From knowledge to action: a blended training to enhance shared decision making skills in primary care physicians – a pilot study

BACKGROUND: Shared decision making (SDM) is a process to actively involve both patients and clinicians to weigh the benefits and risks of a healthcare decision, based on clinical guidelines and the patients' preferences, needs and values. Despite the ethical foundation of SDM, its implementation remains limited. Possible physician-reported barriers for this limited uptake include insufficient level of SDM training. Training physicians in SDM could be a part of the puzzle. A recent systematic review showed that there is a shift towards blended training more than live or online learning. We therefore developed and pilot-tested a blended training program for general practitioners (GPs) in SDM in Belgium. Acquired skills were evaluated by three viewpoint - observer, patient and physician. METHODS: In a pre-post study, GPs participated in the blended training program consisting of an e-learning and a face-to-face session with simulation patients (SPs) GPs and SPs completed surveys before (T0) and after (T1) the blended training. Consultations were recorded for analysis by observer reported scales (OPTION12 and 4SDM scale). Secondary outcomes were SDM-Q9-patient, satisfaction with consultation, knowledge and intentions towards SDM. FINDINGS: Ten GPs were included. There was a significant increase in both OPTION12 (mean (SD) from 19·37 before to 37·70 after training, p = 0·0010, 95% CI [9·65 - 27·02]) and 4SDM scale (mean (SD) from 9·2 (4·66) before to 17·00 (5·08) after training, p = 0·0001, 95% CI [5·47 - 10·13]) with a moderate-large effect after training (Cohen's D = 2·39, 95% CI [1·13 - 3·63]. INTERPRETATION: The SDM blended training for GPs improved their skills, knowledge and intentions in SDM in simulated consultations on the short term.