A Trial Comparing Approaches to Shared Decision Making Skills Training for Clinicians

Study Overview
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Brief Summary
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The Health Decision Sciences Center (HDSC) staff has deployed different approaches to training clinicians to engage patients in shared decision making for common medical tests and treatments. The purpose of the study is to compare the effectiveness of shared decision making (SDM) skills training courses using standardized patient interactions (SPI) and written evaluations.

Detailed Description
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There is limited evidence on approaches to training clinicians to engage patients in shared decision making for common medical tests and treatments. The purpose of the study is to compare the effectiveness of different approaches to shared decision making (SDM) skills training. Participants will be randomly assigned to either receive two decision aids or a webinar to review. Participants will also be randomly assigned to receive feedback on standardized patient interaction rating their shared decision making skills and highlighting opportunities for improvement or not. Clinician participants will be assigned to one of four intervention groups using a 2x2 factorial design: Group 1: Decision aid viewing with feedback Group 2: Decision aid viewing and no feedback Group 3: webinar with feedback Group 4: webinar and no feedback The pilot study will provide evidence on the comparative effectiveness and feasibility on training formats to determine if: Clinicians improved in SDM communication skills Clinicians have an increased confidence to use SDM with their patients The training is acceptable to clinicians

Official Title
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A Pilot Randomized Trial Comparing Approaches to Shared Decision Making Skills Training for Clinicians

Conditions
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Depression, Low Back Pain

Intervention / Treatment
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* Behavioral: Webinar
* Behavioral: DA viewing
* Behavioral: SPI feedback


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults 18 and older English speaking Physician Nurse Practitioner Physician Assistant Registered Nurse Exclusion Criteria: Not clinically active (research faculty only) Medical Trainees Medical Students Medical Assistants Social Workers

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: DA viewing with SPI Feedback<br>Group 1 receives three decision aids and feedback on their standardized patient (SPI) interaction rating their shared decision making skills and highlighting opportunities for improvement. | Behavioral: DA viewing<br>* Participants will receive 3 decisions aids to review.<br>Behavioral: SPI feedback<br>* Rating of shared decision making skills and opportunities for improvement based on transcript of a standardized patient interaction<br>|
| Experimental: DA viewing with no SPI Feedback<br>Group 2 receives three decision aids. This group does not receive any feedback from the SPI. | Behavioral: DA viewing<br>* Participants will receive 3 decisions aids to review.<br>|
| Experimental: Webinar with SPI Feedback<br>Group 3 receives an online, interactive webinar that focuses on SDM skills in clinical encounters and feedback on their standardized patient (SPI) interaction rating their shared decision making skills and highlighting opportunities for improvement. | Behavioral: Webinar<br>* 1 hour online, interactive webinar that covers shared decision making skills in clinical encounters.<br>Behavioral: SPI feedback<br>* Rating of shared decision making skills and opportunities for improvement based on transcript of a standardized patient interaction<br>|
| Experimental: Webinar with no SPI Feedback<br>Group 4 receives an online, interactive webinar that focuses on SDM skills in clinical encounters. This group does not receive any feedback from the SPI. | Behavioral: Webinar<br>* 1 hour online, interactive webinar that covers shared decision making skills in clinical encounters.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Braddock's Informed Decision Making Score | Transcripts from standardized patient interactions (SPI) will be scored using Braddock's Informed Decision Making (IDM) framework to assess shared decision making skills. Scores with the Braddock's Informed Decision Making Framework range from 0 to 9; the higher scores are better. We subtracted the scores of the baseline SPI collected before the intervention from the second SPI collected 4-6 weeks later, after the intervention, to determine the change in IDM score for each participant and then compared change scores across study arms. | Baseline (before intervention) and 4-6 weeks (after intervention) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Communication skills training, Shared Decision Making, Decision making, Decision Aids, lung cancer screening