Towards a feasible model for shared decision making: focus group study with general practice registrars

Area of Science:

• Medical Education
• Patient-Centered Care
• General Practice

Background:

• General practice registrars reported a lack of formal training in patient involvement.
• Registrars' views on patient involvement varied, from paternalistic to egalitarian approaches.

Purpose of the Study:

• To explore general practice registrars' views on involving patients in decision-making.
• To assess the feasibility of the shared decision-making model in simulated general practice consultations.

Main Methods:

• Qualitative study utilizing focus group interviews.
• 39 registrars and 8 course organizers participated in simulated consultations with 3 simulated patients.
• Content analysis of reactions elicited post-consultation.

Main Results:

• Registrars identified a need for skills in patient involvement.
• Key factors for shared decision-making included information availability, decision timing, and patient readiness.
• Registrars expressed diverse opinions on patient engagement, from paternalism to egalitarianism.

Conclusions:

• Shared decision-making involves openly discussing uncertainties and data limitations, which can cause anxiety for both patients and clinicians.
• Advancing patient involvement requires enhancing both professional skills and attitudes.
• The study outlines necessary steps for progress in shared decision-making within general practice.