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Physician Self-assessment of Shared Decision-making in Simulated Intensive Care Unit Family Meetings.


ABSTRACT: Importance:Professional guidelines have identified key communication skills for shared decision-making for critically ill patients, but it is unclear how intensivists interpret and implement them. Objective:To compare the self-evaluations of intensivists reviewing transcripts of their own simulated intensive care unit family meetings with the evaluations of trained expert colleagues. Design, Setting, and Participants:A posttrial web-based survey of intensivists was conducted between January and March 2019. Intensivists reviewed transcripts of simulated intensive care unit family meetings in which they participated in a previous trial from October 2016 to November 2017. In the follow-up survey, participants identified if and how they performed key elements of shared decision-making for an intensive care unit patient at high risk of death. Transcript texts that intensivists self-identified as examples of key communication skills recommended by their professional society's policy on shared decision-making were categorized. Main Outcomes and Measures:Comparison of the evaluations of 2 blinded nonparticipant intensivist colleagues with the self-reported responses of the intensivists. Results:Of 116 eligible intensivists, 76 (66%) completed the follow-up survey (mean [SD] respondent age was 43.1 [8.1] years; 72% were male). Sixty-one of 76 intensivists reported conveying prognosis; however, blinded colleagues who reviewed the deidentified transcripts were less likely to report that prognosis had been conveyed than intensivists reviewing their own transcripts (42 of 61; odds ratio, 0.10; 95% CI, 0.01-0.44; P?

SUBMITTER: Vasher ST 

PROVIDER: S-EPMC7237960 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Physician Self-assessment of Shared Decision-making in Simulated Intensive Care Unit Family Meetings.

Vasher Scott T ST   Oppenheim Ian M IM   Sharma Basyal Pragyashree P   Lee Emma M EM   Hayes Margaret M MM   Turnbull Alison E AE  

JAMA network open 20200501 5


<h4>Importance</h4>Professional guidelines have identified key communication skills for shared decision-making for critically ill patients, but it is unclear how intensivists interpret and implement them.<h4>Objective</h4>To compare the self-evaluations of intensivists reviewing transcripts of their own simulated intensive care unit family meetings with the evaluations of trained expert colleagues.<h4>Design, setting, and participants</h4>A posttrial web-based survey of intensivists was conducte  ...[more]

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