A Trial Comparing Approaches to Shared Decision Making Skills Training for Clinicians

Not Applicable

Completed

• Conditions: Low Back Pain; Depression
• Interventions: Behavioral: DA viewing; Behavioral: Webinar; Behavioral: SPI feedback

• Registration Number: NCT02871739
• Lead Sponsor: Massachusetts General Hospital

Brief Summary

The Health Decision Sciences Center (HDSC) staff has deployed different approaches to training clinicians to engage patients in shared decision making for common medical tests and treatments. The purpose of the study is to compare the effectiveness of shared decision making (SDM) skills training courses using standardized patient interactions (SPI) and written evaluations.

Detailed Description

There is limited evidence on approaches to training clinicians to engage patients in shared decision making for common medical tests and treatments. The purpose of the study is to compare the effectiveness of different approaches to shared decision making (SDM) skills training. Participants will be randomly assigned to either receive two decision aids or a webinar to review. Participants will also be randomly assigned to receive feedback on standardized patient interaction rating their shared decision making skills and highlighting opportunities for improvement or not. Clinician participants will be assigned to one of four intervention groups using a 2x2 factorial design:

Group 1: Decision aid viewing with feedback Group 2: Decision aid viewing and no feedback Group 3: webinar with feedback Group 4: webinar and no feedback

The pilot study will provide evidence on the comparative effectiveness and feasibility on training formats to determine if:

* Clinicians improved in SDM communication skills

* Clinicians have an increased confidence to use SDM with their patients

* The training is acceptable to clinicians

Study Timeline

• Study Start: 2016-07
• Study First Submitted: 2016-08-09
• Study First Submitted QC: 2016-08-15
• Study First Posted: 2016-08-18
• Primary Completion: 2016-12
• Study Completion: 2016-12
• Results First Submitted: 2017-12-15
• Status Verified: 2018-09
• Results First Submitted QC: 2018-09-18
• Last Update Submitted: 2018-09-18
• Results First Posted: 2019-02-08
• Last Update Posted: 2019-02-08

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 23

Inclusion Criteria

• Adults 18 and older
• English speaking
• Physician
• Nurse Practitioner
• Physician Assistant
• Registered Nurse

Exclusion Criteria

• Not clinically active (research faculty only)
• Medical Trainees
• Medical Students
• Medical Assistants
• Social Workers

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: FACTORIAL

Arm && Interventions

Group	Intervention	Description
DA viewing with SPI Feedback	DA viewing	Group 1 receives three decision aids and feedback on their standardized patient (SPI) interaction rating their shared decision making skills and highlighting opportunities for improvement.
Webinar with SPI Feedback	SPI feedback	Group 3 receives an online, interactive webinar that focuses on SDM skills in clinical encounters and feedback on their standardized patient (SPI) interaction rating their shared decision making skills and highlighting opportunities for improvement.
DA viewing with SPI Feedback	SPI feedback	Group 1 receives three decision aids and feedback on their standardized patient (SPI) interaction rating their shared decision making skills and highlighting opportunities for improvement.
Webinar with SPI Feedback	Webinar	Group 3 receives an online, interactive webinar that focuses on SDM skills in clinical encounters and feedback on their standardized patient (SPI) interaction rating their shared decision making skills and highlighting opportunities for improvement.
DA viewing with no SPI Feedback	DA viewing	Group 2 receives three decision aids. This group does not receive any feedback from the SPI.
Webinar with no SPI Feedback	Webinar	Group 4 receives an online, interactive webinar that focuses on SDM skills in clinical encounters. This group does not receive any feedback from the SPI.

Primary Outcome Measures

Name	Time	Method
Change in Braddock's Informed Decision Making Score	Baseline (before intervention) and 4-6 weeks (after intervention)	Transcripts from standardized patient interactions (SPI) will be scored using Braddock's Informed Decision Making (IDM) framework to assess shared decision making skills. Scores with the Braddock's Informed Decision Making Framework range from 0 to 9; the higher scores are better. We subtracted the scores of the baseline SPI collected before the intervention from the second SPI collected 4-6 weeks later, after the intervention, to determine the change in IDM score for each participant and then compared change scores across study arms.