US-based cross-sectional survey of clinicians' knowledge and attitudes about shared decision-making across healthcare professions and specialties.
OBJECTIVE
In this study, we aim to compare shared decision-making (SDM) knowledge and attitudes between US-based physician assistants (PAs), nurse practitioners (NPs) and physicians across surgical and family medicine specialties.


SETTING
We administered a cross-sectional, web-based survey between 20 September 2017 and 1 November 2017.


PARTICIPANTS
272 US-based NPs, PA and physicians completed the survey. 250 physicians were sent a generic email invitation to participate, of whom 100 completed the survey. 3300 NPs and PAs were invited, among whom 172 completed the survey. Individuals who met the following exclusion criteria were excluded from participation: (1) lack of English proficiency; (2) area of practice other than family medicine or surgery; (3) licensure other than physician, PA or NP; (4) practicing in a country other than the US.


RESULTS
We found few substantial differences in SDM knowledge and attitudes across clinician types, revealing positive attitudes across the sample paired with low to moderate knowledge. Family medicine professionals (PAs) were most knowledgeable on several items. Very few respondents (3%; 95% CI 1.5% to 6.2%) favoured a paternalistic approach to decision-making.


CONCLUSIONS
Recent policy-level promotion of SDM may have influenced positive clinician attitudes towards SDM. Positive attitudes despite limited knowledge warrant SDM training across occupations and specialties, while encouraging all clinicians to promote SDM. Given positive attitudes and similar knowledge across clinician types, we recommend that SDM is not confined to the patient-physician dyad but instead advocated among other health professionals.
['Forcino|Rachel C|RC|', 'Yen|Renata West|RW|', 'Aboumrad|Maya|M|', 'Barr|Paul J|PJ|', 'Schubbe|Danielle|D|', 'Elwyn|Glyn|G|', 'Durand|Marie-Anne|MA|']
D000328:Adult D001291:Attitude of Health Personnel D003430:Cross-Sectional Studies D003657:Decision Making D005260:Female D006302:Health Services Research D006801:Humans D008297:Male D009722:Nurse Practitioners D010358:Patient Participation D010823:Physician Assistants D010817:Physician-Patient Relations D010820:Physicians
organisation of health services quality In health care