ArticleBMJ open2024
Unravelling clinicians' shared decision-making adoption: a qualitative exploration through the lens of diffusion of innovations theory.
Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Article
- Shared decision-making in pediatric physical therapy: A qualitative study among adolescents, parents, and physical therapists.PloS one · 2026Article
- A guideline-based preference elicitation tool to enhance shared decision-making in supervised exercise therapy for patients with intermittent claudication: a process evaluation.Annals of medicine · 2025Article
- Key tips to shift student perspectives through transformative learning in medical education.BMC medical education · 2025Review
- Development of Worksheets for Immunomodulator Shared Decision-Making to Facilitate Patient-Clinician Communication: A Quality Improvement Project Employing Design Thinking Principles.Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases · 2024Article
- Evidence on Patient Decision Aids and Shared Decision-Making Across Breast Centers in Europe: A Cross-Sectional Survey Study.Cancer control : journal of the Moffitt Cancer CenterArticle
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Authors and funding
4 authors.
Funding
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Abstract
objectivesThis study uses the diffusion of innovations (DOI) theory to comprehensively understand the adoption of shared decision-making (SDM) in clinical practice, specifically focusing on the 'knowledge' and 'persuasion' stages within DOI. We aim to understand the challenges and dynamics associated with SDM adoption, offering insights for more patient-centred decision-making in healthcare.
designThis qualitative study employs a modified framework analysis approach, integrating ethnographic and interview data from prior research, along with additional interviews. The framework used is based on the DOI theory. STUDY SETTING AND
participantsThis study was conducted in the obstetrics and gynaecology department of a tertiary teaching hospital in the Eastern region of the Netherlands. It included interviews with 20 participants, including gynaecologists, obstetrics registrars and junior doctors currently practising in the department. Additionally, data from prior research conducted within the same department were incorporated, ensuring the maintenance of contextual consistency.
resultsFindings reveal a complex interplay between SDM's benefits and challenges. Clinicians value SDM for upholding patient autonomy and enhancing medical practice, viewing it as valuable for medical decision-making. Decision aids are seen as advantageous in supporting treatment decisions. Challenges include compatibility issues between patient and clinician preferences, perceptions of SDM as time-consuming and difficult and limitations imposed by the rapid pace of healthcare and its swift decisions. Additionally, perceived complexity varies by situation, influenced by colleagues' attitudes, with limited trialability and sparsely observed instances of SDM.
conclusionsClinicians' decision to adopt or reject SDM is multifaceted, shaped by beliefs, cognitive processes and contextual challenges. Cognitive dissonance is critical as clinicians reconcile their existing practices with the adoption of SDM. Practical strategies such as practice assessments, open discussions about SDM's utility and reflective practice through professional development initiatives empower clinicians to make the best informed decision to adopt or reject SDM.
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