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Table 5 Overview over the entire evaluation plan and corresponding results

From: Ready for SDM: evaluating a train-the-trainer program to facilitate implementation of SDM training in Norway

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
  1. This table presents an overview over the entire evaluation plan and corresponding results structured according to Kirkpatrick’s levels of evaluation. In the study, all questions were provided in Norwegian language. * the 4-point Likert scale ranged from 1 = “strongly disagree” to 4 = “strongly agree”