Department of Pediatrics, University Medical Center Schleswig-Holstein, Kiel, Germany; MSH Medical School Hamburg, Germany; Institute of Medical Psychology and Sociology, University Medical Center Schleswig-Holstein, Kiel, Germany.
Institute of Medical Psychology and Sociology, University Medical Center Schleswig-Holstein, Kiel, Germany; Unit of Health Sciences and Education, University of Hamburg, Germany; Institute of Neuroimmunology and Clinical MS Research (INiMS), University of Hamburg, Germany.
Patient Educ Couns. 2017 Dec;100(12):2331-2338. doi: 10.1016/j.pec.2017.06.022. Epub 2017 Jun 19.
Training to improve physicians' shared decision making (SDM) competencies with proven effectiveness and efficiency is rare. This study evaluated the brief in situ training module 'doktormitSDM'.
In a multicenter RCT, each physician recorded four consultations, each of which included a diagnostic or treatment decision (N=152 consultations from seven medical specialties). The doktormitSDM training module included two video-based individual coaching sessions (15min) at the physicians' workplaces, supplemented by a manual and a video tutorial. Primary endpoint was the compound measure SDMmass (based on the MAPPIN'SDM system) which incorporates patient and observer perceptions of involvement and doctor-patient concordance on perceived involvement.
SDMmass increased significantly in the intervention group compared to the controls (effect size 0.58; p=0.05; t-test). This effect tended to persist at follow-up (effect size 0.63; p=0.06). Patients' perceived involvement increased accordingly (effect sizes 0.9/.58; p=0.01/.07).
The doktormitSDM training module is effective and efficient at improving SDM competencies. This is the first SDM training to be evaluated with a compound measure simultaneously considering doctor, patient and observer ratings.
Owing to its very brief form and its reference to the doctors' own consultation videos, the doktormitSDM training module meets clinicians' needs and time constraints.
提高医生共享决策（SDM）能力的培训很少具有经过证实的有效性和效率。本研究评估了简短的现场培训模块“doktormitSDM”。
在一项多中心 RCT 中，每位医生记录了四个咨询，每个咨询都包含诊断或治疗决策（来自七个医学专业的 152 个咨询）。doktormitSDM 培训模块包括在医生工作场所进行的两次基于视频的个人辅导课程（每次 15 分钟），并辅以手册和视频教程。主要终点是 SDMmass 的复合测量（基于 MAPPIN'SDM 系统），该测量包含患者和观察者对参与的感知以及医患双方对感知参与的一致性。
与对照组相比，干预组的 SDMmass 显著增加（效应大小 0.58；p=0.05；t 检验）。这种效果在随访时趋于持续（效应大小 0.63；p=0.06）。患者的感知参与也相应增加（效应大小分别为 0.9/0.58；p=0.01/0.07）。
doktormitSDM 培训模块在提高 SDM 能力方面是有效和高效的。这是第一个使用复合措施同时考虑医生、患者和观察者评分的 SDM 培训。
由于其非常简短的形式和对医生自己咨询视频的参考，doktormitSDM 培训模块满足了临床医生的需求和时间限制。
