دورية أكاديمية
أعرض في EDS

Integrating training in evidence-based medicine and shared decision-making: a qualitative study of junior doctors and consultants.

التفاصيل البيبلوغرافية
العنوان: Integrating training in evidence-based medicine and shared decision-making: a qualitative study of junior doctors and consultants.
المؤلفون: Simons M; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia. mary.simons@mq.edu.au.; Australian Institute of Health Innovation, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia. mary.simons@mq.edu.au., Fisher G; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia., Spanos S; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia., Zurynski Y; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia., Davidson A; Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, VIC, 3050, Australia., Stoodley M; Department of Clinical Medicine, Macquarie University, Sydney, NSW, 2109, Australia., Rapport F; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia., Ellis LA; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia.
المصدر: BMC medical education [BMC Med Educ] 2024 Apr 18; Vol. 24 (1), pp. 418. Date of Electronic Publication: 2024 Apr 18.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101088679 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6920 (Electronic) Linking ISSN: 14726920 NLM ISO Abbreviation: BMC Med Educ Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Evidence-Based Medicine*/education , Consultants*, Humans ; Qualitative Research ; Attitude of Health Personnel ; Medical Staff, Hospital ; Decision Making
مستخلص: Background: In the past, evidence-based medicine (EBM) and shared decision-making (SDM) have been taught separately in health sciences and medical education. However, recognition is increasing of the importance of EBM training that includes SDM, whereby practitioners incorporate all steps of EBM, including person-centered decision-making using SDM. However, there are few empirical investigations into the benefits of training that integrates EBM and SDM (EBM-SDM) for junior doctors, and their influencing factors. This study aimed to explore how integrated EBM-SDM training can influence junior doctors' attitudes to and practice of EBM and SDM; to identify the barriers and facilitators associated with junior doctors' EBM-SDM learning and practice; and to examine how supervising consultants' attitudes and authority impact on junior doctors' opportunities for EBM-SDM learning and practice.
Methods: We developed and ran a series of EBM-SDM courses for junior doctors within a private healthcare setting with protected time for educational activities. Using an emergent qualitative design, we first conducted pre- and post-course semi-structured interviews with 12 junior doctors and thematically analysed the influence of an EBM-SDM course on their attitudes and practice of both EBM and SDM, and the barriers and facilitators to the integrated learning and practice of EBM and SDM. Based on the responses of junior doctors, we then conducted interviews with ten of their supervising consultants and used a second thematic analysis to understand the influence of consultants on junior doctors' EBM-SDM learning and practice.
Results: Junior doctors appreciated EBM-SDM training that involved patient participation. After the training course, they intended to improve their skills in person-centered decision-making including SDM. However, junior doctors identified medical hierarchy, time factors, and lack of prior training as barriers to the learning and practice of EBM-SDM, whilst the private healthcare setting with protected learning time and supportive consultants were considered facilitators. Consultants had mixed attitudes towards EBM and SDM and varied perceptions of the role of junior doctors in either practice, both of which influenced the practice of junior doctors.
Conclusions: These findings suggested that future medical education and research should include training that integrates EBM and SDM that acknowledges the complex environment in which this training must be put into practice, and considers strategies to overcome barriers to the implementation of EBM-SDM learning in practice.
(© 2024. The Author(s).)
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فهرسة مساهمة: Keywords: Evidence-based medicine; Medical education; Medical practice; Person-centered care; Shared decision-making
تواريخ الأحداث: Date Created: 20240418 Date Completed: 20240422 Latest Revision: 20240426
رمز التحديث: 20240426
مُعرف محوري في PubMed: PMC11027546
DOI: 10.1186/s12909-024-05409-y
PMID: 38637798
قاعدة البيانات: MEDLINE
الوصف
تدمد:1472-6920
DOI:10.1186/s12909-024-05409-y