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使用 incorpoRATE 评估家庭医学住院医师参与共享决策的意愿:一项研究。

Using incorpoRATE to examine clinician willingness to engage in shared decision making: A study of Family Medicine residents.

机构信息

Department of Family Medicine, McGill University, Montréal, Canada.

Department of Family Medicine, McGill University, Montréal, Canada.

出版信息

Patient Educ Couns. 2022 Dec;105(12):3529-3533. doi: 10.1016/j.pec.2022.08.012. Epub 2022 Aug 23.

Abstract

OBJECTIVES

We evaluated the willingness of Family Medicine residents to engage in SDM, before and after an educational intervention.

METHODS

We delivered a lecture and a workshop for residents on implementing SDM in preventive health care. Before the lecture (T1), participants completed a measure of their willingness to engage in SDM. Six months later, participants completed the measure a second time (T2).

RESULTS

At T1, 64 of 73 residents who attended the educational session completed incorpoRATE. Six months later, 44 of 64 participants completed the measure a second time (T2). The range of incorpoRATE sum scores at T1 was from 4.9 to 9.1 out of 10. Among the 44 participants who completed incorpoRATE at both time points, the mean scores were 7.0 ± 1.0 at T1 and 7.4 ± 1.0 at T2 (t = -2.833, p = 0.007, Cohen's D = 0.43).

CONCLUSION

Among Family Medicine residents, the willingness to engage in SDM is highly variable. This suggests a lack of consensus in the mind of these residents about SDM. Although mean scores at T2 were significantly higher, we question the educational importance of this change.

PRACTICE IMPLICATIONS

incorpoRATE is a promising measure for educators. Understanding how willing a particular physician audience is to undertake SDM, and which elements require attention, could be helpful in designing more targeted curricula. Further research is needed to understand how the perceived stakes of a clinical situation influence physician willingness to engage in SDM.

摘要

目的

在接受教育干预前后,评估家庭医学住院医师参与共享决策的意愿。

方法

我们为住院医师讲授了一堂关于在预防保健中实施共享决策的讲座和研讨会。在讲座前(T1),参与者完成了一项关于参与共享决策意愿的衡量标准。六个月后,参与者再次完成了该衡量标准(T2)。

结果

在 T1 时,参加教育课程的 73 名住院医师中有 64 名完成了 incorpoRATE。六个月后,64 名参与者中有 44 名再次完成了该衡量标准(T2)。T1 时 incorpoRATE 总分的范围为 10 分制的 4.9 至 9.1 分。在 44 名两次均完成 incorpoRATE 的参与者中,T1 时的平均得分为 7.0±1.0,T2 时为 7.4±1.0(t=-2.833,p=0.007,Cohen's D=0.43)。

结论

在家庭医学住院医师中,参与共享决策的意愿差异很大。这表明这些住院医师对共享决策的看法存在分歧。尽管 T2 的平均得分明显更高,但我们对这种变化的教育意义提出质疑。

实践意义

incorpORATE 是教育者的一种有前途的衡量标准。了解特定医生群体对共享决策的接受意愿以及需要关注的哪些方面,可能有助于设计更有针对性的课程。需要进一步研究如何理解临床情况的感知利害关系如何影响医生参与共享决策的意愿。

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