A randomised trial of training student clinicians in how to facilitate shared decision making and communicate evidence: the ignored step in evidence-based practice?

Abstract text
Background: Successful evidence-based practice requires clinicians to practice patient-centred care. Central to this is shared decision making (SDM); of which, a key skill is communicating statistical information clearly to patients. Most clinicians do this poorly, if at all. One reason is lack of training: evidence-based practice courses and workshops typically do not include these skills. Teaching these skills to student clinicians during evidence-based practice training may be valuable, but methods for doing this have not been evaluated.

Objectives: To evaluate, in a multi-site randomised trial, the effectiveness of a brief intervention designed to increase student clinicians’ ability to facilitate SDM and evidence communication skills.

Methods: Medical, physiotherapy and occupational therapy undergraduate, honours, and postgraduate students (n=107) were randomly allocated to an intervention or control group. Intervention group participants received brief training in SDM and evidence communication skills. At baseline and post-intervention, participants performed role-plays which were videorecorded and evaluated by a blinder assessor using the Observing Patient Involvement (OPTION) scale (range 1-100) and selected Assessing Communication about Evidence and Preferences (ACEP) Coding Scheme items (range 0-5) to assess shared decision-making and evidence communication skill as the primary outcome measures. Secondary outcome measures were confidence in and attitudes towards SDM.

Results: Post-intervention, intervention group participants scored significantly higher on the OPTION scale (mean between-group difference = 19.2, 95% CI 12.3 to 26.0), ACEP items (difference = 1.0, 95% CI 0.5 to 1.4), confidence measure (difference = 13.3, 95% CI 7.3 to 19.4), and Sharing subscale of the attitude measure (difference = 0.5, 95% CI 0.2 to 0.7). The between-group difference for the Caring subscale of the attitude measure was not significant.

Conclusions: The intervention was effective in improving student clinicians’ ability, attitude, and confidence in facilitating SDM and communicating evidence. Further evaluation of this intervention is warranted.
Hoffmann T1, Del Mar C1, Bennett S2, Claire T2
1 Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Australia
2 School of Health and Rehabilitation Sciences, The University of Queensland, Australia
Presenting author and contact person
Presenting author: 
Tammy Hoffmann
Contact person Affiliation Country
Tammy Hoffmann (Contact this person) Bond University Australia
Date and Location
Oral session A1O2
Monday 1 October 2012 - 11:20 - 11:40