A systematic process for creating and appraising clinical vignettes to illustrate interprofessional shared decision making

Abstract

Vignettes and written case simulations have been widely used by educators and health services researchers to illustrate plausible situations and measure processes in a wide range of practice settings. We devised a systematic process to create and appraise theory-based vignettes for illustrating an interprofessional approach to shared decision making (IP-SDM) for health professionals. A vignette was developed in six stages: (1) determine IP-SDM content elements; (2) choose true-to-life clinical scenario; (3) draft script; (4) appraise IP-SDM concepts illustrated using two evaluation instruments and an interprofessional concept grid; (5) peer review script for content validity; and (6) retrospective pre-/post-test evaluation of video vignette by health professionals. The vignette contained six scenes demonstrating the asynchronous involvement of five health professionals with an elderly woman and her daughter facing a decision about location of care. The script scored highly on both evaluation scales. Twenty-nine health professionals working in home care watched the vignette during IP-SDM workshops in English or French and rated it as excellent (n = 6), good (n = 20), fair (n = 0) or weak (n = 3). Participants reported higher knowledge of IP-SDM after the workshops compared to before (p < 0.0001). Our video vignette development process resulted in a product that was true-to-life and as part of a multifaceted workshop it appears to improve knowledge among health professionals. This could be used to create and appraise vignettes targeting IP-SDM in other contexts.

• Continuing education
• health services research
• interprofessional learning
• interprofessional education
• patient-centered practice
• shared decision making
• work-based learning

Acknowledgements

We would like to acknowledge the work of Carol Puma in coordinating the development and evaluation of the video vignette. Dawn Stacey holds a University Research Chair in Knowledge Translation to Patients. France Légaré holds the Canada Research Chair in Implementation of Shared Decision Making in Primary Care. Sophie Desroches holds a New Investigator Award from the Canadian Institutes of Health Research.