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Abstract
Introduction Shared decision making (SDM) is a goal of modern medicine; however, it is not currently embedded in routine care. Barriers include clinicians’ attitudes, lack of knowledge and training and time constraints. Our goal is to support the development and delivery of a robust SDM curriculum in medical education. Our objective is to assess undergraduate medical students’ knowledge of and attitudes towards SDM in four countries.
Methods and analysis The first phase of the study involves a web-based cross-sectional survey of undergraduate medical students from all years in selected schools across the United States (US), Canada and undergraduate and graduate students in the Netherlands. In the United Kingdom (UK), the survey will be circulated to all medical schools through the UK Medical School Council. We will sample students equally in all years of training and assess attitudes towards SDM, knowledge of SDM and participation in related training. Medical students of ages 18 years and older in the four countries will be eligible. The second phase of the study will involve semistructured interviews with a subset of students from phase 1 and a convenience sample of medical school curriculum experts or stakeholders. Data will be analysed using multivariable analysis in phase 1 and thematic content analysis in phase 2. Method, data source and investigator triangulation will be performed. Online survey data will be reported according to the Checklist for Reporting the Results of Internet E-Surveys. We will use the COnsolidated criteria for REporting Qualitative research for all qualitative data.
Ethics and dissemination The study has been approved for dissemination in the US, the Netherlands, Canada and the UK. The study is voluntary with an informed consent process. The results will be published in a peer-reviewed journal and will help inform the inclusion of SDM-specific curriculum in medical education worldwide.
- Shared decision making
- Medical education & training
- Patient-centered care
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Footnotes
Contributors M-AD planned the study and designed the initial iteration of the survey. RY and M-AD developed the second iteration of the survey, in collaboration with PJB, NC and GE. RY obtained ethical approval in the USA and piloted the survey. JA facilitated the recruitment of medical schools in the Netherlands. MR obtained ethical approval in the UK and facilitated the recruitment of medical schools in partnership with the UK Medical School Council. FL and GPG facilitated the recruitment of medical schools in Canada and related ethical approval process, and translated materials into French. PS supported the ethical approval process in Canada and translation of materials into French. AJO provided guidance on the statistical analysis. M-AD and RY drafted the manuscript. All authors contributed to writing the manuscript and approved the final draft.
Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. France Légaré is Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation.
Competing interests Financial: M-AD is a consultant to Access Community Health Network, Chicago. GE has been a consultant to: (1) Emmi Solutions LLC who develop patient knowledge tools; (2) National Quality Forum on certification of patient knowledge tools; (3) Washington State Health Department on certification of patient knowledge tools; (4) PatientWisdom LLC, (5) SciMentum, Amsterdam, and (6) Access Community Health Network, Chicago. GE has edited / published books that provide royalties on sales by the publishers: the books have been on Shared Decision Making (Oxford University Press) and Groups (Radcliffe Press). Non-Financial: Many authors are authors of SDM and communication training programs in medical schools. However, they get no financial benefits from it. GE initiated and leads the Option Grid TM patient decision aids Collaborative, which produces and publishes patient knowledge tools in the form of comparison tables (http://optiongrid.org/), and has part ownership of the registered trademark. GE owns copyright in CollaboRATE, IntegRATE, and Observer OPTION measures of shared decision making and care integration. These measures are freely available for use. PJB owns copyright in CollaboRATE.
Ethics approval Institutional Review Boards at Dartmouth College (USA), University of California San Francisco (USA), McGill University (Canada), Université Laval (Canada) and University of Ottawa (Canada). Brighton and Sussex Medical School Research Governance and Ethics Committee (UK).
Provenance and peer review Not commissioned; externally peer reviewed.
Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with 'BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected these errors and the correct publishers have been inserted into the references.