Development and preliminary evaluation of a decision coach training module for nurses in Norway

Shared decision-making (SDM) is a collaborative patient-centred process for arriving at informed healthcare decisions. Decision coaching can help support SDM when combined with patient decision aids. As part of a meta-curriculum "Ready for SDM" for training different healthcare professionals in SDM, we developed and pilot-tested a new module designed to train nurses as decision coaches. The study assessed nurses' perceptions of a decision coach training module, focusing on its feasibility, acceptability and its role in developing decision coaching capabilities.

We used a two-phase approach guided by the Knowledge-to-Action Framework. In the first phase, we developed a decision coach training module. The second phase involved preliminary testing, using a descriptive design with qualitative and quantitative methods. We recruited a convenience sample of participants from two hospitals. Participants completed questionnaires at the end of Part A (classroom training). The assessment was informed by Kirkpatrick's first three levels of educational outcomes: reaction (acceptability), learning (self-reported attitudes, intentions and confidence) and behaviour (practical application of decision coaching). A post-hoc inquiry investigated low participation in Part B of the coach training. Qualitative data underwent content analysis and quantitative data were analysed using descriptive statistics.

The development resulted in a decision coach training comprising a Part A (6 h) on SDM and decision coaching fundamentals and a Part B (1 h) which involved practical application of decision coaching in the participants' own practice (audio recorded) with self-appraisal and individualised feedback. In preliminary testing with 19 nurses from seven clinical departments, 90% of participants rated Part A as acceptable and relevant to practice. Only one nurse completed Part B due to reluctance to audio record coaching sessions. The most reported perceived barrier was time constraints. Key perceived facilitators identified were interprofessional collaboration, management support and additional practical training.

Decision coach training was feasible to deliver in the classroom. Participants reported Part A as acceptable and relevant to their practice. The second part, including an audio recording component, proved unfeasible. Further research should explore alternative methods for skill assessment and feedback in clinical practice. The results from this study will inform further refinement of the Norwegian Ready for SDM meta-curriculum and implementation strategies, particularly regarding the practical training components.

Retrospectively registered (14.02.2023) at ISRCTN (ISRCTN44143097).