Training in shared decision-making for registered nurses taking a master’s degree and/or a postgraduate programme

Abstract

Background: Registered nurses play a decisive role in supporting patients to participate in decisions on their own health, also referred to as shared decisionmaking. Official recommendations and up-to-date knowledge demonstrate that, although shared decision-making is necessary for patients, there are few training programmes within or outside the education system that can meet this need for competence. Objective: To gain insight into how RNs taking a master’s degree and/or a postgraduate programme respond to a three-hour training module in SDM and decision coaching, and how students perceive the effect on learning. We also wanted to identify possible barriers and facilitators in relation to the use of decision coaching. Method: We used a multi-method research design based on Kirkpatrick’s four-step model for evaluating training interventions. We reported on the first two levels – reaction and learning – using a questionnaire to assess how students reacted to and learned from the training. The quantitative data were analysed using descriptive statistics, but we analysed the free-text questions using qualitative content analysis. Results: Eighty-two registered nurses taking a master’s degree and/or a postgraduate programme in cancer nursing or nephrology nursing participated in the course, and 76 of them consented to take part in the study. The registered nurses reported that the teaching was useful for clinical practice and recommended it to others. They also wanted more skills training in order to increase their competence in shared decisionmaking. They highlighted the ‘Six steps to shared decision-making’ in addition to role play and exercises as among the most useful elements of the training. A broad spectrum of barriers and facilitators across individual, organisational and systemic levels were reported. Conclusion: The study shows that the registered nurses found that the training provided them with relevant knowledge that they could use in their daily work in order to promote the development of knowledge about the shared decision-making process. Further training is both desirable and necessary in order to increase registered nurses’ self-confidence and skills in practising decision coaching.