University of Exeter Medical School, University of Exeter, Exeter; Royal Cornwall Hospital NHS Trust, Truro.
University of Exeter Medical School, University of Exeter, Exeter.
Br J Gen Pract. 2023 Mar 30;73(729):e310-e317. doi: 10.3399/BJGP.2022.0194. Print 2023 Apr.
Although shared decision making (SDM) is key to delivering patient-centred care, there are barriers to GPs implementing SDM in practice. SDM training is undergoing development by organisations, including the Royal College of General Practitioners. However, GPs' perceptions of the delivery of SDM training in general practice remain largely unexplored.
To explore GPs' perceptions of teaching methods in SDM training.
Qualitative study of GPs with teaching roles at the University of Exeter Medical School.
Purposive sampling recruited 14 GPs. Semi-structured interviews explored their SDM educational experiences. Data were analysed using thematic framework analysis.
Three themes were identified. The GPs described role-play, receiving feedback, and on-the-job learning as modes of delivering SDM training that mostly informed their SDM in clinical practice positively. Learning from knowledgeable individuals and using realistic patient cases were perceived as beneficial components of SDM learning, although most learning occurred implicitly through reflections on their clinical experiences. The GPs identified that their training on SDM should reflect the uncertainty that is present when sharing decisions with patients in real-life general practice consultations. GPs also identified the targeting of individual GPs' SDM learning needs and explanation of the potential benefits of SDM on consultation outcomes as important methods to facilitate the implementation of SDM in practice.
To the authors' knowledge, this is the first UK study to explore GPs' perceptions of SDM training and provide recommendations for practice. As SDM occurs in partnership with patients, further research should obtain and incorporate patients' views alongside those of GPs in the evaluation of future programmes.
尽管共享决策（SDM）是提供以患者为中心的护理的关键，但全科医生在实践中实施 SDM 仍存在障碍。包括皇家全科医师学院在内的组织正在对 SDM 培训进行开发。然而，全科医生对一般实践中 SDM 培训的实施的看法在很大程度上仍未得到探索。
探讨全科医生对 SDM 培训教学方法的看法。
对埃克塞特大学医学院有教学角色的全科医生进行定性研究。
采用目的抽样法招募了 14 名全科医生。半结构化访谈探讨了他们的 SDM 教育经验。使用主题框架分析对数据进行分析。
确定了三个主题。全科医生描述了角色扮演、接受反馈和在职学习是提供 SDM 培训的模式，这些模式主要对他们在临床实践中的 SDM 产生了积极的影响。向有知识的人学习和使用现实的患者病例被认为是 SDM 学习的有益组成部分，尽管大多数学习是通过对临床经验的反思而隐含发生的。全科医生认为，他们的 SDM 培训应该反映在现实的一般实践咨询中与患者分享决策时存在的不确定性。全科医生还确定，针对个别全科医生的 SDM 学习需求，并解释 SDM 对咨询结果的潜在益处，是促进实践中 SDM 实施的重要方法。
据作者所知，这是第一项探索英国全科医生对 SDM 培训的看法并为实践提供建议的研究。由于 SDM 是与患者合作进行的，因此应在评估未来的计划时，从患者和全科医生的角度获取并纳入他们对 SDM 的看法。
