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Structured reflection on shared decision making.

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Medical students improved their understanding of shared decision making (SDM) through critical reflection on clinical role models. This training highlighted SDM

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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.