PDF(Pubmed)
Abstract：
BACKGROUND: Shared decision making (SDM) has been presented as the preferred approach for decisions where there is more than one acceptable option and has been identified a priority feature of high-quality patient-centered care. Considering the foundation of trust between general practitioners (GPs) and patients and the variety of diseases in primary care, the primary care context can be viewed as roots of SDM. GPs are requesting training programs to improve their SDM skills leading to a more patient-centered care approach. Because of the high number of training programs available, it is important to overview these training interventions specifically for primary care and to explore how these training programs are evaluated.
METHODS: This review was reported in accordance with the PRISMA guideline. Eight different databases were used in December 2022 and updated in September 2023. Risk of bias was assessed using ICROMS. Training effectiveness was analyzed using the Kirkpatrick evaluation model and categorized according to training format (online, live or blended learning).
RESULTS: We identified 29 different SDM training programs for GPs. SDM training has a moderate impact on patient (SMD 0.53 95% CI 0.15-0.90) and observer reported SDM skills (SMD 0.59 95%CI 0.21-0.97). For blended training programs, we found a high impact for quality of life (SMD 1.20 95% CI -0.38-2.78) and patient reported SDM skills (SMD 2.89 95%CI -0.55-6.32).
CONCLUSIONS: SDM training improves patient and observer reported SDM skills in GPs. Blended learning as learning format for SDM appears to show better effects on learning outcomes than online or live learning formats. This suggests that teaching facilities designing SDM training may want to prioritize blended learning formats. More homogeneity in SDM measurement scales and evaluation approaches and direct comparisons of different types of educational formats are needed to develop the most appropriate and effective SDM training format.
BACKGROUND: PROSPERO: A systematic review of shared-decision making training programs in a primary care setting. PROSPERO 2023 CRD42023393385 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023393385 .
METHODS: This review was reported in accordance with the PRISMA guideline. Eight different databases were used in December 2022 and updated in September 2023. Risk of bias was assessed using ICROMS. Training effectiveness was analyzed using the Kirkpatrick evaluation model and categorized according to training format (online, live or blended learning).
RESULTS: We identified 29 different SDM training programs for GPs. SDM training has a moderate impact on patient (SMD 0.53 95% CI 0.15-0.90) and observer reported SDM skills (SMD 0.59 95%CI 0.21-0.97). For blended training programs, we found a high impact for quality of life (SMD 1.20 95% CI -0.38-2.78) and patient reported SDM skills (SMD 2.89 95%CI -0.55-6.32).
CONCLUSIONS: SDM training improves patient and observer reported SDM skills in GPs. Blended learning as learning format for SDM appears to show better effects on learning outcomes than online or live learning formats. This suggests that teaching facilities designing SDM training may want to prioritize blended learning formats. More homogeneity in SDM measurement scales and evaluation approaches and direct comparisons of different types of educational formats are needed to develop the most appropriate and effective SDM training format.
BACKGROUND: PROSPERO: A systematic review of shared-decision making training programs in a primary care setting. PROSPERO 2023 CRD42023393385 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023393385 .
摘要：
背景：共享决策（SDM）已被提出为决策的首选方法，其中有多个可接受的选择，并已被确定为高质量的以患者为中心的护理的优先特征。考虑到全科医生（GP）与患者之间的信任基础以及初级保健中的各种疾病，初级保健上下文可以被视为SDM的根。全科医生正在要求培训计划，以提高他们的SDM技能，从而实现更加以患者为中心的护理方法。由于培训项目数量众多，重要的是概述这些专门针对初级保健的培训干预措施,并探讨如何评估这些培训计划.
方法：本综述按照PRISMA指南报告。2022年12月使用了八个不同的数据库，并于2023年9月更新。使用ICROMS评估偏倚风险。使用柯克帕特里克评估模型对培训效果进行分析，并根据培训形式（在线，现场或混合学习)。
结果：我们为GP确定了29个不同的SDM训练计划。SDM训练对患者有中等影响(SMD0.5395%CI0.15-0.90),观察者报告SDM技能(SMD0.5995CI0.21-0.97)。对于混合培训计划，我们发现对生活质量(SMD1.2095%CI-0.38-2.78)和患者报告的SDM技能(SMD2.8995CI-0.55-6.32)有很大影响.
结论：SDM训练可提高GP患者和观察者报告的SDM技能。混合学习作为SDM的学习格式似乎比在线或实时学习格式对学习成果的影响更好。这表明设计SDM培训的教学设施可能希望优先考虑混合学习格式。需要SDM测量量表和评估方法的更多同质性以及不同类型教育格式的直接比较，以开发最合适和有效的SDM培训格式。
背景：PROSPERO：初级保健环境中共享决策培训计划的系统评价。PROSPERO2023CRD42023393385可从以下网址获得：https://www.crd.约克。AC.uk/prospro/display_record.php?ID=CRD42023393385。
方法：本综述按照PRISMA指南报告。2022年12月使用了八个不同的数据库，并于2023年9月更新。使用ICROMS评估偏倚风险。使用柯克帕特里克评估模型对培训效果进行分析，并根据培训形式（在线，现场或混合学习)。
结果：我们为GP确定了29个不同的SDM训练计划。SDM训练对患者有中等影响(SMD0.5395%CI0.15-0.90),观察者报告SDM技能(SMD0.5995CI0.21-0.97)。对于混合培训计划，我们发现对生活质量(SMD1.2095%CI-0.38-2.78)和患者报告的SDM技能(SMD2.8995CI-0.55-6.32)有很大影响.
结论：SDM训练可提高GP患者和观察者报告的SDM技能。混合学习作为SDM的学习格式似乎比在线或实时学习格式对学习成果的影响更好。这表明设计SDM培训的教学设施可能希望优先考虑混合学习格式。需要SDM测量量表和评估方法的更多同质性以及不同类型教育格式的直接比较，以开发最合适和有效的SDM培训格式。
背景：PROSPERO：初级保健环境中共享决策培训计划的系统评价。PROSPERO2023CRD42023393385可从以下网址获得：https://www.crd.约克。AC.uk/prospro/display_record.php?ID=CRD42023393385。
