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Challenges in SDM education: The heterogeneity of SDM training programs and the search for consensus on core competencies

Date and Location

Session: 

P4.096

Date

Monday 23 September 2013 - 10:30 - 12:00

Location

Presenting author and contact person

Presenting author

France Légaré

Contact person

France Légaré
Abstract text
Background: One obstacle to integrating shared decision making (SDM) into routine clinical practice is the lack of standardized training for healthcare professionals. No international consensus exists about core competencies required to involve patients in medical decision making. We present an update of an inventory of SDM training programs for healthcare professionals and share reflections on SDM core competencies that emerged during an international interdisciplinary workshop. Methods: In 2010, we performed an international environmental scan to identify and analyze SDM training programs for healthcare professionals. We created an inventory of the programs (contact, date, language, country, objectives, target users) that is regularly updated. We also organized an interdisciplinary, international workshop in April 2012 and asked participants to identify core competencies for SDM training programs. Results: The inventory lists 80 training activities conducted between 1996 and 2012 in 15 countries and 11 languages. Fifty programs targeted licenced professionals, 15 targeted pre-licensure, 12 targeted both, and 3 did not report. Most programs (45/80) were developed after 2010. Components of 54 programs were analyzed in detail. Teaching methods and program duration vary greatly. Few programs (12/80) were rigorously evaluated. The international working group did not reach a consensus on a core set of competencies for SDM training programs. Some participants believed that existing SDM models should now be translated into core competencies for training, while others argued that without consensus on the definition of SDM this is premature. In discussing the desirability and feasibility of developing core competencies, two essential skill categories nevertheless emerged: relational and risk communication. Conclusions: Rapid development of new SDM training programs worldwide and lack of evidence on their effectiveness represent a challenge for reaching a consensus on core competencies for SDM training. An international research strategy is needed to establish solid evidence for recommending core competencies for SDM training.