Ready for SDM: evaluating a train-the-trainer program to facilitate implementation of SDM training in Norway

Abstract Background Healthcare providers need training to implement shared decision making (SDM). In Norway, we developed “Ready for SDM”, a comprehensive SDM curriculum tailored to various healthcare providers, settings, and competence levels, including a course targeting interprofessional healthca...

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Main Authors: Simone Kienlin, Marie-Eve Poitras, Dawn Stacey, Kari Nytrøen, Jürgen Kasper
Format: Article
Language:English
Published: BMC 2021-04-01
Series:BMC Medical Informatics and Decision Making
Subjects:
Online Access:https://doi.org/10.1186/s12911-021-01494-x
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author Simone Kienlin
Marie-Eve Poitras
Dawn Stacey
Kari Nytrøen
Jürgen Kasper
author_facet Simone Kienlin
Marie-Eve Poitras
Dawn Stacey
Kari Nytrøen
Jürgen Kasper
author_sort Simone Kienlin
collection DOAJ
description Abstract Background Healthcare providers need training to implement shared decision making (SDM). In Norway, we developed “Ready for SDM”, a comprehensive SDM curriculum tailored to various healthcare providers, settings, and competence levels, including a course targeting interprofessional healthcare teams. The overall aim was to evaluate a train-the-trainer (TTT) program for healthcare providers wanting to offer this course within their hospital trust. Methods Our observational descriptive design was informed by Kirkpatrick´s Model of Educational Outcomes. The South-Eastern Regional Health Authority invited healthcare providers from all health trusts in its jurisdiction to attend. The TTT consisted of a one-day basic course with lectures on SDM, exercises and group reflections followed by a two-day advanced course including an SDM observer training. Immediately after each of the two courses, reaction and learning (Kirkpatrick levels 1 and 2) were assessed using a self-administered questionnaire. After the advanced course, observer skills were operationalized as accuracy of the participants’ assessment of a consultation compared to an expert assessment. Within three months post-training, we measured number of trainings conducted and number of healthcare providers trained (Kirkpatrick level 3) using an online survey. Qualitative and quantitative descriptive analysis were performed. Results Twenty-one out of 24 (basic) and 19 out of 22 (advanced) healthcare providers in 9 health trusts consented to participate. The basic course was evaluated as highly acceptable, the advanced course as complex and challenging. Participants identified a need for more training in pedagogical skills and support for planning implementation of SDM-training. Participants achieved high knowledge scores and were positive about being an SDM trainer. Observer skills regarding patient involvement in decision-making were excellent (mean of weighted t = .80). After three months, 67% of TTT participants had conducted more than two trainings each and trained a total of 458 healthcare providers. Conclusion Findings suggest that the TTT is a feasible approach for supporting large-scale training in SDM. Our study informed us about how to improve the advanced course. Further research shall investigate the efficacy of the training in the context of a comprehensive multifaceted strategy for implementing SDM in clinical practice. Trial registration: Retrospectively registered at ISRCTN (99432465) March 25, 2020.
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spelling doaj.art-7d347fb93dbd4d5d8822c60943bfda6c2022-12-21T21:56:47ZengBMCBMC Medical Informatics and Decision Making1472-69472021-04-0121111910.1186/s12911-021-01494-xReady for SDM: evaluating a train-the-trainer program to facilitate implementation of SDM training in NorwaySimone Kienlin0Marie-Eve Poitras1Dawn Stacey2Kari Nytrøen3Jürgen Kasper4Department of Health and Caring Sciences, Faculty of Health Sciences, University of TromsøDepartment of Family Medicine and Emergency Medicine/School of Nursing, Faculty of Medicine and Health Sciences, Université de SherbrookeSchool of Nursing, University of OttawaFaculty of Medicine, University of OsloDepartment of Health and Caring Sciences, Faculty of Health Sciences, University of TromsøAbstract Background Healthcare providers need training to implement shared decision making (SDM). In Norway, we developed “Ready for SDM”, a comprehensive SDM curriculum tailored to various healthcare providers, settings, and competence levels, including a course targeting interprofessional healthcare teams. The overall aim was to evaluate a train-the-trainer (TTT) program for healthcare providers wanting to offer this course within their hospital trust. Methods Our observational descriptive design was informed by Kirkpatrick´s Model of Educational Outcomes. The South-Eastern Regional Health Authority invited healthcare providers from all health trusts in its jurisdiction to attend. The TTT consisted of a one-day basic course with lectures on SDM, exercises and group reflections followed by a two-day advanced course including an SDM observer training. Immediately after each of the two courses, reaction and learning (Kirkpatrick levels 1 and 2) were assessed using a self-administered questionnaire. After the advanced course, observer skills were operationalized as accuracy of the participants’ assessment of a consultation compared to an expert assessment. Within three months post-training, we measured number of trainings conducted and number of healthcare providers trained (Kirkpatrick level 3) using an online survey. Qualitative and quantitative descriptive analysis were performed. Results Twenty-one out of 24 (basic) and 19 out of 22 (advanced) healthcare providers in 9 health trusts consented to participate. The basic course was evaluated as highly acceptable, the advanced course as complex and challenging. Participants identified a need for more training in pedagogical skills and support for planning implementation of SDM-training. Participants achieved high knowledge scores and were positive about being an SDM trainer. Observer skills regarding patient involvement in decision-making were excellent (mean of weighted t = .80). After three months, 67% of TTT participants had conducted more than two trainings each and trained a total of 458 healthcare providers. Conclusion Findings suggest that the TTT is a feasible approach for supporting large-scale training in SDM. Our study informed us about how to improve the advanced course. Further research shall investigate the efficacy of the training in the context of a comprehensive multifaceted strategy for implementing SDM in clinical practice. Trial registration: Retrospectively registered at ISRCTN (99432465) March 25, 2020.https://doi.org/10.1186/s12911-021-01494-xShared decision-makingTrain-the-trainerCurriculumCommunication skillsEducationComplex intervention
spellingShingle Simone Kienlin
Marie-Eve Poitras
Dawn Stacey
Kari Nytrøen
Jürgen Kasper
Ready for SDM: evaluating a train-the-trainer program to facilitate implementation of SDM training in Norway
BMC Medical Informatics and Decision Making
Shared decision-making
Train-the-trainer
Curriculum
Communication skills
Education
Complex intervention
title Ready for SDM: evaluating a train-the-trainer program to facilitate implementation of SDM training in Norway
title_full Ready for SDM: evaluating a train-the-trainer program to facilitate implementation of SDM training in Norway
title_fullStr Ready for SDM: evaluating a train-the-trainer program to facilitate implementation of SDM training in Norway
title_full_unstemmed Ready for SDM: evaluating a train-the-trainer program to facilitate implementation of SDM training in Norway
title_short Ready for SDM: evaluating a train-the-trainer program to facilitate implementation of SDM training in Norway
title_sort ready for sdm evaluating a train the trainer program to facilitate implementation of sdm training in norway
topic Shared decision-making
Train-the-trainer
Curriculum
Communication skills
Education
Complex intervention
url https://doi.org/10.1186/s12911-021-01494-x
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