Faculty of Health Sciences, Department of Health and Caring Sciences, UiT The Arctic University of Norway, Langnes, Norway.
The South-Eastern Norway Regional Health Authority, Department of Medicine and Healthcare, Hamar, Norway.
J Eval Clin Pract. 2020 Apr;26(2):610-621. doi: 10.1111/jep.13380. Epub 2020 Mar 1.
While shared decision-making (SDM) training programmes for health professionals have been developed in several countries, few have been evaluated. In Norway, a comprehensive curriculum, "klar for samvalg" (ready for SDM), for interprofessional health-care teams was created using generic didactic methods and guidance to tailor training to various contexts. The programmes adapted didactic methods from an evidence-based German training programmes (doktormitSDM). The overall aim was to evaluate two particular SDM modules on facilitating SDM implementation into clinical practice.
A descriptive mixed methods study using questionnaires and a focus group guided by the Medical Research Council Complex Interventions Framework. The training was provided as two different applications (module AB [introduction and SDM-basics] and module ABC [introduction, SDM-basics and interactive training]) with differing learning objectives, extent of interactivity, and duration (1 vs 2 hours). Groups of participants were recruited consecutively based on requests for health professional SDM training in university/college- and hospital-settings. By a focus group and a self-administered questionnaire comprehensibility, relevance and acceptance were assessed and qualitative feedback collected after the training. Data passed descriptive and content analysis, respectively. Knowledge was assessed twice using five multiple-choice items and analysed using paired t-tests.
In 11 (six AB and five ABC) training sessions, 357/429 (296 AB and 133 ABC) eligible nurses, physicians and health professional students with varying clinical backgrounds and previous levels of SDM-knowledge participated. SDM-knowledge increased from 25-78% (range pretest) to 85-95% (range post-test) (P ≤ .001). The training was rated easy to understand, acceptable and relevant for practice. Findings to improve the education suggest higher emphasis on interprofessional teaching methods.
The two SDM training modules met the basic requirements for use in a broader SDM implementation strategy and can even improve knowledge.
尽管许多国家都为卫生专业人员开发了共享决策 (SDM) 培训计划，但对其进行评估的却很少。在挪威，为跨专业医疗团队创建了一个全面的课程“klar for samvalg”（准备好进行 SDM），该课程使用通用教学方法和指导原则，根据各种情况调整培训内容。该课程改编自基于证据的德国培训课程（doktormitSDM）的教学方法。总体目标是评估两个特别的 SDM 模块，以促进 SDM 在临床实践中的实施。
采用描述性混合方法研究，使用问卷调查和焦点小组，以医学研究理事会复杂干预框架为指导。培训以两种不同的应用形式（模块 AB [介绍和 SDM 基础知识]和模块 ABC [介绍、SDM 基础知识和互动培训]）提供，具有不同的学习目标、互动程度和持续时间（1 小时与 2 小时）。参与者小组根据大学/学院和医院中卫生专业人员 SDM 培训的要求连续招募。通过焦点小组和自我管理问卷评估培训的可理解性、相关性和可接受性，并在培训后收集定性反馈。数据分别通过描述性和内容分析进行处理。使用 5 个多项选择题两次评估知识，并使用配对 t 检验进行分析。
在 11 次（6 次 AB 和 5 次 ABC）培训中，有 357/429 名（296 名 AB 和 133 名 ABC）合格的护士、医生和具有不同临床背景和之前 SDM 知识水平的卫生专业学生参加了培训。SDM 知识从 25%到 78%（预测试范围）提高到 85%到 95%（后测试范围）（P≤0.001）。培训被评为易于理解、可接受且与实践相关。改进教育的建议是更加强调跨专业教学方法。
这两个 SDM 培训模块满足了更广泛的 SDM 实施策略的基本要求，甚至可以提高知识水平。
