The development of interprofessional training tools in shared decision-making; a shared journey

Abstract

The implementation program of Shared Decision Making (SDM) in medical and nursing curricula was part of the national program Uitkomstgerichte Zorg (UZ) (Outcome-Oriented Care) in the Netherlands. This initiative was embedded in evolving policies aiming to restructure care. Together with the Netherlands Patients Federation, Netherlands Federation of University Medical Centres, Dutch Federation of Medical Specialists, and the Dutch Professional Nurse Practitioner Organisation, the project was successfully completed in 2023. The result is a comprehensive educational package with support materials to help educators integrate SDM into national curricula.

An evaluation among stakeholders and research in three hospitals revealed challenges in implementing SDM in clinical practice. Although healthcare providers report proficiency in SDM, its application, measured with the OPTION-5 instrument, remains limited. Interprofessional collaboration is critical, but role division is often unclear. Nurses, in particular, express uncertainty about their role and see opportunities for improvement. Continuing education on SDM is scarce, with healthcare providers primarily acquiring these skills informally through colleagues or experiential learning.

This program highlights the need for clear role definitions and structured training to embed SDM into clinical practice effectively, bridging the gap between self-reported competence and observed implementation.