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Does training general practitioners result in more shared decision making during consultations?

A R J Sanders1, J M Bensing2, M A L U Essed1

  • 1Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Mailbox 85500, 3508 GA Utrecht, The Netherlands.

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Summary

Training general practitioners (GPs) in shared decision-making (SDM) improved patient autonomy and consultation quality. However, the study suggests focusing more on patients' treatment expectations for effective SDM.

Keywords:
Medical educationPatient participationPatient-oriented outcomesPrimary health careShared decision-making

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Area of Science:

  • Healthcare research
  • Clinical practice improvement
  • Patient-centered care

Background:

  • Shared decision-making (SDM) is crucial for patient recovery.
  • General practitioners (GPs) play a key role in implementing SDM.
  • Understanding the impact of SDM training on GP behavior is essential.

Purpose of the Study:

  • To evaluate the effect of SDM training on GP behavior.
  • To assess if trained GPs exhibit enhanced SDM and reinforcement of patient expectations.
  • To compare consultation outcomes between trained and untrained GPs.

Main Methods:

  • A clustered randomized controlled trial was conducted.
  • 86 consultations by trained GPs and 89 by untrained GPs were analyzed.
  • Primary outcomes included SDM (OPTION scale) and positive reinforcement; secondary outcomes were patient autonomy and consultation duration.

Main Results:

  • Trained GPs demonstrated significantly higher SDM and patient autonomy.
  • Consultations with trained GPs were, on average, three minutes longer.
  • The average SDM score for the trained group remained below the average.

Conclusions:

  • GP training enhanced SDM behaviors and patient autonomy.
  • The observed improvements were not linked to adopting a patient perspective.
  • Measuring the reinforcement of patients' positive expectations was unreliable.