Educational programs to teach shared decision making to medical trainees: A systematic review.

Area of Science:

• Medical Education
• Patient-Clinician Communication
• Healthcare Quality Improvement

Background:

• Shared decision-making (SDM) is a collaborative process between patients and clinicians.
• There is a growing number of educational initiatives designed to teach SDM.
• Evaluating the effectiveness of these SDM educational programs is crucial.

Purpose of the Study:

• To systematically review and evaluate the evidence on the outcomes of SDM educational programs for medical trainees.
• To assess the impact of these programs on knowledge, attitudes, skills, behaviors, and patient outcomes.

Main Methods:

• A systematic review was conducted on studies teaching SDM to medical trainees.
• Independent and duplicate review processes were used for study selection, data extraction, and bias assessment.
• Eighteen studies were included in the analysis.

Main Results:

• Most programs targeted residents/fellows and combined didactic learning with practical experience (e.g., standardized patients).
• Participants reported satisfaction with the educational programs.
• The impact on knowledge, attitudes, and comfort with SDM was small, with no clear improvement in SDM skills. Clinical behavior and patient outcome evaluations were limited, and studies had a moderate risk of bias.

Conclusions:

• Current evidence, though of very low quality, indicates that SDM educational programs are well-received and offer minor gains in knowledge and comfort.
• The effect on clinical skills, professional behavior, and patient outcomes remains unclear.
• Future programs should integrate formal, systematic evaluation of effects on behavior and clinical practice.