-year medicine residents (PGY1) shared decision-making (SDM) communication skill, risk-benefit education, and attitude. Methods: A SDM skills-focused workshop was integrated into an academic medical center PGY1 ambulatory rotation in 2016–2017. Pre/post recordings of virtual Objective Structured Clinical Examinations (OSCEs) with standardized patients sharing decisions were scored using OPTION5. Risk-benefit education, including decision aid use, was measured. Pre/post surveys assessed SDM practice attitudes and perceived barriers. Results: 31 of 48 (65%) PGY1 workshop attendees completed pre/post OSCEs yielding 62 videos. OPTION5 scores improved from 27/100 pre to 56/100 post (p < 0.001). Pre/post increases in integration of qualitative (15/31 vs 31/31, p < 0.001) and quantitative (3/31 vs 31/31, p < 0.001) risk measures, and decision aids (1/3 vs 31/31, p < 0.001) were observed. Pro-SDM attitude of decisional neutrality increased 16.6% pre to 71.9% post-survey (P < 0.001). Barriers to SDM remain. Conclusion: This PGY1 workshop with virtual OSCEs improved SDM communication skills, the ability to find and provide risk-benefit education, and SDM-facilitating attitude. Practice implications: Residency programs can improve SDM skills, risk-benefit education, and attitudes with a workshop intervention. Perceived time constraints and cognitive biases regarding risk-benefit estimates should be addressed to ensure quality SDM in practice.

Original languageEnglish (US)
JournalPatient Education and Counseling
DOIs
StateAccepted/In press - 2021
Externally publishedYes

Keywords

  • Evidence-based medicine
  • Graduate medical education
  • Patient communication
  • Patient education
  • Residency education
  • Risk-benefit
  • Shared decision-making

ASJC Scopus subject areas

  • Medicine(all)

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