Revising a Training Curriculum on Shared Decision Making for Application in Routine Clinical Care: A Report on the SHARE Approach
Douglas H. Fernald, Daniel D. Matlock, Christopher E. Knoepke, W. Perry Dickinson, R. Mark Gritz, Laura D. SchererBackground:
Improving shared decision making (SDM) training curricula may support wider training uptake and the use of SDM across health care settings. Limited uptake of a freely available SDM training curriculum suggested it could benefit from a systematic review and revision process. This report describes the process and revisions of the SHARE Approach curriculum, subsequently used in an implementation trial demonstrating that the revised curriculum remained effective.
Methods:
A qualitative study using a systematic review on shared decision making, training, and physicians published between 2015 and 2020; clinician and patient reviews and feedback on curriculum training materials; and synthesis of recommended improvements and a team-revised curriculum for testing in clinical practice.
Results:
Recommendations from the literature and reviewers (9 clinicians and 6 patients) focused on substantially reducing the length of the training curriculum, ideally under 4 h. Reviewers found original content well done and important but suggested removing content that was not explicitly focused on training clinicians how to implement shared decision making in clinical practice by removing discussions of applicable laws, medical interpreters, and patient-centered outcomes research while retaining important strategies for addressing patient health literacy/numeracy and use of decision aids.
Limitations:
Clinician and patient feedback might not represent the full scope of clinical specialties or patient types who may have different recommendations for revising the original curriculum for other clinical settings.
Conclusion:
Literature review and user feedback agreed that training curricula on shared decision making needed to be shorter and focus on only essential techniques clinicians need to effectively implement shared decision making in routine practice.
Implications:
A substantially shortened SHARE Approach curriculum is effective and may facilitate broader shared decision making training of clinicians.