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      Study protocol of a randomized controlled trial on two new dissemination strategies for a brief, shared-decision-making (SDM) training for oncologists: web-based interactive SDM online-training versus individualized context-based SDM face-to-face training

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          Abstract

          Background

          Oncological patients often feel left out of important treatment decisions. However, when physicians engage them in shared decision-making (SDM), patients benefit in many ways and the situation is improved. SDM can effectively be taught to physicians, but participation barriers for SDM physician group trainings are high, making it hard to convince physicians to participate.

          With this in mind, we aim to develop and evaluate two new dissemination strategies for a brief, SDM training program based upon a proven SDM group-training concept: an individualized context-based SDM face-to-face training (IG I) and a web-based interactive SDM online training (IG II).

          We aim to analyze which improvements can be achieved by IG I and II compared to a control group (CG) in physician SDM competence and performance as well as the impact on the physician-patient relationship. Furthermore, we analyze differences in satisfaction concerning the two dissemination strategies by means of a training evaluation.

          Methods/design

          We examine – based on a three-armed randomized controlled trial (IG I, IG II, CG) – the effectiveness of two new dissemination strategies for a SDM training program compared to a CG receiving no SDM training (voluntary access to SDM training as an incentive for participation after completion of the study). We aim to include 162 physicians randomized to one of the three arms. There will be two assessment points in time (before intervention: T 0 and post-training: T 1). The main outcome is the SDM competence of physicians as measured by an established observational assessment rating system (OPTION-12) by means of consultations with Standardized Patients. Standardized Patients are individuals trained to act as “real” patients. Secondary outcome measures are the SDM performance (SDM-Q-9) and the Questionnaire on the Quality of Physician-Patient-Interaction (QQPPI) both rated by Standardized Patients as well as the physicians’ training evaluation.

          Discussion

          This trial will assess the effectiveness and acceptability of two new dissemination strategies for a brief, SDM training program for physicians. Opportunities and challenges regarding implementation in daily routines will be discussed.

          Trial registration

          ClinicalTrials.gov, Identifier: NCT02674360. Prospectively registered on 4 February 2016.

          Electronic supplementary material

          The online version of this article (10.1186/s13063-018-3112-7) contains supplementary material, which is available to authorized users.

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          Most cited references35

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          Shared decision making: Concepts, evidence, and practice

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            Expertise Reversal Effect and Its Implications for Learner-Tailored Instruction

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              The OPTION scale: measuring the extent that clinicians involve patients in decision-making tasks.

              To examine the psychometric properties of a revised scale, named 'observing patient involvement in decision making' (OPTION), by analysing its reapplication to a sample of routine primary care consultations. The OPTION instrument assesses to what degree clinicians involve patients in decision making. Cross-sectional assessment of medical interaction by two calibrated raters. Primary care. Twenty-one general practitioners provided 186 consultations for assessment. Observational score using the OPTION instrument. Compared with the first version of the OPTION scale, the revised scale that uses a magnitude instead of an attitude scale, when applied to the same data set, resulted in improvement in the scale's reliability and to lower scores for the levels of involvement achieved by the practitioners. Factor analysis confirms that it is acceptable to regard the scale as a single construct. Although there is moderate variability when raters are assessed on an item by item basis, the agreements between raters at the level of the overall OPTION score is high (the intraclass correlation coefficient scores for total OPTION score was 0.77), a level that is acceptable for the evaluation of a set of consultations per practitioner (e.g. between 5 and 10 consultations), where aggregate scores would be used for determining overall performance. We conclude that OPTION is sufficiently reliable to be used for formal assessment at the level of the whole instrument (all 12 items).
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                Author and article information

                Contributors
                nicole.mueller@med.uni-heidelberg.de
                kathrin.gschwendtner@med.uni-heidelberg.de
                s.dwinger@uke.de
                bergelt@uke.de
                Wolfgang.Eich@med.uni-heidelberg.de
                m.haerter@uke.de
                0049/6221/56-38657 , Christiane.Bieber@med.uni-heidelberg.de
                Journal
                Trials
                Trials
                Trials
                BioMed Central (London )
                1745-6215
                7 January 2019
                7 January 2019
                2019
                : 20
                : 18
                Affiliations
                [1 ]ISNI 0000 0001 0328 4908, GRID grid.5253.1, Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, , Heidelberg University Hospital, ; Thibautstraße 4, 69115 Heidelberg, Germany
                [2 ]ISNI 0000 0001 2180 3484, GRID grid.13648.38, Department of Medical Psychology, Center for Psychosocial Medicine, , University Medical Center Hamburg-Eppendorf, ; Martinistr. 52, 20246 Hamburg, Germany
                Author information
                http://orcid.org/0000-0003-4634-0513
                Article
                3112
                10.1186/s13063-018-3112-7
                6323749
                30616653
                a6568c15-4467-4339-aa5a-22ac96e163bd
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 7 May 2018
                : 6 December 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100005972, Deutsche Krebshilfe;
                Award ID: DKH109956
                Award ID: DKH110010
                Award Recipient :
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2019

                Medicine
                shared decision-making,randomized controlled trial,oncology,web-based online training,coaching,standardized patients

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