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Area of Science:

  • Medical Communication
  • Shared Decision-Making (SDM)
  • Pediatric Healthcare

Background:

  • Shared decision-making (SDM) is crucial for patient-centered care, involving patients in medical choices.
  • Effective communication of treatment options is essential for successful SDM.
  • Understanding how clinicians create choice awareness is key to improving SDM implementation.

Purpose of the Study:

  • To characterize the methods pediatric clinicians use to create choice awareness during SDM.
  • To analyze clinician communication strategies for presenting multiple treatment options to patients.
  • To identify variations in how choice awareness is established in pediatric clinical encounters.

Main Methods:

  • Secondary analysis of a cross-sectional observational study involving videotaped pediatric encounters.
  • Conversation analysis applied to 34 shared decisions from 21 encounters where clinicians reported performing SDM.
  • Inclusion of clinicians from 6 pediatric specialties at a single US children's hospital.

Main Results:

  • Two primary approaches for creating choice awareness were identified: the 'single-option approach' and the 'multiple-options approach'.
  • The single-option approach presents one recommended option initially, allowing others to emerge if needed.
  • The multiple-options approach explicitly presents all available choices upfront, facilitating SDM more unambiguously.

Conclusions:

  • Pediatric clinicians exhibit variability in establishing choice awareness during SDM.
  • The multiple-options approach appears more effective in unambiguously facilitating SDM.
  • Standardizing the communication of choice awareness can enhance the implementation and effectiveness of SDM.