Attitudes toward shared decision-making and risk communication practices in residents and their teachers

Figures & data

Table

Practice points

Teachers most often use verbal risk communication practices, and they might benefit from additional training on risk communication in numerical and graphical forms. More attention during medical education and training is needed to improve risk communication practices in the future. Comparing teachers and residents views provides important insights into postgraduate medical training programs.

Table 1  Residents’ opinions: differences in mean scores for risk communication education, negative attitudes toward SDM, and lack of time for SDM (one-way ANOVA)

	Risk communication education				Negative attitudes toward SDM				Lack of time for SDM
	N	Mean	SD	F	N	Mean	SD	F	N	Mean	SD	F
Specialty				15.3*				8.4*				27.0*
Internal medicine	1373	4.11^a	1.03		1372	3.28^b	1.16		1367	3.63^c	1.46
Anesthesiology	300	3.91^a	1.16		297	3.37^b	1.13		296	3.02^a,b	1.42
Surgery	720	4.04^a	1.07		719	3.18^a,b	1.11		719	3.28^b	1.35
Gynecology	366	4.36^b	0.99		366	2.98^a	1.14		366	3.08^a,b	1.42
Pediatrics	304	3.96^a	0.99		303	3.05^a	1.08		303	3.36^b	1.38
Psychiatry	675	4.36^b	1.11		672	3.00^a	1.16		670	2.89^a	1.42
Orthopedic surgery	227	4.42^b	0.98		227	3.17^a,b	1.18		226	3.03^a,b	1.30
Size of residency				65.3*				15.7*				117.3*
1–3 residents	223	4.58^c	1.15		223	2.96^a	1.23		221	2.60^a	1.39
4–10 residents	1142	4.31^b	1.10		1140	3.08^b	1.16		1139	2.99^b	1.42
≥11 residents	2600	4.08^a	1.08		2593	3.21^c	1.15		2587	3.44^c	1.44

Notes: Identical superscripts (within columns, per variable) indicate a non-significant difference between a pair of means, whereas different superscripts indicate a significant difference using the Games–Howell post hoc test (α = 0.05). Scores ranged from 1 “does not apply at all” to 6 “fully applies.” SD, standard deviation.

* = p < 0.001.

Table 2  Teachers’ opinions: differences in mean scores for attitudes toward SDM and risk communication attitudes and practices by seven important specialties

	Internal medicine	Anesthesiology	Surgery	Gynecology	Pediatrics	Psychiatry	Orthopedic surgery	F
	Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)
	N = 148	N = 45	N = 92	N = 63	N = 30	N = 89	N = 55
Attitudes toward SDM
Negative attitudes toward SDM	2.82^b (1.08)	3.13^b (1.23)	2.95^b (1.03)	2.72^a,b (0.94)	2.60^a,b (1.26)	2.31^a (1.01)	2.97^b (1.15)	4.45**
Lack of time for SDM	3.32^b (1.34)	3.33^b (1.51)	2.63^a (1.13)	2.65^a (1.25)	2.43^a (1.28)	2.98^a,b (1.31)	2.62^a (1.35)	5.56**
Attitudes toward risk communication
If I have the impression that patient would not understand risk information, then I will leave this information out of the conversation	2.22^a (1.23)	2.68^a (1.57)	2.39^a (1.48)	2.14^a (1.29)	1.93^a (1.12)	2.03^a (1.16)	1.89^a (1.06)	2.35*
For my profession, I need to know more about the best way to communicate risks to patients	2.45 (1.14)	2.39 (1.17)	2.26 (1.28)	2.10 (1.01)	2.34 (1.32)	2.55 (1.25)	2.24 (1.15)	1.25
I know how to communicate risks to patients in an understandable manner	4.70 (1.14)	4.57 (1.17)	4.65 (1.37)	4.57 (1.51)	4.31 (1.76)	5.00 (0.98)	4.74 (1.12)	1.55
Risk communication practices
I discuss false positive and false negative test results with patients.	3.89^a (1.22)	3.53^a (1.56)	4.07^a,b (1.40)	4.57^b (1.19)	4.30^a,b (1.15)	4.24^a,b (1.34)	4.52^b (1.26)	4.58**
Risk communication–numbers	3.50^a (1.13)	3.81^a,b,c (1.20)	3.92^b,c (0.89)	4.13^c (1.08)	3.75^a,b,c (1.01)	3.56^a,b (1.13)	4.12^c (0.85)	4.81**
Risk communication–graphs	2.37^a,b (1.06)	1.99^a (1.14)	2.73^b,c (1.20)	3.26^c (1.38)	3.28^c (1.42)	2.70^b,c (1.21)	2.54^a,b,c (1.31)	7.84**
Risk communication–verbal	5.16 (0.74)	5.19 (0.82)	5.13 (0.98)	5.32 (0.78)	5.10 (0.86)	5.17 (0.78)	5.24 (0.67)	0.47

Notes: The number of teachers in the analysis might slightly differ between variables because of missing values. Identical superscripts (within rows) indicate a non-significant difference between a pair of means, whereas different superscripts indicate a significant difference using the Games–Howell post hoc test (α = 0.05). Scores ranged from 1 “does not apply at all” to 6 “fully applies.”

SD, standard deviation.

* = p < 0.05, ** = p < 0.001.