ABSTRACT
Despite the many benefits of shared decision-making, uptake of its practices is low. These tools and frameworks can help you to engage patients in their care decisions.
Subject(s)
Decision Making, Shared , Decision Making , Humans , Patient ParticipationABSTRACT
BACKGROUND: A foundation of care within a Patient-centered Medical Home (PCMH) is respect for patients' values and preferences. Shared decision making (SDM) involves a set of principles and approaches to working with patients that integrates medical information and data with the preferences, values, and support systems of individual patients facing medical decisions. The value of SDM is increasingly evidenced by the incorporation of principles of SDM into the definitions of patient-centered care and PCMHs, accountable care organizations, and the language of the Health Reform Act of 2010. METHODS: We developed and integrated a curriculum on SDM in the third-year Family Medicine Clerkship at Dartmouth Medical School. The curriculum consisted of a mix of experiential, classroom, and online experiences designed to provide students with opportunities to learn content, practice skills, and share observations from their preceptorships. RESULTS: Student feedback was an important component of evaluating the SDM curriculum. Themes identified from students' reflections on their own behavior in a Simulated Patient Encounter included an increase in confidence and competence in their ability to use SDM, while noting the disconnect that may exist between what is taught in the clerkship and what they experience in their preceptorships. CONCLUSIONS: As this curriculum has developed, we have acquired a deep appreciation of the benefits and challenges of attempting to teach sophisticated communication and decision-making precepts to medical students who are working to master fundamentals of clinical work and who may or may not see such precepts reinforced in practice.
Subject(s)
Clinical Clerkship/statistics & numerical data , Clinical Competence , Curriculum , Decision Making , Education, Medical, Undergraduate/methods , Students, Medical , Clinical Clerkship/standards , Communication , Feedback , Health Knowledge, Attitudes, Practice , Humans , Internet , Learning , New Hampshire , Program Development , Program Evaluation , Schools, Medical , TeachingSubject(s)
Book Reviews as Topic , Family Practice/methods , Guidelines as Topic , Mass Media , Writing , HumansABSTRACT
Primary dysmenorrhea is commonly a straightforward diagnosis that can be made accurately with an attentive history. In young women who have classic symptoms and no specific indication, a pelvic examination is often unnecessary in the initial evaluation. The opportunity for primary care practitioners to support women in unearthing the best approach to this chronic recurrent discomfort to minimize adverse life impact is significant and valuable. Identification of patients who are incapacitated by their symptoms or have symptoms that represent underlying pathology is a critical component of a careful history. The wide range of treatments available for primary dysmenorrhea virtually ensures that all females troubled by the symptoms can find relief with safe and inexpensive treatments while limiting negative side effects.
