Evidence summaries (decision boxes) to prepare clinicians for shared decision-making with patients: a mixed methods...

Area of Science:

• Health Professions Education
• Clinical Decision Support
• Evidence-Based Practice

Background:

• Decision boxes (Dboxes) offer research evidence for clinical questions without a single best answer.
• They serve as rapid training tools for clinician-patient communication and shared decision-making.
• This study investigated barriers and facilitators to integrating Dbox information into clinical practice.

Purpose of the Study:

• To assess the utility and impact of Decision boxes (Dboxes) in primary healthcare settings.
• To explore clinicians' intentions and attitudes towards using Dboxes for patient communication.
• To identify contextual factors influencing the adoption of Dboxes in clinical practice.

Main Methods:

• A mixed-methods study using a sequential explanatory design.
• Recruitment of family physicians, residents, and nurses from six primary healthcare clinics.
• Weekly delivery of eight Dboxes via email, followed by web questionnaires and focus groups/interviews.

Main Results:

• Clinicians reported Dboxes would improve practice (54%) and intended to use them for patients (40%).
• Intention to use Dboxes was linked to social norms, perceived behavioral control, and attitude (Theory of Planned Behaviour).
• Clinicians desired co-interventions like patient decision aids, shared decision-making training, and printed Dboxes.

Conclusions:

• Decision boxes are perceived positively by clinicians.
• Customization and integration support are key for successful Dbox implementation.
• Enhancing Dboxes with clear summaries and accessible formats would improve usability.