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Updated: Jan 20, 2026

Simultaneous Interference Reflection and Total Internal Reflection Fluorescence Microscopy for Imaging Dynamic Microtubules and Associated Proteins
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Reflecting on shared decision making: A reflection-quantification study.

Marleen Kunneman1,2, Christina M LaVecchia1, Naykky Singh Ospina3

  • 1Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, Minnesota.

Health Expectations : an International Journal of Public Participation in Health Care and Health Policy
|August 16, 2019
PubMed
Summary
This summary is machine-generated.

Encouraging patients to reflect before rating shared decision-making (SDM) did not significantly improve survey performance. This "stop-and-think" approach did not reduce ceiling effects in patient-reported outcome measures.

Keywords:
argumentationcommunicationmeasurementpatient involvementshared decision making

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Area of Science:

  • Healthcare research
  • Patient experience
  • Clinical communication

Background:

  • Self-reported measures of shared decision making (SDM) can be limited by ceiling and halo effects.
  • Encouraging patients to reflect before rating may improve the accuracy of SDM assessments.

Purpose of the Study:

  • To investigate if a "stop-and-think" reflection intervention improves patient-reported measures of SDM.
  • To assess the impact of reflection on reducing ceiling effects in SDM surveys.

Main Methods:

  • Two studies were conducted with diverse US patient samples.
  • Study 1 rephrased SDM survey items to prompt reflection.
  • Study 2 used open-ended questions to encourage reflection before completing the SDM scale.

Main Results:

  • Adding reflection slightly lowered SDM scores and reduced ceiling scores in Study 1, but not significantly.
  • Reflection did not significantly alter SDM score distribution or ceiling scores in Study 2.
  • Patients reported high confidence in their care plans, weakly correlated with SDM scores.

Conclusions:

  • Reflection-before-quantification interventions may not effectively enhance patient-reported SDM measures with significant ceiling effects.
  • Further research is needed to develop strategies that mitigate bias in SDM outcome measures.