While a key challenge is the need to strengthen practitioners' decision support skills [ 29] training interventions have been shown to markedly improve the quality of practitioners' decision support skills for other clinical problems [ 33].
The quality of decision support skills will be assessed using audio-taped interactions between participants and simulated patients.
Quality of Decision Support Skills will be measured with DSAT modelled on the ODSF and Ivey's Problem Solving Model [ 68].
Few studies have investigated the efficacy of an evidence-based, theory guided intervention aimed at assisting clinicians to strengthen their patient decision support skills.
Specific workshop objectives are that participants will: understand concepts of decisional needs, decision support, and decision quality, learn to use decision support tools, evaluate decision support skills, and analyze barriers and facilitators to implementing decision support in practice.
The tool demonstrated adequate inter-rater reliability for scoring on both decision support skills (75%, kappa = 0.58) and communication skills (76%, Kappa = 0.68) when it was tested in physician/patient dyads (n = 34 dyads).
c. 2 6 weeks following completion of the full intervention the quality of the participants' decision support skills will be assessed with a different simulated patient scenario using the same methodology as the baseline assessment.
The primary aim of this study is to evaluate the efficacy of a theory driven, framework-based training intervention, as compared with a control condition (usual care approach) in enhancing the quality of practitioners' patient decision support skills regarding place of care at end of life.
However the use of simulated callers is recognized as a relatively reliable method for assessing professional performance, facilitates a standardized experience across participants, provides a clearer picture of decision support skills in general, is a more accurate measure of current practice compared to self-report or chart audit, and has been used widely [ 72- 77].
Clinicians can identify patients' decisional needs and provide decision support, yet generally lack skills and confidence in doing so.
