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When and how to train GP trainees in shared decision making? The value of self-directed workplace learning and feedback in an integrated educational program.

Projectomschrijving

Samen Beslissen in de huisartsopleiding: onderzoek naar optimaal werkplekleren

Samen Beslissen vraagt om communicatieve en besliskundige competenties, waarvoor in medische curricula weinig expliciete aandacht bestaat. Er zijn 2 uitdagingen:

  1. het integreren van onderwijs over deze competenties in de bestaande curricula
  2. het vertalen van deze competenties in flexibel gedrag in de spreekkamer

Samen Beslissen is geen trucje maar complex en context-gevoelig gedrag.

Doel

In deze 6-jarige Delphi studie onder 30 experts onderzoeken we deze uitdagingen in 4 fasen:

  1. Welke competenties zijn nodig om Samen Beslissen effectief te integreren in de dagelijkse praktijk?
  2. Beschrijvende studie bij 30 aios: Hoe vaardig zijn 1e en 3e jaars aios in Samen Beslissen, en wat zijn knelpunten voor verbetering?
  3. Ontwikkel studie: Wat is de gewenste vorm, timing en dosering voor een flexibele module over Samen Beslissen inclusief werkplekleren, context-gevoelige feedback, en een train-de-trainer instructie?
  4. Pilot study onder 40 à 60 aios: hoe haalbaar en aanvaardbaar is deze module voor 3e-jaars aios?

Producten

Titel: Leerplein Samen Beslissen voor de huisartsopleiding voor jaar 1 en 3 (inclusief docentenhandleidingen, dia/s en ondersteunende materialen)
Auteur: Anouk Baghus, Angelique Timmerman, Trudy van der Weijden, Esther Giroldi
Titel: 10th International Shared Decision making Conference (ISDM), Quebec, 7-10 July. Oral presentation: Family medicine residents’ experienced barriers and facilitators in learning and applying SDM: a qualitative study
Auteur: A. Baghus, E. Giroldi, A. Timmerman, T. van der Weijden
Titel: 9th International Shared Decision Making Conference (ISDM), Lyon, 2-5 juli. Oral presentation: The development of competencies for Shared Decision Making in postgraduate medical education: a Delphi study
Auteur: Anouk Baghus
Titel: Workshop ISDM congres Kolding, Denemarken. 19-22 juni 2022: Designing a longitudinal curriculum in shared decision-making for workplace-based learning
Auteur: Anouk Baghus, Trudy van der Weijden
Titel: 16th International Conference on Communication in Healthcare (ICCH). European Association of Communication in Healthcare (EACH). 1- 4 september 2018, Porto. Towards effective Shared Decision Making: how to stimulate workplace based learning and feedback
Auteur: A. Baghus, E. Giroldi, A. Timmerman, T. van der Weijden
Titel: EACH Forum on Healthcare Communication, Leiden, 16-18 September 2019. Family medicine residents’ experienced barriers and facilitators in learning and applying SDM in workplace-based learning
Auteur: A. Baghus, E. Giroldi, A. Timmerman, T. van der Weijden
Titel: WONCA conference, 6-10 July 2021, A systematic approach to identify and prioritize option tables for recommendations in NHG-guidelines.
Auteur: Anouk Baghus & Gerda van der Weele
Titel: MMV Congres, 13 december 2017, Nieuwegein, Symposium Samen beslissen: een effectief trainingsmodel
Auteur: Anouk Baghus, Esther Giroldi, Angelique Timmerman, Trudy van der Weijden
Link: https://www.medischevervolgopleidingen.nl
Titel: Landelijke APC werkconferentie, 22 juni 2018, Amsterdam, Workshop Ontwikkelen van onderwijs in Samen Beslissen voor de Huisartsopleiding
Auteur: Anouk Baghus, Esther Giroldi, Angelique Timmerman, Trudy van der Weijden
Titel: Identifying residents’ educational needs to optimizing postgraduate medical education about shared decision-making.
Auteur: Baghus A, Giroldi E, Timmerman A, Schmitz E, Erkan F, Röhlinger D, Pieterse A, Dielissen P, Kramer A, Rietmeijer C, Muris J, van der Weijden T.
Magazine: Patient Education and Counseling
Titel: Onderzoek naar optimale aios-training Shared Decision Making
Auteur: Anouk Baghus
Magazine: Huisarts en Wetenschap
Titel: Tips voor aiossen en opleiders over Leren van Samen Beslissen. Huisarts en Wetenschap,
Auteur: Anouk Baghus, Angelique Timmerman, Esther Giroldi, Inge Henselmans, Jean Muris & Trudy van der Weijden
Magazine: Huisarts & Wetenschap
Titel: Identifying Entrustable Professional Activities for Shared Decision Making in Postgraduate Medical Education: A National Delphi Study
Auteur: Baghus A, Giroldi E, Timmerman A, Schmitz E, Erkan F, Röhlinger D, Pieterse A, Dielissen P, Kramer A, Rietmeijer C, Muris J, van der Weijden T
Magazine: Academic Emergency Medicine
Titel: Nominatie NHG wetenschapsprijs 2022
Titel: Abstract award WONCA-Europe congres 2021 (top 20 abstract van de ruim 1000 ingediende abstracts)

Verslagen


Samenvatting van de aanvraag

Background The current call in health care for so-called Shared Decision Making (SDM) demands new and flexible approaches in GP training. We are faced with two educational challenges: 1) How to merge such a new topic as an integrated educational program into the existing curriculum?; 2) How to advance from competencies to actual performance in practice by means of context-sensitive workplace learning? SDM is an interesting case to explore these challenges as it is not a unique clinical behavior but rather a complex clinical approach consisting of a set of clinical behaviors. Within the competency-based integrated educational program we focus on the development of feasible and acceptable feedback tools that enable self-directed learning. In most communication and medical decision making curricula, SDM does not have an explicit place yet. We now face a new era of democratising knowledge, where patients will shift from passive (e.g. by non-adherence to prescriptions) to active involvement in decision making. Although patients are increasingly empowered in this respect, the problem is that SDM suffers from lack of implementation. Education of young professionals is seen as one of the pillars for change. SDM is an approach that entails choice talk, option talk, preference talk, and decision talk. Choice talk refers to the step of making sure that patients are aware that more than one reasonable option is available, including a wait-and-see option, if relevant. Next, option talk refers to providing more detailed information about the options. Preference and decision talk refers to supporting the process of deliberation in considering the preferences and deciding what is best. Aim and research questions To develop a flexible competency-based integrated educational program for SDM, that will be designed in line with the current patient movement initiatives, and with tailoring to the opportunities of local GP training institutes. . 1. What specific competencies are prioritized by stakeholders for training professionals to ensure awareness, knowledge and skills with regard to integrating SDM in daily practice? 2. Given these competencies; what is the current (variation in) baseline level of competencies in 1st and 3rd year GP trainees, and what are relevant needs and barriers for change? 3. What is the preferred format for a flexible competency-based program on SDM education with regard to integration in existing curricula, and timing and dosing of self-directed workplace learning? 4. What are the feasibility and acceptability of a 3rd year training module on SDM, with incorporation of context-sensitive feedback that enables self-directed workplace learning? Workplan This 6-year study has a mixed methods design and consists of four phases: I) Qualitative interviews with 10 experts and modified RAND Delphi consensus procedure with 30 stakeholders to define a common starting position (question 1). II) Observational study among 30 1st and 3rd year trainees and their supervisors with videotaping of consultations and interviews to describe the gap between theory of SDM and practice and the opportunities and barriers for change (question 2). III) Fine tuning of the competencies based on the findings of phase II, and development of a competency-based integrated flexible educational program for SDM, that will include a training, valid context-sensitive assessment tools, and a train-the-trainer module (question 3). IV) Pilot study of the training among 40-60 3rd year trainees and their supervisors with mixed methods evaluation of feasibility and acceptability (question 4). Deliverables 1. Consensus on SDM competencies in Dutch family medicine. 2. Insight in in gap between actual performance and appropriate SDM performance and in opportunities and needs for SDM education in the GP trainee curriculum. 3. Flexible template for integration of SDM education in existing EBM and clinical curricula. 4. A systematically developed SDM communication training module for trainees including assessment tools for valid feedback and self-directed learning, and a train-the-trainer module (for the GP trainee staff and clinical supervisors), tested on feasibility and acceptability, designed according the principles of design-centred research.

Kenmerken

Projectnummer:
839130006
Looptijd: 99%
Looptijd: 99 %
2016
2024
Gerelateerde subsidieronde:
Projectleider en penvoerder:
dr. A.A. Timmerman
Verantwoordelijke organisatie:
Maastricht University
Afbeelding

Onderzoek van onderwijs

Om de kwaliteit van de opleidingen tot huisarts en specialist ouderengeneeskunde te verbeteren, financieren we onderzoek van onderwijs. Dit project is één van die onderzoeken. Bekijk de andere projecten.