A Qualitative Analysis of Attending Physicians' Use of Shared Decision-Making: Implications for Resident Education

Journal of Graduate Medical Education
Elizabeth M SchoenfeldKathleen M Mazor

Abstract

Physicians need to rapidly and effectively facilitate patient-centered, shared decision-making (SDM) conversations, but little is known about how residents or attending physicians acquire this skill. We explored emergency medicine (EM) attending physicians' use of SDM in the context of their experience as former residents and current educators and assessed the implications of these findings on learning opportunities for residents. We used semistructured interviews with a purposeful sample of EM physicians. Interviews were transcribed verbatim, and 3 research team members performed iterative, open coding of transcripts, building a provisional codebook as work progressed. We analyzed the data with a focus on participants' acquisition and use of skills required for SDM and their use of SDM in the context of resident education. Fifteen EM physicians from academic and community practices were interviewed. All reported using SDM techniques to some degree. Multiple themes noted had negative implications for resident acquisition of this skill: (1) the complex relationships among patients, residents, and attending physicians; (2) residents' skill levels; (3) the setting of busy emergency departments; and (4) individual attending factors...Continue Reading

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Citations

Mar 27, 2018·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Elizabeth M SchoenfeldKathleen M Mazor
May 22, 2019·Journal of Human Lactation : Official Journal of International Lactation Consultant Association·Samantha A Chuisano, Olivia S Anderson

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