Abstract
BackgroundIn this study, we sought to assess healthcare professionals’ acceptance of and satisfaction with a shared decision making (SDM) educational workshop, its impact on their intention to use SDM, and their perceived facilitators and barriers to the implementation of SDM in clinical settings in Iran.MethodsWe conducted an observational quantitative study that involved measurements before, during, and immediately after the educational intervention at stake. We invited healthcare professionals affiliated with Tabriz University of Medical Sciences, East Azerbaijan, Iran, to attend a half-day workshop on SDM in December 2016. Decisions about prenatal screening and knee replacement surgery was used as clinical vignettes. We provided a patient decision aid on prenatal screening that complied with the International Patient Decision Aids Standards and used illustrate videos. Participants completed a sociodemographic questionnaire and a questionnaire to assess their familiarity with SDM, a questionnaire based on theoretical domains framework to assess their intention to implement SDM, a questionnaire about their perceived facilitators and barriers of implementing SDM in their clinical practice, continuous professional development reaction questionnaire, and workshop evaluation. Quantitative data was analyzed descriptively and with multiple linear regression.ResultsAmong the 60 healthcare professionals invited, 41 participated (68%). Twenty-three were female (57%), 18 were specialized in family and emergency medicine, or community and preventive medicine (43%), nine were surgeons (22%), and 14 (35%) were other types of specialists. Participants’ mean age was 37.51 ± 8.64 years with 8.09 ± 7.8 years of clinical experience. Prior to the workshop, their familiarity with SDM was 3.10 ± 2.82 out of 9. After the workshop, their belief that practicing SDM would be beneficial and useful (beliefs about consequences) (beta = 0.67, 95% CI 0.27, 1.06) and beliefs about capability of using SDM (beta = 0.32, 95% CI -0.08, 0.72) had the strongest influence on their intention of practicing SDM. Participants perceived the main facilitator and barrier to perform SDM were training and high patient load, respectively.ConclusionsParticipants thought the workshop was a good way to learn SDM and that they would be able to use what they had learned in their clinical practice. Future studies need to study the level of intention of participants in longer term and evaluate the impact of cultural differences on practicing SDM and its implementation in both western and non-western countries.
Highlights
In this study, we sought to assess healthcare professionals’ acceptance of and satisfaction with a shared decision making (SDM) educational workshop, its impact on their intention to use SDM, and their perceived facilitators and barriers to the implementation of SDM in clinical settings in Iran
Future studies need to study the level of intention of participants in longer term and evaluate the impact of cultural differences on practicing SDM and its implementation in both western and non-western countries
The questions that we evaluated during this educational innovation were: [1] To what extent do participants consider the SDM continuing professional development workshop acceptable and satisfactory? [2] To what extent does healthcare professionals’ participation in this workshop influence their intention to adopt SDM in their clinical practice? [3] According to participants, what are the facilitating factors and barriers that could influence the adoption of SDM in the Iranian healthcare system?
Summary
Study design and context We conducted an observational study design with quantitative methods. Participants completed the sociodemographic questions and a questionnaire to evaluate their knowledge about SDM and intention to use it in clinical practice. The first, adapted from previous work in the field, assessed the impact of the workshop, i.e. to evaluate whether healthcare professionals were likely to implement what they learned [25] This questionnaire is based on constructs (i.e. intention, social influences, beliefs about capabilities, moral norm, and beliefs about consequences) [25] and scored on a 7-point Likert scale, except for one question which is scored on a 5-point percentage scale. We used the mean with standard deviation for continuous and ordinal variables (age, experience, theoretical domains, and workshop evaluation questions) and frequency with percentage for categorical variables (gender, type of healthcare professional, prior knowledge about SDM, facilitators and barriers). The data related to the facilitators and barriers were coded by two researchers, and their frequency and percentage were calculated
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