Resources for Educational interventions for shared decision making and the role of patient Agency: A Systematic Review

This deposit contains the the search strategies and the related PRISMA checklist for the manuscript: Educational interventions for shared decision making and the role of patient Agency:  A Systematic Review. 

Abstract: 

Background:  Shared decision making is critical to patient-centered care and yet there is limited consensus on effective teaching approaches for training physicians in this domain. As a collaborative process in which the patient and physician co-create a decision, patient and relational agency may be important contributors and studies with patient-reported outcomes may identify successful approaches and determine gaps in pedagogy.  The authors conducted a systematic review of educational interventions for shared decision making, focusing on patient-reported outcomes and consideration of agency. 

Methods:  Multiple databases were searched for studies describing educational interventions with patient-level outcomes published between 2000 and 2020.   Data about the educational methods used were extracted and included studies were assessed for quality.  Thematic analysis was performed to identify the potential role of agency.

Results:  26 articles were identified describing 17 unique studies.  Educational interventions were diverse in duration and content, with multiple components.  Three-quarters of studies used role play or simulated patients and 82% included tools to facilitate shared decisions.  Although no articles explicitly discussed facilitating agency as a component of the intervention or as an outcome, one qualitative study demonstrated themes of patient and relational agency.

Conclusions:  Educational interventions included small group discussion, decision aids, role play, and simulated patients, and improved a range of patient outcomes. Interventions have not included explicit instructional design around agency, but qualitative analyses demonstrated interventions may facilitate agency and shared decision making. Future instructional strategies should consider the complexity inherent in co-constructing decisions.