Exploring the black box of shared decision making (SDM)
Research type
Research Study
Full title
Understanding, promoting and enhancing shared decision making (SDM) in the clinical consultation.
IRAS ID
150994
Contact name
Lynne Stobbart
Contact email
Sponsor organisation
Northumbria NHS Foundation Trust
Research summary
There is good evidence that involving patients in decisions about their healthcare can improve patient outcomes, experience and the quality of their care. Despite extensive work to promote shared decision making as part of everyday clinical practice, patient involvement in decision making appears to be erratic and progress slow. Identifying why this is the case has proved difficult using questionnaire and interview approaches as patient and clinician perceptions and experience often differ. It therefore remains unclear as to what actually happens when decisions are being made during healthcare consultations. This study will address this by using video recordings of consultations to allow the direct observation of what actually happens within the actual clinical encounter. The video recordings will be examined for the extent to which clinicians and patients (and other participants where necessary/appropriate) engage in a shared decision making process and how they do this. It is important also to understand why patient and clinician perspectives often differ when questionnaire methods are used to explore their experience of the same encounter. This study will therefore examine the understanding, acceptability, desirability and utility of shared decision making from these different perspectives using brief questionnaires and interviews. Questionnaire and interview responses from patients and clinicians involved in the same consultations will then be analysed alongside the video recording of their encounter, to help identify what may contribute to these differences in experience and understanding. This will inform how current questionnaire measures of shared decision making can be improved. By triangulating the analysis in this way this study will provide a very unique and comprehensive picture of shared decision making in practice, and what behaviours and beliefs can promote or inhibit its use. Importantly, this will promote progress by informing how to better support patients and clinicians in this collaborative approach to healthcare.
REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
14/WM/0158
Date of REC Opinion
14 May 2014
REC opinion
Further Information Favourable Opinion