Salzburg statement on shared decision making

The "Salzburg statement" on shared decision-making puts again on the
table our responsibility to take into account patient values and
preferences in healthcare decisions.[1] Despite new models of evidence-
based decision-making acknowledge that patients' preferences rather than
clinicians' preferences should be considered first whenever it is possible
to do so, this is often neglected.[2]

If it is expected that core undergraduate curriculum in medical
schools prepare students for their future people-centered practice, we
must provide innovative and transformative learning environments to
achieve this goal.[3] This include innovative ways to teach communication
and shared decision-making competences.

There are already sets of competences proposed for the practice of
informed and shared decision-making by physicians and patients, that could
be used as frameworks for teaching, practice, and research.[4] Also
several instruments have been developed to evaluate shared decision making
among patients and health professionals.[5,6] Most of these instruments
have not been yet adapted to undergraduate medical education, and none of
this has been validated for Spanish-speaking countries. How can we expect
that our health professionals foster participatory decision-making if
these skills are not included in the intended or delivered curriculum of
medical schools?

Then we must also made a call to educators to develop, validate and
implement educative interventions to achieve the competences needed for
healthcare students to foster shared decision-making in their future
practice.

References

1. Salzburg statement on shared decision making. BMJ 2011; 342:d1745.

2. Haynes RB, Devereaux PJ, Guyatt GH. Clinical expertise in the era
of evidence-based medicine and patient choice. ACP journal club 2002; A11-
A14.

3. Frenk J, Chen L, Bhutta Z, Cohen J, Crisp N, Evans T, et al.
Health professionals for a new century: transforming education to
strengthen health systems in an interdependent world. The Lancet 2010;
376(9756):1923-1958.

4. Towle A, Godolphin W. Framework for teaching and learning informed
shared decision making. BMJ 1999; 319(7212):766-71.

5. Shields CG, Franks P, Fiscella K, Meldrum S, Epstein RM. Rochester
Participatory Decision-Making Scale (RPAD): reliability and validity.
Annals of family medicine 2005; 3(5):436-42.

6. Elwyn G, Edwards a, Wensing M, Hood K, Atwell C, Grol R. Shared
decision making: developing the OPTION scale for measuring patient
involvement. Quality & safety in health care 2003; 12(2):93-9.