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Teaching Shared Decision Making to Family Medicine Residents: A Descriptive Study of a Web-Based Tutorial
Maxime Dion1,2, Ndeye Thiab Diouf1,3, Hubert Robitaille1
1Population Health and Practice-Changing Research Group, CHU de Québec Research Centre, Saint-François-d'Assise Hospital, Quebec, QC, Canada.
JMIR Medical Education
|December 21, 2016
Summary
Family medicine residents showed increased use of a web-based antibiotic decision-making tutorial, but it was less effective for shared decision-making (SDM) knowledge. Improved data collection is needed to fully evaluate such training programs.
Area of Science:
- Medical Education
- Digital Health Interventions
- Family Medicine Training
Background:
- A web-based tutorial, DECISION+2, was developed to train family physicians in shared decision making (SDM) for antibiotic use in acute respiratory infections (ARIs).
- The tutorial is mandatory for second-year family medicine residents at Université Laval, Canada.
- Current understanding of tutorial usage, knowledge impact, and participation assessment is limited.
Purpose of the Study:
- To describe the longitudinal usage patterns of the DECISION+2 web-based training platform by family medicine residents.
- To evaluate the tutorial's effect on residents' knowledge scores over time.
- To identify necessary data for a comprehensive analysis of usage and knowledge acquisition.
Main Methods:
- Analysis of participation and usage data for the web-based tutorial and its pre- and post-knowledge tests.
- Categorization of residents into three log-in periods (2012-2015) to compare participation rates.
- Statistical analysis (Cochran-Armitage, Wilcoxon signed-rank tests) of knowledge score changes and identification of data gaps.
Main Results:
- Out of 387 eligible residents, 247 (63.8%) accessed the tutorial, with participation rates varying significantly between cohorts (P=.006).
- For the 109 residents completing both tests, significant improvements were observed in total and category knowledge scores (all P<.001).
- Knowledge gains in shared decision-making (SDM) were not significant (P>.99, P=.25), and data were insufficient to link tutorial use to score improvements.
Conclusions:
- Resident engagement with the web-based tutorial increased over time, particularly after SDM program changes.
- The tutorial was more effective in improving diagnosis and treatment knowledge than SDM knowledge.
- Enhanced data collection is crucial for effectively evaluating web-based SDM tutorials and their impact on resident knowledge.
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