TY - JOUR
T1 - A shared decision-making communications workshop improves internal medicine resident skill, risk-benefit education, and counseling attitude
AU - Amell, Fred
AU - Park, Caroline
AU - Sheth, Pooja
AU - Elwyn, Glyn
AU - LeFrancois, Darlene
N1 - Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2022/4
Y1 - 2022/4
N2 - 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.
AB - 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.
KW - Evidence-based medicine
KW - Graduate medical education
KW - Patient communication
KW - Patient education
KW - Residency education
KW - Risk-benefit
KW - Shared decision-making
UR - http://www.scopus.com/inward/record.url?scp=85111944377&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85111944377&partnerID=8YFLogxK
U2 - 10.1016/j.pec.2021.07.040
DO - 10.1016/j.pec.2021.07.040
M3 - Article
C2 - 34362609
AN - SCOPUS:85111944377
SN - 0738-3991
VL - 105
SP - 1018
EP - 1024
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 4
ER -