scholarly journals Identifying Entrustable Professional Activities for Shared Decision Making in Postgraduate Medical Education: A National Delphi Study

2020 ◽  
Vol 96 (1) ◽  
pp. 126-133
Author(s):  
Anouk Baghus ◽  
Esther Giroldi ◽  
Jean Muris ◽  
Anne Stiggelbout ◽  
Marjolein van de Pol ◽  
...  
Keyword(s):  
Decision Making ◽  
Medical Education ◽  
Shared Decision Making ◽  
Delphi Study ◽  
Postgraduate Medical Education ◽  
Entrustable Professional Activities ◽  
Shared Decision ◽  
Professional Activities

scholarly journals THU0647-HPR SHARED DECISION MAKING AMONGST RHEUMATOLOGISTS IN TRAINING IN THE NETHERLANDS: WHERE DO WE STAND?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 568.2-568
Author(s):  
L. Kranenburg ◽  
M. Dankbaar ◽  
N. Basoski ◽  
W. Van den Broek ◽  
J. Hazes
Keyword(s):  
Decision Making ◽  
The Netherlands ◽  
Shared Decision Making ◽  
Online Survey ◽  
Daily Practice ◽  
Clear Understanding ◽  
Shared Decision ◽  
Professional Activities ◽  
Self Evaluation ◽  
The Subject

Background:The training curriculum for rheumatologists in training in the Netherlands describes competences and entrusted professional activities (EPA) to monitor the progress in learning. However, this training program does not discuss training of Shared Decision Making. As the basis for shared care and patient participation is made during these years, the question arises how rheumatologist in training think about Shared Decision Making and how they use this in daily practice.Objectives:Inventory of vision, experience and self-evaluation of skills related to Shared Decision Making amongst rheumatologists in training in the Netherlands in order to identify barriers in the implementation of Shared Decision Making in daily practice.Methods:Qualitative data was collected from on online survey amongst rheumatologists in training who were registered in January 2018 by the Dutch Society of Rheumatology.Results:Forty-two rheumatologists in training from various years of training responded (60%). Respondents think that Shared Decision Making is important. A third applies Shared Decision Making on a regular basis in daily practice. Self rating of skills for Shared Decision Making varies from sufficient to good. However, respondents are uncertain about their performance due to a lack of feedback and unclearness of the concept. They indicate that Shared Decision Making is not possible for all patients and find it difficult to assess whether the patient has a clear understanding of the options. Patient’s preferences are discussed only by 33% of the doctors on a regular basis when starting new treatment.Conclusion:Rheumatologists in training agree on the importance of Shared Decision Making, but are uncertain about their performance. Unclearness of the concept is described as a known barrier in literature1,2and is frequently mentioned by respondents. Rheumatologist in training indicate that not all patients are fit for Shared Decision Making. Regarding the limited training on the subject this could also be a misjudgment of patients preferences and lack of experience how to deal with different patient types. There is a clear plea for more training and feedback on the subject. Training should be integrated in the curriculum focusing on how to assess patients preferences and how to apply Shared Decision Making also for patients who indicate to leave decisions up to their doctor.References:[1]van Veenendaal, H.et al.Accelerating implementation of shared decision-making in the Netherlands: An exploratory investigation.Patient Educ Couns101, 2097-2104 (2018).[2]Legare, F., Ratte, S., Gravel, K. & Graham, I. D. Barriers and facilitators to implementing shared decision-making in clinical practice: update of a systematic review of health professionals’ perceptions.Patient Educ Couns73, 526-535 (2008).Disclosure of Interests:Laura Kranenburg Grant/research support from: Pfizer and UCB for the development of the Reuma App, a tool to support selfmanagement for patients. This is not used for the research related to the submitted abstract., Mary Dankbaar: None declared, Natalja Basoski: None declared, Walter Van den Broek: None declared, Johanna Hazes: None declared

scholarly journals OP0331-HPR BARRIERS TO SHARED DECISION-MAKING WITH WOMEN OF REPRODUCTIVE AGE AFFECTED BY CHRONIC INFLAMMATORY DISEASES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 203-203
Author(s):  
S. Murray ◽  
R. Fischer-Betz ◽  
M. Augustyniak ◽  
J. Murase ◽  
C. Nelson-Piercy ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Medical Education ◽  
Mixed Methods ◽  
Shared Decision Making ◽  
Reproductive Age ◽  
Second Phase ◽  
Shared Decision ◽  
Women Of Reproductive Age ◽  
Advisory Boards

Background:Previous research has indicated that women with a chronic inflammatory disease (CID) are likely to discontinue treatment during pregnancy. [1] Reasons for this are complex, including sub-optimal integration of shared decision-making (SDM) into practice.Objectives:The purpose of this study was to assess: 1) physicians’ competencies in risk assessment, treatment and management of women of reproductive age (WoRA) with a CID, and 2) clinical gaps, barriers and challenges to SDM with these patients.Methods:A mixed-methods needs assessment was conducted. [2] Participants included rheumatologists and dermatologists practicing in Germany, United Kingdom, or United States, with at least three years of experience. Exposure to patients diagnosed with rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis or psoriasis was required. A first phase involved collection and thematic analysis of data from semi-structured interviews to identify main challenge areas. The second phase consisted of online surveys to validate and quantify identified challenges, gaps and barriers. Chi-square and Kruskal Wallis H statistical tests were performed to assess differences by specialty, country and gender. Qualitative and quantitative findings were triangulated with insight from experts in medical education and relevant behavioural and clinical fields. [3] The present summary reports data pertaining to rheumatologists only.Results:A total of 24 interviews and 173 surveys were completed with rheumatologists. Depending on the country and specific item, 22% to 64% reported having sub-optimal knowledge of treatment options, patient education aids, and strategies to assess treatment adherence among WoRA with a CID (see figure 1). In addition, 36% reported having sub-optimal knowledge of methods to achieve SDM. Unplanned pregnancies were reported as a barrier to prescribing biologics to WoRA with a CID. Yet, 61% of rheumatologists reported having sub-optimal skills discussing contraceptive methods with patients. In addition, 41% reported having sub-optimal skills adjusting treatment according to changes in pregnancy status or child-bearing aspirations. Few differences in clinical gaps were observed by gender. Notably, a greater proportion of male rheumatologists reported having sub-optimal skills approaching WoRA in a way that makes them feel comfortable discussing their health concerns, compared to female rheumatologists (52% vs. 30%, p=0.046). This skill gap was identified as a contributing barrier to SDM with these patients.Conclusion:This study identified multiple challenges, gaps and barriers relevant to rheumatologists that prevent optimal SDM, risk assessment, treatment and management of WoRA with CID. Findings may be used to develop medical education and continuous professional development interventions for target learners.References:[1]Tsao NW, Lynd LD, Sadatsafavi M, Hanley G and De Vera MA. Patterns of biologics utilization and discontinuation before and during pregnancy in women with autoimmune diseases: a population-based cohort study.Arthritis Care Res.,2018;70(7):979-986.[2]Creswell JW, Klassen AC, Plano Clark VL, Smith KC. Best practices for mixed methods research in the health sciences, 2nd Ed. Bethesda: NIH, 2018:541-545,.[3]Turner SF, Cardinal LB, Burton RM, A triangulation-based framework and roadmap.Organ. Res. Methods,2017;20(2): 243-26.Acknowledgments:This research was financially supported with educational funds from UCB BioPharma SRL. The authors thank T. Kellner for his contribution.Disclosure of Interests:Suzanne Murray: None declared, Rebecca Fischer-Betz Consultant of: UCB, Speakers bureau: Abbvie, Amgen, Biogen, BMS, Celgene, Chugai, GSK, Janssen, Lilly, Medac, MSD, Novartis, Roche, UCB, Pfizer., Monica Augustyniak: None declared, Jenny Murase Consultant of: I have led advisory boards for UCB., Speakers bureau: I have done non-branded talks on psoriasis management in women for UCB., Catherine Nelson-Piercy Consultant of: I have received consultancy fees from UCB, Speakers bureau: I have received fees for speaking from UCB., Ivo Vlaev Consultant of: For UCB., Speakers bureau: For UCB, Pfizer, Novartis and boehringer Ingelheim., Cecile Ecoffet Shareholder of: UCB, Employee of: UCB, Morgan Peniuta: None declared, Dean Jenkins Employee of: UCB

Do continuing medical education articles foster shared decision making?

2010 ◽  
Vol 30 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Michel Labrecque ◽  
Valérie Lafortune ◽  
Judith Lajeunesse ◽  
Anne-Marie Lambert-Perrault ◽  
Hermes Manrique ◽  
...  
Keyword(s):  
Decision Making ◽  
Medical Education ◽  
Shared Decision Making ◽  
Continuing Medical Education ◽  
Shared Decision

Mapping the Demand for Serious Games in Postgraduate Medical Education Using the Entrustable Professional Activities Framework

2015 ◽  
Vol 4 (5) ◽  
pp. 381-386 ◽  
Author(s):  
Maurits Graafland ◽  
Olle Ten Cate ◽  
Jan-Pieter van Seventer ◽  
Jan Maarten C. Schraagen ◽  
Marlies P. Schijven
Keyword(s):  
Medical Education ◽  
Serious Games ◽  
Postgraduate Medical Education ◽  
Entrustable Professional Activities ◽  
Professional Activities

scholarly journals Towards a global framework for assessing male involvement in maternal health: results of an international Delphi study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e051361
Author(s):  
Anna Galle ◽  
Sally Griffin ◽  
Nafissa Osman ◽  
Kristien Roelens ◽  
Olivier Degomme
Keyword(s):  
Decision Making ◽  
Maternal Health ◽  
Gender Equality ◽  
Shared Decision Making ◽  
Delphi Study ◽  
Male Involvement ◽  
Shared Decision ◽  
Emotional Involvement ◽  
International Panel ◽  
Sensitivity Specificity

PurposeCurrently, no standard instrument exists for assessing the concept of male involvement in maternal health, hampering comparison of results and interpretation of the literature. The aim of this study was to construct the key elements of a global multidimensional male involvement framework, based on the latest evidence and input of experts in the field.MethodsFor this purpose, a Delphi study, including an international panel of 26 experts, was carried out. The study consisted of three rounds, with 92% of respondents completing all three surveys. Experts were asked to rate indicators within six categories in terms of validity, feasibility, sensitivity, specificity and context robustness. Furthermore, they were encouraged to clarify their rating with open text responses. Indicators were excluded or adapted according to experts’ feedback before inclusion. A 85% agreement was used as threshold for consensus.ResultsA general consensus was reached for a global framework for assessing male involvement in maternal health, consisting of five categories: involvement in communication, involvement in decision-making, practical involvement, physical involvement and emotional involvement.ConclusionsUsing the male involvement framework as a tool to assess the concept of male involvement in maternal health at local, national, and international levels could allow improved assessment and comparison of study findings. Further research is needed for refining the indicators according to context and exploring how shared decision-making, gender equality and women’s empowerment can be assessed and facilitated within male involvement programmes.

scholarly journals Patient Education and Continuing Medical Education to Promote Shared Decision-Making. A Systematic Literature Review

2019 ◽  
Vol 16 (14) ◽  
pp. 2482
Author(s):  
Anke Wagner ◽  
Natalia Radionova ◽  
Monika A. Rieger ◽  
Achim Siegel
Keyword(s):  
Decision Making ◽  
Medical Education ◽  
Patient Education ◽  
Shared Decision Making ◽  
Continuing Medical Education ◽  
Evaluation Studies ◽  
Decision Aids ◽  
Shared Decision ◽  
Cochrane Database ◽  
Study Designs

Background: Over recent years, the use of decision aids to promote shared decision-making have been examined. Studies on patient education and on continuing medical education for physicians are less common. This review analyzes intervention and evaluation studies on patient education and continuing medical education which aim to enhance shared decision-making. The following study parameters are of interest: Study designs, objectives, numbers of participants in the education courses, interventions, primary results, and quality of the studies. Methods: We systematically searched for suitable studies in two databases (Pubmed and the Cochrane Database of Systematic Reviews) from the beginning of April through to mid-June 2016. Results: 16 studies from a total of 462 hits were included: Three studies on patient education and 13 studies on continuing medical education for physicians. Overall, the study parameters were heterogeneous. Major differences were found between the courses; how the courses were conducted, their length, and participants. Conclusions: The differences found in the studies made it difficult to compare the interventions and the results. There is a need for studies that systematically evaluate and further develop interventions in this area to promote shared decision-making.

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