A best-worst scaling survey of medical students\u2019 perspective on implementing shared decision-making in China

Richard Huan XU,Lingming ZHOU,Dong WANG,Eliza Lai-Yi WONG,Chao XU,Guo Chun XIANG

doi:10.1186/s12909-020-02406-9

Richard Huan XU, Lingming ZHOU + Show 4 more

Open Access

https://doi.org/10.1186/s12909-020-02406-9

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Abstract

BackgroundThe objective of this study was to ascertain the importance rankings of factors affecting the implementation of shared decision-making (SDM) in medical students in China and determine whether these factors were consistent across the respondents’ individual characteristics.MethodStudents studying clinical medicine were recruited from three medical universities in China. A cross-sectional online survey using best-worst object scaling with a balanced incomplete block design was adopted to investigate their preference towards implementing SDM in China. Count analysis, multinomial logit analysis and mixed logit analysis were used to estimate the preference heterogeneity of the SDM factors among respondents.ResultsA total of 574 medical students completed the online survey. The three most important factors for implementing SDM were trust and respect, (providing) high-quality medical information and multi-disciplinary collaboration. The mixed logit regression model identified significant heterogeneity in SDM preferences among respondents, and sub-group analysis showed that some heterogeneities varied in respondents by sex, study programs and their experience of visiting doctors.ConclusionThe importance rankings provide rich information for implementing SDM and facilitate the reform of education in medical schools in China. However, the heterogeneities in SDM preference need further explorations.

Highlights

The objective of this study was to ascertain the importance rankings of factors affecting the implementation of shared decision-making (SDM) in medical students in China and determine whether these factors were consistent across the respondents’ individual characteristics
The mixed logit regression model identified significant heterogeneity in SDM preferences among respondents, and sub-group analysis showed that some heterogeneities varied in respondents by sex, study programs and their experience of visiting doctors
We found that trust and respect, high-quality medical information, and multi-disciplinary collaboration were consistently ranked as the three most important factors by medical students

Summary

Introduction

The objective of this study was to ascertain the importance rankings of factors affecting the implementation of shared decision-making (SDM) in medical students in China and determine whether these factors were consistent across the respondents’ individual characteristics. Shared decision-making (SDM) is a process in which a patient and her/his healthcare professionals work together as decision-making partners. It offers a structured way to incorporate evidence as well as patient values and preferences into medical decision making [1]. SDM helps patients to understand what kind of health care is important to them, and feel supported and empowered to make choices about their health care. Full list of author information is available at the end of the article health and social care professionals to tailor the care to meet the needs of individual patients. A growing number of policymakers and medical professionals have encouraged the normalizations of principles of SDM in clinical practice during the past four decades [3,4,5], the adoption of SDM into clinical practice has been remarkably slow [6]

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