Informed Shared Decision-Making: Continuing Education for Physicians

Summary

The goal of this project was to change physician behaviour over the long term in order to facilitate two outcomes: improved patient satisfaction with the clinical encounter, and increased efficiency and effectiveness from the physician’s perspective. 80% of patient complaints against physicians can be attributed to a breakdown in effective communications. This project introduced a program to teach medical students and physicians the importance of communication and trust in the patient-doctor relationship. The researchers found that the communication skills of medical students at UBC deteriorated as their medical education progressed. In order to improve the relationship between doctors and patients, the ISDM project recognized the need to show that better communication resulted in improved health outcomes and less wasted time, as patients were more likely to understand and follow their health regimes more closely.

Grant Outputs

Framework for Teaching and Learning Informed Shared Decision Making – http://www.chd.ubc.ca/dhcc/sites/default/files/documents/BMJ%20ISDM%20Framework%20short%20cvr.pdf

This report outlines specific competencies expected of doctors in order to effectively communicate with patients. These range from developing a partnership with the patient, ascertaining and responding to patient ideas, concerns and expectations, and identifying choices for patient care. The report provides a list of patient competencies that would help eliminate the power-imbalance inherent in the doctor-patient relationship. These include the need for patients to define for themselves their health needs and the kind of relationship they expect to have with the doctor. The report documents the most commonly cited barriers to effective doctor-patient relationships, including a perceived lack of time, physicians’ predisposition and skill, and patients’ inexperience with making decisions about treatment.

Challenges in Family Practice Related to Informed Shared Decision Making – http://www.cmaj.ca/content/165/4/434.short

This report identifies competencies that are considered essential to building effective communication skills and positive patient-doctor relationships. The report recommends that undergraduate medical students should be trained in conflict resolution and negotiating skills in order to most successfully deal with their patients, and that training should also provide students with strategies for managing decision-making in the context of patients and their companions.

Future Doctors Focus on Communication – http://www.publicaffairs.ubc.ca/ubcreports/1999/99jun10/isdm.html

This article highlights an initiative whereby medical students attend high schools in order to teach students how to effectively communicate with their doctors. This health initiative sought to train doctors on how to better listen to patients, but it also acknowledged the need to train patients in medical communication. It introduced a teaching module into schools that allowed students to practice communicating with their doctors and provided them with a clear idea of what were appropriate topics of discussion between doctor and patient.