Teaching clinicians shared decision making and risk communication online: an evaluation study.
Del Mar, Chris
BMJ evidence-based medicine
MetadataShow full item record
Hoffmann, T. C., Del Mar, C., Santhirapala, R., & Freeman, A. (2020). Teaching clinicians shared decision making and risk communication online: an evaluation study.. BMJ evidence-based medicine https://doi.org/10.1136/bmjebm-2020-111521
Objectives: To describe the development and initial evaluation of a brief e-learning course as a means of teaching shared decision making and risk communication skills to clinicians of all specialties. Design: Comparison pre- and post-course of scores in subjective confidence and objective knowledge about shared decision making and risk communication. Setting: Online, and open to all specialties and levels of clinical experience. Participants: The course is freely available online and all who started the course from Sept 2018-May 2020 were invited to participate in the evaluation study. Intervention: The self-guided e-learning course is made up of 4 modules and takes approximately 2 hours to complete. It is hosted on the website of the Winton Centre for Risk Communication and the UK’s National Health Service e-learning platform. Main outcome measures: Pre-course and post-course confidence in performing shared decision making (as measured by a 10 item scale adapted from the OPTION tool; total score range 10-50), and objective knowledge about basic principles of shared decision making and risk communication, as measured by performance on 4 knowledge questions and 3 calculations. A single item from the Berlin Numeracy Test, and the 8-item Subjective Numeracy Test were also asked. Results: Of 366 unique participants who consented and commenced the course, 210 completed all modules and the final post-course test. Participants’ mean age was 38.1 years, 69% were in current clinical practice, and had a mean of 10.5 years of clinical practice. Numeracy was relatively low, with 50.7% correctly answering the Berlin Numeracy Test item. Participants who completed the course showed a significant improvement in their confidence by a mean summed score of 3.7 units (95% CI 2.9 to 4.6, p<0.0001) from a mean pre-course of 37.4 (SD 6.1) to post-course of 41.1 (SD 6.9). There was an increase in the proportion of correct answers for most knowledge questions (p<0.0001, p=0.013 for two directly compared) although no improvement in most skill questions that involved numbers (for example, calculating relative risks). Participants with higher numeracy showed higher skills and confidence on most questions. Conclusions: This online, free e-learning course was successful in increasing participants’ confidence in, and some aspects of knowledge about, shared decision making and risk communication. It has also highlighted the need for improvements in clinicians’ numerical skills as a vital part of training. We suggest that the course is used in combination with practical face-to-face experience and more intensive numerical skills training.
The development of the original e-learning course was funded by the Australian Commission on Safety and Quality in Health Care. The adaptations for the UK and different specialties was funded by the Winton Centre for Risk and Evidence Communication at the University of Cambridge, which is itself funded by a donation from the David & Claudia Harding Foundation
Embargo Lift Date
External DOI: https://doi.org/10.1136/bmjebm-2020-111521
This record's URL: https://www.repository.cam.ac.uk/handle/1810/308738
All rights reserved