Table 5 Overview over the entire evaluation plan and corresponding results
Outcome | Operationalization | Time | Results | |
|---|---|---|---|---|
Level 1: reactions | ||||
Engagement | Interest: The workshop kept your interest throughout the day (s) | Self-reported, questionnaire (4-point Likert scale)* | After basic | 95% (19 of 20) agreed or strongly agreed |
After advanced | 74% (14 of 19) agreed or strongly agreed | |||
Interferences: Was there anything about the course that interfered with my learning process? | Self-reported questionnaire (open-ended question) | After basic | Challenges regarding technique issues and the room where the course was held We would wish to see a SDM gold standard video | |
After advanced | A bit theoretical I was frustrated since I felt low agreement in the observer training The MAPPIN´SDM manual should be simplified in terms of language and examples Too few breaks | |||
Relevance | Usefulness & applicability I consider what I learned through the workshop as useful for carrying out my work | Self-reported questionnaire (4-point Likert scale)* | After basic | 90.5% (19/21) agreed or strongly agreed |
Through the workshop I became aware of how I can apply what I have learned | 86% (18/21) agreed or strongly agreed | |||
Usefulness & applicability I consider what I learned through the workshop as useful for carrying out my work | After advanced | 68% (13/19) agreed or strongly agreed | ||
Through the workshop I became aware of how I can apply what I have learned | 63% (12 of 19) agreed or strongly agreed | |||
Applicability: What elements in the TTT course have been most useful for you? | Self-reported, online questionnaire (open question) | After three months | Watching video clips and recognizing the steps to SDM Learning about how to disseminate the steps of an SDM process Day one was absolutely most helpful. Both to gain basic knowledge about SDM, what, why, how. Very good with all the teaching material that was ready for use Learning about the difference between this and other communication methods with patients regarding health decisions To watch videos where SDM is actually happening and to understand that SDM is a sequence in a patient conversation Interprofessional discussions of different perspectives within the group Interesting to watch videos in light of the 6 steps of an SDM process, but also challenging Becoming well acquainted with the purpose and understanding behind SDM Day two did not quite meet what I needed in terms of conducting teaching in practice. Nice to see and reflect on videos, but a bit too extensive and deep-diving | |
Satisfaction | Willingness to recommend: I would recommend this course to others who are going to provide SDM training | Self-reported questionnaire (4-point Likert scale)* | After basic | 95% (20 of 21) agreed or strongly agreed |
After advanced | 56% (11 av 19) agreed or strongly agreed | |||
Need for revision: What can we do to improve the TTT-course? | Self-reported, online questionnaire (open ended question) | After three months | Frame it less research oriented The course was good, good lectures and instructive content on lecture. Nice balance between exercises / assessment of videos / self-activity and lecture Clarify the relationship between “four habits” [39, 40], “choosing wisely” [38] and the Norwegian campaign “what is important for you” Put more focus on anchoring within the hospital trust and strategic work on implementing SDM Fewer videos to allow for more in-depth review and professional discussion More practice in how to perform the training More practicing in how to assemble the SDM training based on different needs and more training in didactics More time for discussing experiences with teaching More time for discussing how to reach the various target groups | |
Level 2: learning | ||||
Knowledge | Subjective understanding SDM: I have understood the concept of SDM | Self-reported questionnaire (4-point Likert scale)* | After basic | 95% (20 of 21) agreed or strongly agreed |
Subjective understanding SDM: I know the quality criteria for SDM | After advanced | 84% (16 of 19) agreed or strongly agreed | ||
Five-item SDM knowledge test SDM is indicated Patient involvement in decision-making means What does the patient need to make an informed choice? Which knowledge base is used to consider the benefit of medical interventions? When is SDM contraindicated? | Multiple-choice questions | After basic | Participants knowledge scored higher than knowledge measured in the training group in an earlier RCT [24] | |
Attitude | Attitudes regarding patient involvement It is desirable to involve patients in medical decisions | Self-reported questionnaire (4-point Likert scale)* | After basic | 100% (21 of 21) agreed or strongly agreed |
After advanced | 100% (19 of 19) agreed or strongly agreed | |||
It is beneficial for health care providers to receive SDM training | 95% (21 of 21) agreed or strongly agreed | |||
Attitudes regarding the INTERPROF module: It is beneficial for health care providers to receive SDM INTERPROF training | 100% (19 of 19) agreed or strongly agreed | |||
Skills | Accuracy of communication judgements | Observation test using MAPPIN | After advanced | Participants attained excellent skills in quality appraisal (mean = .80, N = 19) |
Confidence | Regrading handling barriers, conducting training, conveying SDM appraisal: I am able to convey what SDM means to others | Self-reported questionnaire (4-point Likert scale)* | After basic | 81% (17 of 21) agreed or strongly agreed |
I am able to answer typical questions / barriers about SDM | 86% (18 of 21) agreed or strongly agreed | |||
I am able to assess degree/extent of SDM within HCP-patient consultations | After advanced | 68% (13 of 19) agreed or strongly agreed | ||
I can convey to what extent / why / why not SDM is being conducted | 53% (9 av 17) agreed or strongly agreed | |||
I feel confident in providing SDM INTERPROF training to HCP | 53% (10 of 19) agreed or strongly agreed | |||
Confidence to conduct training: What additional support would you need to complete 2-h training? | Self-reported questionnaire (open ended questions) | More practice exchange with other SDM trainers More information about adult learning methods More exercise in assembling components of the curriculum to tailor the SDM training to the target audiences More practical training and experience Guidance from the course developers later on More training resources, clinical videos on klarforsamvalg.no More observer training Practical advice on how to get clinicians to set aside time / prioritize | ||
Confidence to conduct training: What are the barriers to delivering SDM trainings? | Lack of time of the target group Uncertainty regarding how to invite and get access to clinicians Anchoring SDM in the management at the hospital Feeling not yet confident enough to provide skills-training using clinical videos with feedback provision and group discussions rather than just delivering information about SDM | |||
Commitment | Concrete plans for realization: I consider it to be likely that I will teach others (HCP) in SDM within the next 6 months | Self-reported questionnaire 4-point Likert* | After advanced | 42% (8 of 19) agreed or strongly agreed |
Level 3: Behaviour | ||||
Realization | Number of trainings performed; number of HCPs trained | Self-reported, online questionnaire | After three months | 69% (9 of 13) had conducted SDM trainings 62% (8 of 13) had conducted more than two SDM trainings 458 HCPs had received training |
Barriers | Preparation: It was easy to construct a training using the materials provided on the platform | Self-reported, online questionnaire (4-point Likert scale)* | 64% (6/11) agreed or strongly agreed | |
Barriers met during training conducts: What were the barriers to delivering the SDM trainings? | Self-reported, online questionnaire (open ended questions) | Lack of opportunities to deliver the trainings Difficult access to clinicians caused by time limitations and lack of invitation The absence of an implementation strategy for the hospital trust Challenging to know the program and to adapt it, even though the resources on the webpage were very helpful It is a difficult role to convey with credibility and dedication if you yourself are no longer working clinically The SDM presentation might be considered very theoretical and even as another “must” task. HCP feel they are doing SDM already | ||