SRFP031: Different levels of willingness for shared decision making among resident physicians
Michael Alexander Ferrante; Amrita Sandhu, BSc; Vinita D'Souza, MSc; Roland Grad, MD, CCFP, FCFP; Glyn Elwyn, MD, PhD, BA, MSc; Gabrielle Stevens
Abstract
Context: The willingness of Family Medicine residents to engage in shared decision making (SDM) has not been previously assessed. Objective: To assess the willingness of family medicine residents to engage in SDM in the context of preventive health care. Study Design: Single group cohort. Setting: Department of Family Medicine, McGill University, Montreal. Population: By email and online, all 200 residents (102 R1, 98 R2) were offered participation before the intervention. Intervention/Instrument: On May 26, 2021, we delivered a lecture followed immediately by a skills development workshop. To start this educational intervention, residents answered demographic questions and the 7-item incorpoRATE measure. For each item, residents were asked to respond using a 0-10 scale. Each resident’s total measure score is the average of all items (possible range 0-10). Outcome Measures: Baseline (pre-intervention) incorpoRATE scores. Results: Of the 73 residents in attendance, 66 (90%) consented and completed all questions in the baseline measure. The mean total incorpoRATE score was 7.0±1.0; range 4.9 to 9.1. Second year resident scores (n=21) were significantly higher than first year resident scores (7.4±1.2 versus 6.8±0.8, p<0.002). Male and female scores were similar. Compared to a high stakes situation, in a low stakes situation residents would feel more comfortable providing care when a patient chooses an option that is not aligned with their clinical recommendation (6.9±1.9 versus 3.8±2.5). Conclusions: Willingness to engage in SDM varies greatly, as indicated by the range in scores. Second year residents showed a greater willingness to engage in SDM. The “stakes” of a clinical situation appear to make a difference in resident comfort when thinking about the provision of clinical care that involves SDM. Future work will assess the impact of the educational intervention on resident physician willingness for SDM.