Mary Fay1, Stuart W Grande2, Kyla Donnelly3, Glyn Elwyn4. 1. Dartmouth Hitchcock Medical Center, Lebanon, USA; Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, USA. Electronic address: Mary.E.Fay@hitchcock.org. 2. The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, USA. Electronic address: Stuart.S.W.Grande@dartmouth.edu. 3. The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, USA. Electronic address: Kyla.Z.Donnelly.GR@dartmouth.edu. 4. The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, USA. Electronic address: glynelwyn@gmail.com.
Abstract
OBJECTIVES: To assess the impact, acceptability and feasibility of a short encounter tool designed to enhance the process of shared decision-making and parental engagement. METHODS: We analyzed video-recordings of clinical encounters, half undertaken before and half after a brief intervention that trained four clinicians how to use Option Grids, using an observer-based measure of shared decision-making. We also analyzed semi-structured interviews conducted with the clinicians four weeks after their exposure to the intervention. RESULTS: Observer OPTION(5) scores were higher at post-intervention, with a mean of 33.9 (SD=23.5) compared to a mean of 16.1 (SD=7.1) for pre-intervention, a significant difference of 17.8 (95% CI: 2.4, 33.2). Prior to using the intervention, clinicians used a consent document to frame circumcision as a default practice. Encounters with the Option Grid conferred agency to both parents and clinicians, and facilitated shared decision-making. Clinician reported recognizing the tool's positive effect on their communication process. CONCLUSIONS: Tools such as Option Grids have the potential to make it easier for clinicians to achieve shared decision-making. PRACTICE IMPLICATIONS: Encounter tools have the potential to change practice. More research is needed to test their feasibility in routine practice.
OBJECTIVES: To assess the impact, acceptability and feasibility of a short encounter tool designed to enhance the process of shared decision-making and parental engagement. METHODS: We analyzed video-recordings of clinical encounters, half undertaken before and half after a brief intervention that trained four clinicians how to use Option Grids, using an observer-based measure of shared decision-making. We also analyzed semi-structured interviews conducted with the clinicians four weeks after their exposure to the intervention. RESULTS: Observer OPTION(5) scores were higher at post-intervention, with a mean of 33.9 (SD=23.5) compared to a mean of 16.1 (SD=7.1) for pre-intervention, a significant difference of 17.8 (95% CI: 2.4, 33.2). Prior to using the intervention, clinicians used a consent document to frame circumcision as a default practice. Encounters with the Option Grid conferred agency to both parents and clinicians, and facilitated shared decision-making. Clinician reported recognizing the tool's positive effect on their communication process. CONCLUSIONS: Tools such as Option Grids have the potential to make it easier for clinicians to achieve shared decision-making. PRACTICE IMPLICATIONS: Encounter tools have the potential to change practice. More research is needed to test their feasibility in routine practice.
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Authors: Marie-Anne Durand; Renata W Yen; A James O'Malley; Danielle Schubbe; Mary C Politi; Catherine H Saunders; Shubhada Dhage; Kari Rosenkranz; Julie Margenthaler; Anna N A Tosteson; Eloise Crayton; Sherrill Jackson; Ann Bradley; Linda Walling; Christine M Marx; Robert J Volk; Karen Sepucha; Elissa Ozanne; Sanja Percac-Lima; Emily Bergin; Courtney Goodwin; Caity Miller; Camille Harris; Richard J Barth; Rebecca Aft; Sheldon Feldman; Amy E Cyr; Christina V Angeles; Shuai Jiang; Glyn Elwyn Journal: Cancer Date: 2020-11-10 Impact factor: 6.860