Structured reflection on shared decision making

Area of Science:

• Medical Education
• Health Professions Education
• Patient-Centered Care

Background:

• Shared decision making (SDM) offers benefits but faces slow clinical integration.
• Existing medical curricula rarely involve students reflecting on clinicians' SDM practices.
• Role models are crucial for fostering patient-centered attitudes in medical students.

Purpose of the Study:

• To evaluate an educational intervention for undergraduate medical students focused on SDM.
• To assess the impact of critical reflection on clinicians' SDM practices.
• To explore students' engagement with the SHARE (seek, help, assess, reach, evaluate) SDM tool.

Main Methods:

• Qualitative evaluation of a small group educational intervention.
• Students used a structured reflective template based on the SHARE SDM tool.
• Thematic analysis of 44 student templates to evaluate learning and engagement.

Main Results:

• Four themes emerged: new learning, deconstructing SDM, participant responses, and learning struggles.
• Students positively engaged with the SHARE tool, critiquing clinical SDM examples.
• Participants identified areas for improving SDM in practice and acknowledged its scarcity.

Conclusions:

• Structured training promoting critical reflection on role models shifts medical students' SDM understanding and attitudes.
• Ethical arguments, evidence of benefits, and alignment with core values facilitated student acceptance of SDM.
• Students grappled with power, risk, and time constraints, showing empathy for patients and clinicians, and noting SDM's limited practice.