Family medicine residents' perspectives on shared decision-making: A mixed methods study.

Area of Science:

• Medical Education
• Clinical Decision-Making
• Health Professions Research

Background:

• Shared decision-making (SDM) is crucial for patient-centered care.
• Understanding clinician willingness to engage in SDM is essential for effective implementation.
• Resident perspectives on SDM, particularly concerning perceived stakes, are not fully understood.

Purpose of the Study:

• To assess the willingness of Family Medicine residents to engage in shared decision-making.
• To investigate if the perceived stakes of a clinical situation influence residents' willingness to participate in SDM.

Main Methods:

• A sequential mixed-methods design was employed.
• Phase one involved residents completing the IncorpoRATE measure to quantify willingness for SDM.
• Phase two included qualitative content analysis of interviews exploring residents' perceptions of high versus low stakes situations.

Main Results:

• Residents reported significantly higher willingness for SDM in low-stakes situations (mean score 7.59) compared to high-stakes situations (mean score 4.38).
• Qualitative analysis revealed variability in residents' interpretations of the stakes associated with similar clinical decisions.
• Perceived stakes significantly influenced residents' engagement in shared decision-making.

Conclusions:

• Family Medicine residents demonstrate a reduced willingness to engage in shared decision-making when clinical situations are perceived as high-stakes.
• The subjective interpretation of clinical situation stakes by residents can influence the application of shared decision-making.
• Further research is warranted to explore resident understanding and appropriate application of shared decision-making in Family Medicine settings.