Understanding the Impact of Medical Educational Interventions in Training Shared Decision Making for Residents

Background/Objective: Shared decision-making (SDM) is a model of communication between the doctor and patient that helps to empower the patient. SDM is a recent improvement in patient care that allows the consideration of the patient's preferences in the planning and implementation of the treatment plan, which is patient-centered. Purpose: This review aimed to 1) evaluate the nature of interventions implemented in the studies and 2) assess the level of effectiveness employed within these studies using Kirkpatrick’s learning evaluation. Methods: Systematic searches were conducted in five electronic databases: Medline, PsycInfo, Web of Science, CINAHL, and Scopus. Methodological rigor was assessed using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). Kirkpatrick's Evaluation Hierarchy was used to categorize the level of evaluation completed within the studies. Results: In total, 12 articles were included in the final analysis. Interventions were most rated as positive in combining training methods to teach residents SDM with decisional aids (83.3%). In addition, there were significant improvements in residents' knowledge (90%), changes in attitude (75.0%), changes in behavior intended and self-reported by participants (n = 8/9; 88.8%), organizational/clinical changes that aided patient collaboration and decision (n = 1; 8.3%). Conclusion: From this study, educational interventions applied to training SDM skills in residents achieved positive outcomes; however, they could achieve more positive outcomes when diverse approaches to training are applied.