Knowledge Construction Lab, Leibniz-Institut Fuer Wissensmedien , Tuebingen, Germany.
Department of Psychology, University of Tuebingen , Tuebingen, Germany.
Med Educ Online. 2021 Dec;26(1):1886642. doi: 10.1080/10872981.2021.1886642.
Successful shared decision making (SDM) in clinical practice requires that future clinicians learn to appreciate the value of patient participation as early as they can in their medical training. Narratives, such as patient testimonials, have been successfully used to support patients' decision-making process. Previous research suggests that narratives may also be used for increasing clinicians' empathy and responsiveness in medical consultations. However, so far, no studies have investigated the benefits of narratives for conveying the relevance of SDM to medical students. In this randomized controlled experiment, N = 167 medical students were put into a scenario where they prepared for medical consultation with a patient having Parkinson disease. After receiving general information, participants read either a narrative testimonial of a Parkinson patient or a fact-based information text. We measured their perceptions of SDM, their control preferences (i.e., their priorities as to who should make the decision), and the time they intended to spend for the consultation. Participants in the narrative patient testimonial condition referred more strongly to the patient as the one who should make decisions than participants who read the information text. Participants who read the patient narrative also considered SDM in situations with several equivalent treatment options to be more important than participants in the information text condition. There were no group differences regarding their control preferences. Participants who read the patient testimonial indicated that they would schedule more time for the consultation. These findings show that narratives can potentially be useful for imparting the relevance of SDM and patient-centered values to medical students. We discuss possible causes of this effect and implications for training and future research. : The study was pre-registered on the pre-registration platform (aspredicted.org) before data collection began (registration number: #29,342). Date of registration: 17 October 2019.
成功的临床实践中的共享决策（SDM）要求未来的临床医生在医学培训中尽早学会欣赏患者参与的价值。叙事，如患者的见证，已成功地用于支持患者的决策过程。以前的研究表明，叙事也可以用于增加临床医生在医疗咨询中的同理心和响应能力。然而，到目前为止，还没有研究调查叙事对向医学生传达 SDM 的相关性的好处。在这项随机对照实验中，N = 167 名医学生被置于一个情景中，他们为患有帕金森病的患者准备医疗咨询。在接受一般信息后，参与者阅读了帕金森病患者的叙事见证或基于事实的信息文本。我们测量了他们对 SDM 的看法、他们的控制偏好（即，他们应该做出决策的优先级）以及他们打算为咨询花费的时间。阅读叙事患者见证的参与者比阅读信息文本的参与者更强烈地认为患者应该做出决策。阅读患者叙事的参与者还认为，在有几种等效治疗方案的情况下，SDM 更为重要，而不是信息文本条件下的参与者。关于他们的控制偏好，两组没有差异。阅读患者见证的参与者表示，他们将为咨询安排更多时间。这些发现表明，叙事可能对向医学生传授 SDM 和以患者为中心的价值观具有潜在的作用。我们讨论了这种效果的可能原因及其对培训和未来研究的影响。 : 该研究在数据收集开始前在预注册平台 (aspredicted.org) 上进行了预先注册（注册号：#29,342）。注册日期：2019 年 10 月 17 日。
