Evaluating Attitudes of First-Year Residents to Shared Decision Making

Article English OPEN
Caldwell, Jon G. (2008)
  • Publisher: Medical Education Online
  • Journal: Medical Education Online, volume 13 (issn: 1087-2981, eissn: 1087-2981)
  • Related identifiers: doi: 10.3885/meo.2008.Res00276, doi: 10.3402/meo.v13i.4479, pmc: PMC2779608
  • Subject: Research Article | Education | Internship and Residency | Physician-Patient Relations | Medical Residency | Patient Participation/methods | Training | Physician's Role/psychology | Physicians | Decision Making | Interviews/methods | Communication | Patient Participation/psychology | Internship

Objective - Shared decision making (SDM) is recognized as an ideal model of patient-physician interaction, yet clinical application occurs infrequently. The current study evaluated attitudes of first-year residents to identify potential barriers and opportunities regarding SDM. Methods - A total of 70 residents attending orientation at the University of Utah completed a questionnaire that elicited their understanding of SDM, perceptions about the importance of SDM, confidence in utilizing SDM, and reasons for lacking confidence. Results - Most residents reported no prior SDM education (N=42, 60%) or training (N=46, 66%), yet 67 (96%) of them could recognize it in a clinical vignette. Using a Likert scale, the majority of residents (91% to 99%) attributed importance to SDM principles, and most (79% to 90%) indicated confidence in applying them. Lack of training was reported as a barrier by 40 (57%) residents. Conclusions - A minority of residents reported formal education or training in SDM, yet the vast majority recognized and valued the model. A large percentage of residents expressed confidence in their abilities to incorporate SDM into patient care, but many also identified a need for more education and training. Keyword: Decision Making, Interviews/methods, Patient Participation/methods, Physician-Patient Relations, Patient Participation/psychology, Physician’s Role/psychology, Communication, Physi­cians, Education, Training, Internship and Residency, Internship, Medical Residency
  • References (8)

    1. Stewart M, Brown JB, Weston WW, McWhinney IR, McWilliam C, Freeman TR. Patient-centered medicine: transforming the clinical method. Thousand Oaks (CA): Sage Publications; 1995.

    Emanuel EJ, Emanuel LL. Four models of the physician-patient relationship. JAMA. 267(16):2221- 6.

    Coulter A. Partnerships with patients: the pros and cons of shared clinical decision-making. J Health Serv Res Policy. 1997 2(2):112-21.

    Charles C, Gafni A, Whelan T. Shared decisionmaking in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med. 1997;44(5):681-92.

    Charles C, Gafni A, Whelan T. Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model. Soc Sci Med. 1999;49(5):651-61.

    Coulter A, Entwistle V, Gilbert D. Sharing decisions with patients: is the information good enough? BMJ. 1999;318(7179):318-22.

    Cruz M, Pincus HA. Research on the influence that communication in psychiatric encounters has on treatment. Psychiatr Serv. 2002;53(10):1253-65.

    Braddock CH 3rd, Edwards KA, Hasenberg NM, Laidley TL, Levinson W. Informed decision making in outpatient practice: time to get back to basics. JAMA. 282(24):2313-20.

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