An Innovative Shared Decision-Making Curriculum for Internal Medicine Residents: Findings From the University of Pittsburgh Medical Center.
Acad Med
; 93(6): 937-942, 2018 06.
Article
em En
| MEDLINE
| ID: mdl-29068819
ABSTRACT
PURPOSE:
Shared decision making (SDM) is a core competency in health policy and guidelines. Most U.S. internal medicine residencies lack an SDM education curriculum. A standardized patient (SP)-based curriculum teaching key concepts and skills of SDM was developed.METHOD:
This curriculum consisted of an innovative seven-step SDM model and a skills-focused SP case, integrated into the ambulatory rotation for senior medicine residents at the University of Pittsburgh Medical Center in 2015. Evaluation consisted of pre/postcurriculum surveys assessing residents' knowledge of and attitudes toward SDM. Skills development was assessed via pre/postcurricular audio recordings of clinical decision making.RESULTS:
Thirty-six residents completed the curriculum (survey participation rate 88%). There was significant improvement in residents' knowledge (median score pre 75%, post 100%, P < .01); confidence (median composite score pre 2.87, post 3.0, P < .01, where 1 = not confident/important, 4 = very confident/important); and importance of SDM (median composite score pre 3.14, post 3.5, P < .01). Forty-four clinical recordings (31 pre, 13 post) were assessed using the Observing Patient Involvement in Decision-Making scale. Improvement in use of SDM skills was seen among all residents (mean increase 1.84 points, P = .27). When data were stratified post hoc by U.S. versus international medical graduates, there was significant improvement in total score (mean increase of 5.15 points, P = .01) among U.S. graduates only.CONCLUSIONS:
SDM is teachable, and this skill-based curricular intervention resulted in improvement in senior medicine residents' knowledge of, attitudes toward, and demonstration of SDM skills.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Participação do Paciente
/
Currículo
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Educação de Pós-Graduação em Medicina
/
Medicina Interna
/
Internato e Residência
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
/
Qualitative_research
Limite:
Adult
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Female
/
Humans
/
Male
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article