Computer-Based Learning Module Increases Shared Decision Making in Breast Reconstruction

Abstract

Shared decision making (SDM) combines evidence-based medicine with individual patient preferences. Patients who are actively engaged in their own health care management with their physicians have been shown to experience not only increased compliance, but also higher satisfaction and better outcomes. We hypothesize that a computer-based learning module for breast reconstruction increases patient involvement in the decision-making process. Women who underwent either immediate or delayed breast reconstruction at an academic teaching hospital from 2004 to 2007 were identified. Patients meeting inclusion criteria were mailed questionnaires on demographics, informational resources, and decision-making processes. Questionnaire results were divided into 2 groups for analysis: patients who received a standard surgeon consultation and patients who were shown a computer-based decision aid in addition to the standard consultation. There were 358 women eligible for our study. A total of 255 patients (75.9%) responded to the survey; 168 patients were shown the computer-based decision aid and 87 patients were not. Patients who used the computer-based learning module reported a greater role in choosing the type of reconstruction (P < .001). Additionally, these patients reported a greater number of reconstructive options offered to them (P < .001) and were more satisfied with the amount of information provided by their reconstructive surgeon (P = .049). A computer-based learning module allows patients to assimilate information and actively participate in choosing type of breast reconstruction. Use of this educational modality represents a simple and effective way to improve the shared decision-making process.