Chen Esther H, Kanzaria Hemal K, Itakura Kaoru, Booker-Vaughns Juanita, Yadav Kabir, Kane Bryan G
Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA.
Department of Emergency Medicine, Harbor-UCLA Medical Center, Los Angeles, CA.
Acad Emerg Med. 2016 Dec;23(12):1362-1367. doi: 10.1111/acem.13059. Epub 2016 Nov 25.
Shared decision making (SDM) is a patient-centered communication skill that is essential for all physicians to provide quality care. Like any competency or procedural skill, it can and should be introduced to medical students during their clerkships (undergraduate medical education), taught and assessed during residency training (graduate medical education), and have documentation of maintenance throughout an emergency physician's career (denoted as continuing medical education). A subgroup representing academic emergency medicine (EM) faculty, residents, content experts, and patients convened at the 2016 Academic Emergency Medicine Consensus Conference on SDM to develop a research agenda toward improving implementation of SDM through sustainable education efforts. After developing a list of potential priorities, the subgroup presented the priorities in turn to the consensus group, to the EM program directors (CORD-EM), and finally at the conference itself. The two highest-priority questions were related to determining or developing EM-applicable available tools and on-shift interventions for SDM and working to determine the proportion of the broader SDM curriculum that should be taught and assessed at each level of training. Educating patients and the community about SDM was also raised as an important concept for consideration. The remaining research priorities were divided into high-, moderate-, and lower-priority groups. Moreover, there was consensus that the overall approach to SDM should be consistent with the high-quality educational design utilized for other pertinent topics in EM.
共同决策（SDM）是一种以患者为中心的沟通技巧，对于所有医生提供高质量医疗服务至关重要。与任何能力或程序技能一样，它可以而且应该在医学生实习期间（本科医学教育）引入，在住院医师培训期间（研究生医学教育）进行教授和评估，并在急诊医生的整个职业生涯中记录其维持情况（称为继续医学教育）。一个由学术急诊医学（EM）教员、住院医师、内容专家和患者组成的小组在2016年关于SDM的学术急诊医学共识会议上召开会议，以制定一项研究议程，通过可持续的教育努力来改善SDM的实施。在制定了一系列潜在的优先事项清单后，该小组依次将这些优先事项提交给共识小组、EM项目主任（CORD-EM），最后在会议上提出。两个最高优先级的问题与确定或开发适用于EM的SDM可用工具和轮班干预措施有关，并努力确定在每个培训级别应教授和评估的更广泛SDM课程的比例。向患者和社区宣传SDM也作为一个重要概念被提出以供考虑。其余的研究优先事项分为高、中、低优先级组。此外，与会者一致认为，SDM的总体方法应与用于EM中其他相关主题的高质量教育设计相一致。
