Workshops

Session description:
To support shared decision-making (SDM), initiatives often focus on the clinical encounter (micro level) and the use of decision aids. At the meso level, however, many barriers exist related to care path design, Multi-Disciplinary Team (MDT) decision making, and the development and use of Clinical Practice Guidelines (CPGs). In this workshop, we will discuss ways to support SDM through interventions at this meso level. Concerted action is needed by SDM researchers and educators, and CPG developers, together with clinicians and hospital managers, to create a movement towards such SDM support.

Learning objectives:
To understand the role of meso-level structures and interventions in supporting or hindering Shared Decision Making. To learn how to address barriers to and facilitators of SDM at the meso level. To explore tools or methods at the meso level aimed at improving implementation of SDM.

Author & Co-authors:
Anne Stiggelbout – Medical Decision Making, Lumc & Eshpm Erasmus Univ.
Marta Maes-Carballo- Department of General Surgery, Complexo Hospitalario de Ourense
Ester Rake – Knowledge Institute Of The Dutch Association of Medical Specialists, Utrecht, The Netherlands
Dunja Dreesens – Knowledge Institute Of The Dutch Association of Medical Specialists, Utrecht, The Netherlands

Session description:
Many patients and clinicians support the ideals and processes of SDM yet struggle to make decision aids, SDM training, policies, and roles work when they confront the problems that bring patients and clinicians together. This workshop explores what SDM needs to be in practice to help co-produce a way forward that does justice to each patient’s situation and the limited capacity of medicine to aid it. It is based on the Purposeful SDM model that illuminates how the reality of the problems being grappled with fundamentally change the methods, interactions, products, and purposes of meaningful SDM.

Learning objectives:
After this course, participants should be able to: 1. Recognize different forms of SDM in practice and the situations in which they arise. 2. Describe key methodological differences when using different forms of SDM in practice. 3. Critically examine their own experience of working with clinicians or patients to co-produce ways forward in challenging situations. 4. Generate questions for research and practice that arise if SDM is or should be different when used to address different problems that patients experience.

Author & Co-authors:

Ian Hargraves – Mayo Clinic
Misk Al Zahidy – Mayo Clinic
Victor Montori – Mayo Clinic
Maddie O’grady – Mayo Clinic
Ricardo Loor Torres – Mayo Clinic

Session description:
Explore a novel approach to chronic care management that merges Shared Decision Making (SDM) and Advance Care Planning (ACP), addressing three goals of care: fundamental, functional, and disease-specific. This workshop applies to a broad spectrum of chronic conditions with complication risks. Learn to craft evidence based care plans that respect patient preferences and values while considering their fundamental life goals, functional aspirations, and specific health challenges for current and future care. Ideal for healthcare professionals, this session offers insights into a model promoting patient autonomy, informed decision-making and evidence based medicine in diverse chronic care scenarios.

> Learning objectives:

• Understand the integration of SDM and ACP in chronic and severe illness management
• Develop skills for crafting patient-centered care plans considering fundamental, functional, and specific health goals for current and future care plans in cases of forseen and unforeseen emergencies and other situations of incapability of decision making.
• Discuss effective communication strategies for goal concordant care in chronic and severe illness management

Author & Co-authors:
Tanja Krones – Universitätsspital Zürich
Ana Rosca – Stadtspital Zürich
Isabelle Karzig-Roduner – Universitätsspital Zürich

Session description:
Shared Decision Making (SDM) involves collaboration between patients and clinicians in care decisions. Research predominantly focuses on patient-related SDM outcomes. We propose that enhancing SDM implementation requires a consideration of its impact on clinicians, including job satisfaction, stress reduction, and burnout prevention through meaningful patient relationships. The interactive workshop will concentrate on identifying initiatives to benefit clinicians. Our goal is to explore how SDM can enhance clinicians’ work environment while empowering patients in decision-making. By examining both perspectives, we aim to contribute to a holistic understanding of how SDM can transform the patient experience and clinicians’ professional lives.

> Learning objectives:

1. Explore Clinicians’ Experiences in SDM:
   • Gain insights into clinicians’ potential outcomes of SDM. •
   • Understand how SDM is related to and impacts clinicians’ well-being.
2. Examine Research on clinician related SDM outcomes:
   • Examine research on clinicians-related SDM outcomes and review and extract data on job satisfaction, stress, burnout, meaningfulness etc.
3. Enhance Knowledge Sharing:
   • Facilitate knowledge exchange on clinicians’ experiences with SDM. 
   • Emphasize perspectives that go beyond perceived barriers, focusing on the connection between SDM and clinicians’ well-being and conditions for care.
   • Share ideas for new research into impact of practicing SDM on clinicians.

Author & Co-authors:
Lea Lund – Lillebaelt Hospital, University Hospital of Southern Denmark
Stine Rauff Sondergaard – Lillebaelt Hospital, University Hospital of Southern Denmark
Karina Dahl Steffensen – Lillebaelt Hospital, University Hospital of Southern Denmark
Victor Montori – Mayo Clinic

Session description:
In this interactive workshop delegates will learn about and experience the pivotal role of patient participation in the implementation of VBHC. They will get practical handles and theoretical deepening to improve quality of care by discussing outcomes, involving patients in designing improvements (collective patient participation), and discussing outcomes for individual decision-making (individual patient participation/SDM). These two levels of patient participation empower healthcare professionals and patients to work together as partners from the consultation room to the hospital management. Delegates can join this workshop to gain practical insights and engage in a dialogue to advance patient participation in VBHC.

Learning objectives:
We aim to provide participants with a comprehensive understanding of VBHC and practical skills to involve patients at both the individual (i.e. SDM) and collective level. We have formulated the following learning objectives: 1. Understand the fundamental principles of VBHC and the implementation hereof in healthcare systems, including real-world case studies of VBHC implementation 2. Explore the key benefits of patient participation on two levels (individual and collective) in VBHC and the link to SDM 3. Identify strategies to enhance collective patient participation in a VBHC system 4. Discover real-world examples and methods to use outcome information for SDM 5. Collaborate with other participants to develop actionable plans to advance patient participation (individual and collective) in a VBHC system.

Author & Co-authors:
Cato Bresser – St. Antonius Ziekenhuis
Henrike Westerink – St. Antonius Ziekenhuis
Jet Ankersmid  – Santeon
Anne Vogelaar – Santeon
Mirjam Garvelink – St. Antonius Ziekenhuis

Session description:
Decision-making related to pregnancy and childbirth is particularly complex (1) decisions frequently impact on both the woman and her fetus (and baby) but often the potential benefits and harms of treatment conflict (2) there is often an absence of robust evidence to support decision-making (3) inequalities in maternal and neonatal outcomes are stark with Black and Ethnic Minority women and their babies experiencing much higher rates of mortality. Designing and implementing SDM interventions to support complex decision-making that reduce inequalities is vital. This workshop will provide support to develop and implement SDM interventions in pregnancy and childbirth.

Learning objectives:
Develop an understanding of the role of Shared Decision-Making in Maternity and how it can improve outcomes and reduce inequalities. Develop an understanding of the role of Shared Decision-Making when balancing conflicting maternal and perinatal priorities. Understand and be able to develop a research strategy that includes recruiting those with greatest health inequalities to both the co-design and in evaluation phases. Understand and be able to develop a national implementation strategy for you Shared decision-making intervention.

Author:
Rebecca Whybrow – King’s College London

Session description:
We will brainstorm about the meaning of SDM training programs and SDM evaluation scales: Is training in SDM useful? What elements should a training program on SDM minimally contain? How can we measure the effects of an SDM training? Which criteria can be used to evaluate a training on its successful character? From which perspective(s) do we need to evaluate the training effects? Is there any hierarchy to make in the importance of the perspectives of patients, healthcare providers and observers? How should we involve patients in the development and evaluation of SDM training programs?

Learning objectives:
To reflect on the meaning of SDM training and SDM evaluation scales.

Author & Co-author:
Lien Mertens – Ku Leuven
Jasmien Jaeken – Ku Leuven

Session description:
This patient and public-inclusive workshop, informed by team’s previous literature reviews and ongoing expert surveys (qualitative and quantitative studies), aims to shed the lights on the use of AI for shared decision-making (SDM) practice and education, emphasizing ethical considerations and human-centric approaches. Learning Outcomes: – Holistic understanding of AI’s role in enhancing SDM. – Insights into ethical, practical, and technical dimensions of AI-SDM. – Knowledge of how AI-SDM is being applied across different sectors. Target Audience: It targets researchers, health professionals and trainees interested in the intersection between AI and SDM.

Learning objectives:

Learning Outcomes:

• Holistic understanding of AI’s role in enhancing SDM.
• Insights into ethical, practical, and technical dimensions of AI-SDM.
• Knowledge of how AI-SDM is being applied across different sectors.

Author & Co-authors:
Samira A.Rahimi – McGill University and Mila-Quebec AI Institute and is the Canada Research
Glyn Elwy – The Dartmouth Institute for Health Policy and Clinical Practice, USA
Adrian Edwards – Wales Centre For Primary And Emergency Care Research
Anik Giguere – Département de médecine familiale et de médecine d’urgence , Faculté de médecine, Université Laval
Marie-Clare Hunter – Patient-Partner

Session description:
An interactive workshop designed to enhance participants’ competencies in providing decision coaching and appraising its quality. Decision coaching is non-directive support by trained healthcare providers to prepare people to actively participate in making health or social decisions. Ottawa Personal Decision Guide(s) will be used as theory and evidence-based interventions decision coaches may use alongside evidence-based information including patient decision aids. Decision coaching can be delivered face-to-face or by telephone. Evidence from systematic reviews shows it improves knowledge and participation in decision making, without causing unwanted harms. Clinicians, patients and public, and researchers are welcome.

Learning objectives:
a) To enhance participants’ knowledge, skills, and confidence with providing decision coaching;
b) To learn how to use the Ottawa Personal Decision Guide(s) in a conversation with a patient or health consumer considering a health or social decision;
c) To appraise quality of decision coaching;
d) To discuss strategies for incorporating decision coaching in clinical practice; and
e) To reflect on current knowledge gaps for future decision coaching research.

Author & Co-authors:
Dawn Stacey – University Of Ottawa
Krystina Lewis – University Of Ottawa
Jeanette Finderup – Aarhus University
Simone Kielin – Arctic University Of Norway
Birte Berger-Hoeger – Bremen University

Session description:
Person centred care requires a realignment of the power relationships within the clinical setting. To achieve new interactions, approaches such as shared decision-making and coproduction have been proposed. Their message is clear and appealing: Patients and health professionals join to make healthcare and health decisions together. Both approaches are promoted in medical and patient education, guidelines, and the media. Yet, implementation, i.e., regular use in practice, lags behind and has not been as successful as is required. In this session we will explore how this challenge can be overcome using tools that can help change habits.

Learning objectives:
Identify the challenges in shared decision making and coproduction? Develop solutions to address the introduction of shared decision-making? Introduce a coproduction template to change the way interactions can occur in clinical care.

Author & Co-authors:
Christian Von Plessen – Unisanté And Direction General
Jennifer Woods – Patient Partner
Peter Lachman – Royal College Of Physicians Of Ireland
Julie Johnson – Northwestern University
Ezequiel Garcia Elorrio – Institute For Clinical Effectiveness & Health Care Quality & Patient Safety
Paul Batalden – Dartmouth Institute For Health Policy and Clinical Practice

Session description:
This session will discuss the use of an implementation science framework, the Consolidated Framework for Implementation Research (CFIR), to work collaboratively with clinical stakeholders towards sustained implementation of shared decision-making interventions in the practice. At the end of this session, participants will leave with an understanding of how to best engage stakeholders in the design of shared decision making (SDM) interventions, collect qualitative data that elucidates key drivers of sustained implementation, and methods to apply these topics to their own work.

Learning objectives:

1. Articulate the core constructs of the Consolidated Framework for Implementation Research (CFIR.
2. Describe use-cases where CFIR informed co-production of shared decision-making interventions.
3. Apply the CFIR constructs to participant-led shared decision-making projects.

Author & Co-authors:
Kasey Boehmer – Mayo Clinic
Sarah Mccarthy – Mayo Clinic
Angela Sivly – Mayo Clinic
Victor Montori – Mayo Clinic
Misk Al Zahidy – Mayo Clinic
Maria Belen Mateo Chavez – Mayo Clinic

Session description:
With frequent changes to policies and laws about SDM, it can be difficult to keep up with current good practice, and the introduction of policy can sometimes feel time consuming and difficult. In this session, we will present ways to implement policy on SDM using a bottom up approach. The approach we present allows practitioners and the public to use new and changing policies to make life easier and improve their practice. The session will be highly interactive and practical, and we expect that participants will leave with plans of action on designing and using policy going forwards.

Learning objectives:

• To explore how policy can help and hinder SDM practice.
• To compare policies across the world, sharing good and bad aspects of policies participants have experienced.
• To change attitudes to policy by understanding how it can be developed and used at every level to encourage SDM policy.
• To develop skills to use policy to encourage colleagues to practise SDM.

Author & Co-author:
Andy Feltham – St Mary’s University
Grace Jeremy – Freelance

Session description:
Designing care plans that fit for each person requires patients and clinicians to collaborate. There are multiple ways in which such collaboration can be evaluated, most commonly through participant self-reported surveys or observer-based measures. Although helpful, these predefined quantitative evaluations may also limit our views, and risk evaluations to be tokenistic and de-humanized.
In this workshop, we discover and practice with the value of visual notetaking in evaluating patient-clinician conversations. We will focus on noticing humanistic aspects of care, attendees’ (un)conscious interpretation and reflection, and inductively design future research steps.

Learning objectives:
After this course, participants should be able to:

1. Understand the value of visualization as a method to think, remember, concentrate, detect, communicate and co-create,
2. Apply basic visualization techniques to assess aspects of patient-clinician collaboration, and
   
3. Identify opportunities to apply basic visualization techniques to their own work.

Author & Co-authors:
Anka Van Gastel – Leiden University Medical Center
Victor Montori – Mayo Clinic
Marleen Kunneman – Lumc / Mayo Clinic

Session description:
Emerging technologies such as artificial intelligence-driven chatbots, natural language processing tools, and data-integration platforms have the potential to change professional and patient interactions. Some have proclaimed a revolution in the relationship between patients and health professionals. In this interactive session, we will explore how technology can support or complicate shared decision-making and coproduction. Based on clinical examples, participants will try out interactions between patients and healthcare professionals without and with technology. Role plays in small groups and discussions will alternate with short inputs by the presenters.

Learning objectives:
Identify and describe the potential and risk of using chatbot and other AI technology in the coproduction of healthcare.

Author & Co-authors:
Christian Von Plessen – Unisanté And Direction General
Christine Bienvenu – Patient Partner, Haute École Arc, Unisanté
Ben Fehnert – Ctr Group
Glyn Elwy – The Dartmouth Institute for Health Policy and Clinical Practice, USA

Session description:
Although qualitative methods can yield insights, unfamiliarity can be a major barrier to using them effectively. Practical Thematic Analysis (PTA) is an approach to qualitative analysis recently published in The British Medical Journal (BMJ). PTA streamlines to Braun & Clarke’s thematic analysis using three steps: Reading, Coding, and Theming, effectively engaging diverse stakeholders throughout. A hallmark of PTA is simple directives for how to operationalize the complexities of qualitative analysis. In this session, we will offer guidance on drafting high-quality codes, conducting an inter-disciplinary and inter-perspective thematic analysis session, and developing meaningful themes, all in PTA fashion.

Learning objectives:
To develop familiarity with Practical Thematic Analysis (PTA) and its applications in the context of shared decision making, communications and experience research: Describe the key components of PTA. Identify research questions that could be answered using PTA. Demonstrate comfort and familiarity with PTA coding and theming.

Author & Co-authors:
Saunders Catherine – Dartmouth Health
Meredith Macmartin – Dartmouth Health
Renata Yen – Geisel School Of Medicine At Dartmouth
Jacqueline Pogue – Geisel School Of Medicine At Dartmouth

Session description:
Treatment decision-making following severe brain injuries is challenging: often, the patient has limited capacity and choices are made quickly. Strategies to support shared decision-making are needed to increase the likelihood that patients receive preferred care. Preference-sensitive decision timelines might be useful to aid shared-decision making. Such timelines may help stakeholders anticipate decisions to be made and prompt conversations about treatment to take place. We propose a workshop that explores the potential application, utility, and challenges of incorporating decision timelines into efforts to facilitate shared decision-making, taking aneurysmal subarachnoid hemorrhage as a use case.

Learning objectives:
Participants will gain an understanding of the challenges in shared decision-making for acute brain injury and be introduced to the idea of decision timelines. Taking aneurysmal subarachnoid hemorrhage as a use case, participants will become familiar with six key moments when patient preferences should shape the treatment plan. In an interactive way, participants will then explore the potential application and value of integrating such timelines into care. Taking the perspective of clinicians and surrogate decision makers, participants will help generate insight into questions that need further attention to successfully integrate such timelines.

Author & Co-authors:
Beatrix Göcking – Ibme, Uzh
Sophie Gloeckler – Ibme, Uzh
Nikola Biller-Andorno – Ibme, Uzh

Session description:
This session aims to attendees with an understanding of how large language models (LLMs), particularly the Bidirectional Encoder Representation from Transformers (BERT), are utilized in shared decision-making (SDM) research. We will begin by discussing how BERT is used to model dyadic conversations extending our analysis to include diverse mediums such as text, audio, and video. This approach highlights the model’s multimodal ability to facilitate the analysis of SDM. Towards the session’s conclusion, we will highlight the current limitations and ethical issues associated with the use of LLMs like BERT.

Learning objectives:

• Identify the key advantages as well as the limitations including biases and ethical issues of working with large language models like BERT.
• Describe how LLMs can be applied to model dyadic conversations in SDM research.

Author & Co-authors:
Oscar Ponce Ponte – University Hospitals Plymouth Nhs Trust
Misk A. Al Zahidy – Mayo Clinic
Victor Montori – Mayo Clinic
Juan Pablo Brito – Mayo Clinic

Session description:
An interactive two-hour workshop focused on shared decision-making (SDM) from the patients’ perspective, emphasizing the SMART (Specific, Measurable, Achievable, Relevant, Time-bound) approach to enhance SDM practices. Participants will gain insights into SDM from the patient’s viewpoint, learn from real experiences, and develop meaningful SDM approaches with their patients.

Learning objectives:

• Improve doctor-patient relationship by enhancing SDM skills and strategies.
  
• Efficiently implement SDM within a typical 15-minute appointment timeframe.
  
• The importance of SDM in healthcare relationships.
  
• Practical strategies for engaging patients in decision-making.
  
• The application of the SMART method in setting SDM goals.
  
• Identifying specific goals and measurable outcomes for SDM.
  
• Strategies for fostering collaborative and patient-centric healthcare relationships.
  
• Key takeaways that can be easily implemented in practice.
  
• Relevant questions to ask patients, such as their priorities and objectives for the appointment, and how to involve them in the process (« Homework for Patient »).

Authors:
Christine Bienvenu – Patient Partner, Haute École Arc, Unisanté
Jennifer Woods – Deputy Patient Partner for the National Coordination Platform for Clinical Research

Session description:
The shared decision making (SDM) society realizes that training is an indispensable part of its implementation. Join this workshop and learn about effective forms of training and how to apply them. Short theoretical explanations of training approaches are interspersed and deepened with discussion.
Workshop content:

• Explanation of the SDM-teacher’s manual of the Dutch medical specialists and nurses associations[7];
• Choosing, (co)designing, applying and evaluating trainings and preparing appropriate trainings (theory & practice);
• Fostering beneficial preconditions and stakeholder involvement;
• Discussion and conclusions.

Learning objectives:

Knowledge:

• Gain insight into different forms of SDM training and their theoretical underpinnings;
• Gain knowledge on what is important in preparing and organizing trainings for clinicians;

Attitude:

• Strengthen your motivation to start delivering trainings to clinicians; 
• Increase your understanding and sense of control over the importance of training as part of implementation;

Skills:

• Set up (the beginning of) a training (program) for clinicians;
• (Practice with/begin to) apply training.

Author & Co-authors:
Haske Van Veenendaal– Eshpm Rotterdam University, The Netherlands
Arwen Pieterse – Department Of Biomedical Data Sciences, Leiden University Medical Center, The Netherlands
Dirk Ubbink – Amsterdam University Medical Centers, The Netherlands
Maaike Schuurman – School For Shared Decision Making, Utrecht, The Netherlands
Ella Visserman – School For Shared Decision Making, Utrecht, The Netherlands

Session description:
Patients and clinicians use Shared Decision Making (SDM) to collaboratively work through how to respond to the patient’s situation. Traditionally, SDM tools present options and describe their pros and cons (options-led). Of note, SDM tools developed at Mayo Clinic, take an issues-led approach. Issues are factors that make a situation and options desirable or undesirable e.g. burdens, fears, complications etc. These tools look to issues first and seek options that best resolve them. This workshop explores how leading with options or issues affects the design of SDM tools, their use, and ability to support SDM in encounters.

Learning objectives:

1. Identify the advantages and disadvantages of designing SDM options-led and issues-led tools.
2. Discern how the use of different designs affects the effectiveness of how these tools support SDM conversations in practice.
3. Generate a program of research that closes design gaps toward their incorporation into IPDAS criteria specific to SDM encounter tools.

Author & Co-authors:
Ricardo Loor Torres – Mayo Clinic
Esteban Cabezas Rubio – Mayo Clinic
Yvonne Bui – Mayo Clinic
Ian Hargraves – Mayo Clinic
Victor Montori – Mayo Clinic