Effectiveness of a Multimodal Educational Intervention to Improve Shared Decision-Making Skills Among Pediatric Hospitalists

Objective Evaluate the effect of a novel multimodal educational intervention on Pediatric Hospital Medicine (PHM) attendings’ skills, knowledge, attitudes, and self-reported behaviors toward shared decision-making (SDM). Methods We conducted a prospective single-center study of PHM attending physicians. Attendings participated in 3 SDM educational interventions: an asynchronous online module, a 1-hour lecture on patient decision aids, and a 2-hour interactive workshop. Outcomes were measured pre- and postintervention for comparison. The primary outcome was attending SDM skills measured in a simulated encounter with a standardized patient and scored by trained, blinded raters using the OPTION 5 scale. Secondary outcomes were measured by questionnaire and included: knowledge, attitudes towards SDM, and self-reported behaviors measured by the SDM-9-doc based on a case scenario. Paired analyses were conducted using Wilcoxon matched-pairs signed rank test and McNemar’s chi-squared exact method to evaluate for statistically significant differences (P '.05) in pre- versus postintervention period. Results Of 62 attendings approached, 21 participated in the study. Attending OPTION 5 scores improved from a preintervention median of 37.5 (IQR 34.4, 42.5) to 47.5 (IQR 40.0, 57.5) postintervention (P ≤.04). SDM knowledge improved but there were no statistically significant changes in attitudes; baseline attitudes were favorable towards SDM (range: 52%–95%). Self-reported behaviors significantly increased for seeking patients’ desired involvement in decision-making (P = .03) but other behavioral outcomes did not differ significantly. Conclusions While PHM attendings had favorable attitudes toward SDM at baseline, a multimodal educational intervention for teaching PHM faculty was effective in increasing SDM knowledge and observed skills.