An Initiative to Improve Nephrology Clinician Confidence in Shared Decision Making

Area of Science:

• Nephrology
• Medical Education
• Health Communication

Background:

• Shared decision making (SDM) is crucial for kidney failure treatment decisions but is often suboptimal.
• Nephrology clinicians require enhanced skills for effective SDM.

Purpose of the Study:

• To educate nephrology clinicians on implementing comprehensive SDM with empathetic communication.
• To improve the presentation of treatment options, including conservative care, in kidney failure.

Main Methods:

• A single-arm educational intervention involving three virtual sessions for 80 nephrology clinicians.
• Utilized the Ask-Tell-Ask approach and empathetic communication strategies.
• Pre- and post-session confidence ratings were assessed using a 7-point scale and analyzed with the Wilcoxon signed-rank test.

Main Results:

• Median confidence ratings significantly increased for all learning objectives post-intervention (1-2 points).
• Large effect sizes (Cohen's r) were observed for most objectives, particularly in using SDM elements (r=0.84) and presenting all options (r=0.75).
• Qualitative feedback corroborated the quantitative findings.

Conclusions:

• Explicit instruction significantly boosted clinician confidence in conducting comprehensive SDM.
• This educational approach shows promise for improving SDM quality in chronic kidney disease and kidney failure care.
• Further research is needed to assess long-term retention and application in practice.