Advertisement

Topics

Assessment of Medical Students' Shared Decision-Making in Standardized Patient Encounters.

Summary of "Assessment of Medical Students' Shared Decision-Making in Standardized Patient Encounters."


BACKGROUND:
Shared decision-making, in which physicians and patients openly explore beliefs, exchange information, and reach explicit closure, may represent optimal physician-patient communication. There are currently no universally accepted methods to assess medical students' competence in shared decision-making.
OBJECTIVE:
To characterize medical students' shared decision-making with standardized patients (SPs) and determine if students' use of shared decision-making correlates with SP ratings of their communication.
DESIGN:
Retrospective study of medical students' performance with four SPs.
PARTICIPANTS:
Sixty fourth-year medical students.
MEASUREMENTS:
Objective blinded coding of shared decision-making quantified as decision moments (exploration/articulation of perspective, information sharing, explicit closure for a particular decision); SP scoring of communication skills using a validated checklist.
RESULTS:
Of 779 decision moments generated in 240 encounters, 312 (40%) met criteria for shared decision-making. All students engaged in shared decision-making in at least two of the four cases, although in two cases 5% and 12% of students engaged in no shared decision-making. The most commonly discussed decision moment topics were medications (n = 98, 31%), follow-up visits (71, 23%), and diagnostic testing (44, 14%). Correlations between the number of decision moments in a case and students' communication scores were low (rho = 0.07 to 0.37).
CONCLUSIONS:
Although all students engaged in some shared decision-making, particularly regarding medical interventions, there was no correlation between shared decision-making and overall communication competence rated by the SPs. These findings suggest that SP ratings of students' communication skill cannot be used to infer students' use of shared decision-making. Tools to determine students' skill in shared decision-making are needed.

Affiliation

Department of Medicine, University of California, San Francisco, 505 Parnassus Ave, M1078, Box 0120, San Francisco, CA, 94143-0120, USA, karen.hauer@ucsf.edu.

Journal Details

This article was published in the following journal.

Name: Journal of general internal medicine
ISSN: 1525-1497
Pages:

Links

DeepDyve research library

PubMed Articles [29850 Associated PubMed Articles listed on BioPortfolio]

Montreal Accord on Patient-Reported Outcomes Use Series - Paper 3: Patient Reported Outcomes (PRO) Can Facilitate Shared Decision-Making and Guide Self- Management.

There is a shift towards making health care patient-centred whereby patients are part of medical decision-making and take responsibility for managing their health. Patient-reported outcomes (PROs) cap...

Decision-Making Quality in Parents Considering Adenotonsillectomy or Tympanostomy Tube Insertion for Their Children.

Shared decision making is a process in which clinicians and patients make health care decisions in a collaborative manner using the most up-to-date evidence, while considering patient values and prefe...

Pack-Year Cigarette Smoking History for Determination of Lung Cancer Screening Eligibility: Comparison of the Electronic Medical Record versus a Shared Decision Making Conversation.

Implementation of lung cancer screening programs is occurring across the United States. Programs vary in approaches to patient identification and shared decision making. The eligibility of persons ref...

How does decision complexity affect shared decision making? An analysis of patient-provider antiretroviral initiation dialogue.

This study analyzed patient-provider dialogue regarding anti-retroviral therapy (ART) initiation, assessing the degree to which shared decision making (SDM) occurred.

Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia.

Physicians' recommendations are seen as an essential component in many models of medical decision-making, including shared decision-making. It is, however, unclear at what time in the decision-making ...

Clinical Trials [7903 Associated Clinical Trials listed on BioPortfolio]

Shared Decision-Making for Elderly Depressed Primary Care Patients

Shared decision-making (SDM), in contrast to traditional medical decision-making, involves a collaborative process where patients discuss personal values and preferences and clinicians pro...

Shared Decision Making: Prostate Cancer Screening

Interventions to Improve Shared Decision-Making: Prostate Cancer Screening is a prospective study of educational interventions to improve the interaction of physicians and their patients a...

Assessment of Shared Decision Making Aids in Asthma

The purpose of this study is to determine whether the use of shared decision making aids is more effective than usual care in improving asthma knowledge, lessening decisional conflict, and...

Does Shared Decision-Making Improve Asthma Outcomes?

To improve asthma outcomes by developing and evaluating strategies for enhancing the clinic-patient partnership. To develop a model of shared decision-making for asthma treatment, and to ...

Effectiveness of a Patient Decision Aid in Immediate Postpartum Contraceptive Counseling

Effective physician-patient communication in postpartum contraceptive counseling is essential for patients to meet their contraceptive needs and reduce the risk of rapid repeat pregnancies...

Medical and Biotech [MESH] Definitions

Mathematical or statistical procedures used as aids in making a decision. They are frequently used in medical decision-making.

Information systems, usually computer-assisted, that enable providers to initiate medical procedures, prescribe medications, etc. These systems support medical decision-making and error-reduction during patient care.

Patient involvement in the decision-making process in matters pertaining to health.

Computer-based information systems used to integrate clinical and patient information and provide support for decision-making in patient care.

Use of an interactive computer system designed to assist the physician or other health professional in choosing between certain relationships or variables for the purpose of making a diagnostic or therapeutic decision.

Quick Search
Advertisement
 


DeepDyve research library

Relevant Topic

Alzheimer's Disease
Of all the types of Dementia, Alzheimer's disease is the most common, affecting around 465,000 people in the UK. Neurons in the brain die, becuase  'plaques' and 'tangles' (mis-folded proteins) form in the brain. People with Al...


Searches Linking to this Article