The Evolution of an Interprofessional Shared Decision-Making Research Program: Reflective Case Study of an Emerging Paradigm

Funded project	Objectives	Studies & key publications	Dates data collected and analysed
			2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
A) Advancing theories, models and measurement for an interprofessional approach to shared decision making in primary care	Develop conceptual model and propose measures	Study protocol A1 Advancing theories, models and measurement for an interprofessional approach to shared decision making in primary care: a study protocol. BMC Health Serv Res, 2008. 8(1)	✓	✓	✓	✓
	Analyse models and determine their relevance to clinical practice	Study A2 Stacey, D., et al., Shared decision making models to inform an interprofessional perspective on decision making: a theory analysis. Patient Educ Couns, 2010. 80(2): p. 164–72.	✓	✓
Propose and validate a new model	Study A3 Legare, F., et al., An interprofessional approach to shared decision making: an exploratory case study with family caregivers of one IP home care team. BMC Geriatr, 2014. 14: p. 83.		✓
Explore validity of model with stakeholders	Study A4 Legare, F., et al., Validating a conceptual model for an inter-professional approach to shared decision making: a mixed methods study. Journal of Evaluation in Clinical Practice, 2011. 17(4): p. 554–564.			✓	✓
B) Interprofessional shared decision making in home care: feasibility of implementation	Assess feasibility for implementation in home care services	Study protocol B1 Legare, F., et al., A conceptual framework for interprofessional shared decision making in home care: protocol for a feasibility study. BMC Health Serv Res, 2011. 11: p. 23.					✓	✓	✓	✓
	Assess health professionals’ intention to adopt new approach	Study B2 Legare, F., et al., Healthcare providers’ intentions to engage in an interprofessional approach to shared decision-making in home care programs: a mixed methods study. J Interprof Care, 2013. 27(3): p. 214–22					✓	✓
Develop tool for illustrating approach for health professionals	Study B3 Stacey, D., et al., A systematic process for creating and appraising clinical vignettes to illustrate interprofessional shared decision making. J Interprof Care, 2014. 28(5): p. 453–9.					✓	✓
Explore family caregivers’ perceptions of approach in home care context	Study B4 Legare, F., et al., An interprofessional approach to shared decision making: an exploratory case study with family caregivers of one IP home care team. BMC Geriatr, 2014. 14: p. 83					✓
C) Improving the decision process about location of care with the frail elderly and their caregivers	Feasibility of intervention to improve uptake of approach by home care teams & clients	Study protocol C1 Unpublished								✓	✓	✓
D) Implementing shared decision making in interprofessional home care teams	Implement and evaluate intervention to improve uptake of approach by home care teams and clients +/– decision aid	Study Protocol D1 Unpublished

Table 2

Reverse citation searches – notable citations [52, 53].

55 citations of Legare, F., et al., Advancing theories, models and measurement for an interprofessional approach to shared decision making in primary care: a study protocol. BMC Health Serv Res, 2008. 8(1): p. 2; including:

– Elwyn et al 2009 – Decision aids and beyond
– Desroches et al 2011 – SDM beliefs among dietitians
– Dunn – 2011 thesis – IP-SDM in intensive care unit
– Chong et al 2013 – IP and SDM in mental health care (2 articles)
– Col et al 2011 – IP education and SDM
– Yu et al 2014 – IP SDM and goal setting in diabetes care
– Alharbi et al 2014 – Experiences of patient-centred care in medical wards
– Catherine, Ivers et al 2015 – IP-SDM and decision aid for diabetes
– Sieck et al – IP-SDM increasing the shared in SDM

65 citations of Stacey, D., et al., Shared decision making models to inform an interprofessional perspective on decision making: a theory analysis. Patient Educ Couns, 2010. 80(2): p. 164–72, including:

– Korner et al 2012 – IP-SDM train the trainer program
– Korner et al 2013 – Designing an IP training program for SDM
– Stille et al 2013 – Parent partnerships in SDM for children with special needs
– Weinberger et al 2015 – IP-SDM model for the complex patient
– Hajiesmaeili et al 2015 – IP-SDM approach in the intensive care unit

89 citations of Legare, F., et al., Interprofessionalism and shared decision-making in primary care: a stepwise approach towards a new model. J Interprof Care, 2011. 25(1): p. 18–25, including:

– Llewellyn-Thomas & Légaré 2011 – IP education for IP-SDM practice
– Peterson 2012 – SDM in healthcare, role for social work
– Hofstede et al 2012 – Implementation of IP-SDM for sciatica care
– Buhse et al 2012 – SDM program for prevention of heart attack in diabetes
– Ernst et al 2015 – Role of pediatric psychologists in SDM
– Stacey 2015 – IP-SDM in oncology nursing

18 citations of Legare, F., et al., A conceptual framework for interprofessional shared decision making in home care: protocol for a feasibility study. BMC Health Serv Res, 2011. 11: p. 23, including:

– Truglio-Londrigan 2013 – SDM in home care from the nurses perspective
– Truglio-Londrigan 2015 – Patient experience with SDM

19 citations of Legare, F., et al., Healthcare providers’ intentions to engage in an interprofessional approach to shared decision-making in home care programs: a mixed methods study. J Interprof Care, 2013. 27(3): p. 214–22, including:

– Ploeg et al 2014 – IPE and IP collaboration in home care for older adults
– Sohi et al 2015 – Health care professionals’ collaboration to facilitate patient participation in life-prolonging care decisions

4 citations of Stacey, D., et al., A systematic process for creating and appraising clinical vignettes to illustrate interprofessional shared decision making. J Interprof Care, 2014. 28(5): p. 453–9.

2 citations of Legare, F., et al., An interprofessional approach to shared decision making: an exploratory case study with family caregivers of one IP home care team. BMC Geriatr, 2014. 14: p. 83.

Table 3

Key puzzles in merging of interprofessional collaboration (IP) and shared decision-making (SDM) into IP-SDM.

Puzzles	Type	How addressed	Opportunities
No consensus definitions of IP or SDM, therefore no definition of IP-SDM	Conceptual	IP-SDM defined	Further conceptual research that delves into both
SDM and IP lacked common elements	Conceptual	Identification of common ground by interdisciplinary research team	Further interdisciplinary collaborations that identify and build on common ground
Absence of relevant theory/model	Theoretical	Theory analysis of existing frameworks; interdisciplinary collaborative meeting to design new model; validation of model with stakeholders using Knowledge to Action framework.	Refinement of new model
Understanding the impact of the variables in each element of IP-SDM separately	Methodological	Stepwise approaches	Address complex statistical and organizational challenges of stepwise approaches
Measures only available for IP or SDM	Methodological	Learning new literature review methods, combinations of study designs	Development of new study designs and review methodologies
How to involve stakeholders effectively	Methodological	Integrated KT approach	Advancing knowledge about stakeholder involvement
How to recruit IP-SDM participants more effectively	Methodological	Managerial support, personal visits to sites; use of RAs, involvement of management & IP team from start)	Advancing knowledge about recruiting participants
Influence of social, organizational & health-system factors	Methodological	Interdisciplinary research team and a broader conceptualization of IP-SDM	Increased research on methods for measuring impact of these factors on IP-SDM needed
Determining patients’ desired levels of engagement in IP-SDM	Instrumental	Consulting patients and caregivers	Instrument development
Asynchronous nature of IP involvement, and changes in team or decision making involvement over time	Instrumental	Managerial support in involving IP teams, interdisciplinary research	Time-sensitive measures
Evaluation tools for IP-SDM	Instrumental	Search for tools; creation of video-vignette to explain approach	Identify challenges of implementation in real-world
Implementation in a variety of clinical contexts	Instrumental	Different clinical setting identified and feasibility of IP-SDM assessed	Develop strategies for implementing IP-SDM in different clinical contexts
Impacts of SDM on patient health, health systems and financial and human resources	Instrumental	Interdisciplinary research team	Advancing knowledge about these impact factors

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DOI: https://doi.org/10.5334/ijic.2212 | Journal eISSN: 1568-4156

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Language: English

Submitted on: Jul 17, 2015

Accepted on: Jun 29, 2016

Published on: Jul 19, 2016

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

shared decision-making,

interprofessional,

primary care,

knowledge construction,

Kuhn’s theory,

reflective case study

© 2016 Maman Joyce Dogba, Matthew Menear, Dawn Stacey, Nathalie Brière, France Légaré, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 16 (2016): Issue 3