A Need for Targeted Teaching of Shared Decision-Making as Identified from an Assessment of Client-Centered Communication Skills Training with Companion Animal Veterinarians

Shared decision-making has been increasingly discussed as a communication practice within veterinary medicine, and it is gaining more traction for diagnostic and treatment planning conversations and specifically offering a spectrum of care. This teaching tip describes the data from an investigation of veterinarians' shared decision-making in a pre-test/post-test communication skills training intervention that used a client-centered, skills-based communication approach. Practice teams from a purposive sample of four companion animal veterinary clinics in Texas participated in a 15-month communication skills intervention, including interactive group workshops and one-on-one communication coaching. To assess the outcome of the intervention, for nine participating veterinarians, appointments recorded pre- (<i>n </i>=<i> </i>85) and post-intervention (<i>n </i>=<i> </i> 85) were analyzed using the Observer OPTION 5 instrument to assess shared decision-making. The intervention effect was evaluated using mixed logistic regression, adjusting for appointment type. The communication intervention did not significantly impact participating veterinarians' demonstration of shared decision-making (pre<i> </i>=<i> </i>25.42, <i>n </i>=<i> </i>55; post<i> </i>=<i> </i>28.03, <i>n </i>=<i> </i>56; <i>p </i>=<i> </i>0.36). Appointment type was significantly associated with veterinarians' OPTION 5 scores (<i>p </i>=<i> </i>.0004) and health problem appointments (OPTION 5<i> </i>=<i> </i>30.07) demonstrated greater shared decision-making than preventive care appointments (OPTION 5<i> </i>=<i> </i>22.81). Findings suggest that client-centered, skills-based training traditionally used in veterinary curricula and continuing education may not foster the use of shared decision-making, which is a higher-order communication approach that may require a dedicated process-oriented training. This teaching tip highlights the need for a targeted stepwise approach to teach shared decision-making.