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

• Published in: BMC medical informatics and decision making Vol. 21; no. 1; p. 140
• Main Authors: Kienlin, Simone, Poitras, Marie-Eve, Stacey, Dawn, Nytrøen, Kari, Kasper, Jürgen
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 30.04.2021; BioMed Central; Springer; BMC
• Subjects: Clinical decision making; Communication; Communication skills; Complex intervention; Curricula; Curriculum; Decision Making; Decision Making, Shared; Education; Evaluation; Health care; Health care teams; Health informatics; Health Personnel; Health sciences: 800; Helsefag: 800; Hospitals; Humans; Intervention; Knowledge; Medical disciplines: 700; Medical personnel; Medical personnel and patient; Medisinske Fag: 700; Norway; Patient Participation; Patients; Qualitative analysis; Shared decision-making; Skills; Surveys and Questionnaires; Taxonomy; Train-the-trainer; Training; VDP; Norway; Complex intervention; Curriculum; Communication skills; Education; Train-the-trainer; Shared decision-making
• ISSN: 1472-6947; 1472-6947
• DOI: 10.1186/s12911-021-01494-x

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. 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. 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. 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. Retrospectively registered at ISRCTN (99432465) March 25, 2020.