Piloting a shared decision-making clinician training intervention in maternity care in Australia: A mixed methods study.
Clinician training
Maternity care
Mixed methods
Shared decision-making
Timing of planned birth
Journal
Midwifery
ISSN: 1532-3099
Titre abrégé: Midwifery
Pays: Scotland
ID NLM: 8510930
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
17
05
2023
revised:
28
08
2023
accepted:
11
09
2023
medline:
7
11
2023
pubmed:
18
9
2023
entrez:
17
9
2023
Statut:
ppublish
Résumé
Implementation of woman-centred care in evidence-based maternity practice requires clinicians to be skilled in shared decision-making, yet there is limited training or research into such interventions. Shared decision-making enables women to make informed decisions in partnership with clinicians where there are varied clinical options in relation to indications for and timing of planned birth. We aimed to develop a shared decision-making training intervention and evaluate its feasibility and acceptability to midwives and obstetricians. The intervention was co-designed by midwifery and medical clinician-researchers, and a consumer representative. Online training and demonstration videos were distributed to midwives and obstetricians in three Sydney hospitals, followed by two online workshops in 2021 and 2022 where participants practised shared decision-making in roleplaying scenarios tailored to timing of birth. Training was evaluated using post-workshop and post-training surveys and semi-structured qualitative interviews. The training workshop format, duration and content were well received. Barriers to the uptake of shared decision-making were time, paternalistic practices and fear of repercussions of centring women in the decision-making process. The intervention enabled midwifery and medical colleagues to learn communication repertoires from each other in woman-centred discussions around timing of birth. Roleplay scenarios enabled participants to observe and provide feedback on their colleagues' shared decision-making practices, while providing a space for collective reflection on ways to promote, and mitigate barriers to, its implementation in practice. Shared decision-making training supports maternity clinicians in developing skills that implement woman-centred care in the timing of planned birth.
Sections du résumé
PROBLEM
OBJECTIVE
Implementation of woman-centred care in evidence-based maternity practice requires clinicians to be skilled in shared decision-making, yet there is limited training or research into such interventions.
BACKGROUND
BACKGROUND
Shared decision-making enables women to make informed decisions in partnership with clinicians where there are varied clinical options in relation to indications for and timing of planned birth.
AIM
OBJECTIVE
We aimed to develop a shared decision-making training intervention and evaluate its feasibility and acceptability to midwives and obstetricians.
METHODS
METHODS
The intervention was co-designed by midwifery and medical clinician-researchers, and a consumer representative. Online training and demonstration videos were distributed to midwives and obstetricians in three Sydney hospitals, followed by two online workshops in 2021 and 2022 where participants practised shared decision-making in roleplaying scenarios tailored to timing of birth. Training was evaluated using post-workshop and post-training surveys and semi-structured qualitative interviews.
FINDINGS
RESULTS
The training workshop format, duration and content were well received. Barriers to the uptake of shared decision-making were time, paternalistic practices and fear of repercussions of centring women in the decision-making process.
DISCUSSION
CONCLUSIONS
The intervention enabled midwifery and medical colleagues to learn communication repertoires from each other in woman-centred discussions around timing of birth. Roleplay scenarios enabled participants to observe and provide feedback on their colleagues' shared decision-making practices, while providing a space for collective reflection on ways to promote, and mitigate barriers to, its implementation in practice.
CONCLUSION
CONCLUSIONS
Shared decision-making training supports maternity clinicians in developing skills that implement woman-centred care in the timing of planned birth.
Identifiants
pubmed: 37717344
pii: S0266-6138(23)00231-0
doi: 10.1016/j.midw.2023.103828
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
103828Informations de copyright
Copyright © 2023 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest This manuscript is not being considered elsewhere. There are no conflicts of interests in relation to any commercial products, consultancies, stock ownership or other equity interests or patent-licensing arrangements. This work was supported as part of the Timing of Birth study by Maridulu Budyari Gumal, the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE).