Table 5 Strategies to improve training program on shared decision making with older adults with neurocognitive disorders

To improve learning modalities

 Offer the option of receiving the DBs in a single block rather than in sections.

 Make the online activity available in print format for regions with limited Internet access.

 Subdivide the longer modules.

 Use podcasts.

 Give participants the option of skipping the modules on topics they are already familiar with.

 Clarify the availability of the tools throughout the training program, and promote their potential as a teaching aid for interns.

 Create the possibility for learners to adjust the speed of the narration in the videos.

 Make headphones available to learners in shared workspaces.

 Make it easier to pick up training again after pausing.

 Include a user guide for learners who are less tech-savvy.

To improve implementation

Include targeted messages to help promote the training program:

 - By clarifying learners’ preferred objectives (understanding SDM, learning about the tools, understanding the evidence about the different interventions)

 - By highlighting the clinical issues covered by the DBs, since they are practice-oriented

 - By promoting the usefulness of DBs to communicate information to patients

Maintain training credits as a source of motivation, enhance them if possible, and add other possible sources of motivation.

Make the training program shorter.

Officially incorporate the training into the participant’s schedule by negotiating with immediate superior.

Provide training at a more convenient time of the year, e.g., in summer.

Adapt training length to individual needs and experience.

Make DBs easier to access:

 - Facilitate patients’ access to online DBs, e.g., by giving them the website address

 - Create direct access links to the DBs in the EMR (Electronic Medical Record)

 - Create direct access links to the DBs and the e-learning activity directly on clinic websites

 - Offer colour printed versions (budget for them) or equip offices with colour printers

Incorporate short modules specific to each clinical intervention field.

Create DBs for all of the themes addressed in clinical encounters, and expand the practice areas covered.

Offer learners the chance to choose the DBs they wish to review, at the beginning of the training program.

In the online activity, present examples, clinical cases, or role-plays relating to various scopes of professional practice.

Simplify the data presented in the DBs.

In the online activity, explain how to present the wide confidence intervals associated with effect estimates.

Promote the tools with decision makers and employers (nursing or multidisciplinary department heads, professional bodies, universities), via webinar, for example.

Address the barriers mentioned during the learning program with presentations and credited workshops, in collaboration with officially recognized public authorities.

To improve dissemination of the tools, make them available in clinics, health institutes, libraries, and other public places.

Promote the option of doing the training as a group.

Offer incentives to participate, in the form of gifts, money, or meals.

Promote shared decision making in the population and directly support patients and their caregivers in participating to the clinical decision making process.

Promote shared decision making at level of the government.