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Hi all, I have found the following two papers to be very helpful in teaching my students about shared informed decision-making (though they are not specific to discussions of risk). I particularly like Figure 1 in Elwyn et al. 1. Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P et al. Shared decision making: a model for clinical practice. J Gen Intern Med. 2012;27(10):1361-7. 2. Hoffmann T, Légaré F, Simmons M, McNamara K, McCaffery K, Trevena LJ et al. Shared decision making: What do clinicians need to know and why should they bother? Med J Aust. 2014;201(1):35-9. Thanks for the interesting discussion! Julie *************************************** Julie Tilson, PT, DPT, MS, NCS Associate Professor of Clinical Physical Therapy University of Southern California Division of Biokinesiology and Physical Therapy 1540 Alcazar St, CHP155 Los Angeles, CA 90089 Phone: 323-442-1281 Twitter feed: @EBPDPT From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of David Nunan Sent: Thursday, February 11, 2016 12:44 AM To: [log in to unmask] Subject: Re: Communicating risk/evidence to patients Thanks Tammy. Great to see the efforts you've gone to in tackling this area of EBP teaching. Are you planning to assess the new video in another trial setting? Perhaps a larger, internationally collaborative one (I'm fishing for an opportunity in case that's not quite coming across)? In any event I'd welcome a copy of this as and when it's ready. My own view is that why not the current practitioners/leaders of EBM star in such videos to demonstrate the whole EBM cycle - patient problem, finding the evidence, critical appraisal, application (shared decision making etc) and evaluation? Really demonstrate to folk how EBM is done in practice. When you say you found very few resources do you actually mean none? If there are some (good, bad or ugly), would you be willing to point us to them? Also - do you know of any people/papers that criticise EBM/EBP on this issue. Thanks again, David. From: Tammy Hoffmann <[log in to unmask]<mailto:[log in to unmask]>> Date: Tuesday, 9 February 2016 11:47 To: David Nunan <[log in to unmask]<mailto:[log in to unmask]>>, "[log in to unmask]<mailto:[log in to unmask]>" <[log in to unmask]<mailto:[log in to unmask]>> Subject: RE: Communicating risk/evidence to patients Hi Kev and David We have a video consultation that we use as part of our SDM teaching (as part of EBP) - and it was part of the intervention that we evaluated a few years ago in the RCT that's described here: http://www.ncbi.nlm.nih.gov/pubmed/24481686<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.ncbi.nlm.nih.gov_pubmed_24481686&d=CwMF-g&c=clK7kQUTWtAVEOVIgvi0NU5BOUHhpN0H8p7CSfnc_gI&r=O_Kvr476MsrFpXIToT3nBQ&m=0evK6O4pw3U2RCBxxBaqaUlbMksA124DREeAPnjJKMo&s=CWpm0n8JzosZKjPMfSfz0sdiW_VBf3yKKd0m9-27JDc&e=> The bad news is that unfortunately at the time of making the video, we didn't plan ahead and obtain consent from the standardised patient involved in the consultation to post the video online (so only use it for local teaching) - although I do have the script we wrote for it and I'm happy to send that if that's helpful. The good news is that we're currently planning to film another one (at least one - hopefully more; and with consent this time!) in the next few months, so we can share these once done. And to answer your search query David - as part of a project a few years ago, and one again more recently, we have searched on this topic and there are very few such resources - which is a shame as showing and discussing consultations that demonstrate SDM is a very useful way of teaching these skills. Kind regards Tammy Professor Tammy Hoffmann Centre for Research in Evidence-Based Practice Faculty of Health Sciences and Medicine Bond University Gold Coast, Queensland, Australia http://works.bepress.com/tammy_hoffmann/<https://urldefense.proofpoint.com/v2/url?u=http-3A__works.bepress.com_tammy-5Fhoffmann_&d=CwMF-g&c=clK7kQUTWtAVEOVIgvi0NU5BOUHhpN0H8p7CSfnc_gI&r=O_Kvr476MsrFpXIToT3nBQ&m=0evK6O4pw3U2RCBxxBaqaUlbMksA124DREeAPnjJKMo&s=xmKxuAo8s9RQa0shCs58Mzy6mMSqGBUQv68uxDC42nE&e=> Twitter: @Tammy_Hoffmann From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of David Nunan Sent: Tuesday, 9 February 2016 9:23 PM To: [log in to unmask]<mailto:[log in to unmask]> Subject: Re: Communicating risk/evidence to patients Thanks for the update Kev. I think the blank you drew is an important omission on behalf of the EBM community and something we should collaboratively attempt to address. Perhaps a more systematic search and write up of the issue is worth considering with a view to stimulating debate and hopefully action? Happy to help out such a project. Best, David From: "Evidence based health (EBH)" <[log in to unmask]<mailto:[log in to unmask]>> on behalf of Kev Hopayian <[log in to unmask]<mailto:[log in to unmask]>> Reply-To: Kev Hopayian <[log in to unmask]<mailto:[log in to unmask]>> Date: Tuesday, 9 February 2016 08:45 To: "[log in to unmask]<mailto:[log in to unmask]>" <[log in to unmask]<mailto:[log in to unmask]>> Subject: Re: Communicating risk/evidence to patients Hi one and all, Many thanks for the tips. I regret to say I drew a blank. There are resources out there about how to share decisions, how to communicate risk, and how to use decision aids but not consultations per se. Here were the suggestions of some relevance Shared decision making Mayo Clinic shared decision making: http://es.testingtreatments.org/2013/03/25/toma-de-decisiones-compartida/<https://urldefense.proofpoint.com/v2/url?u=http-3A__es.testingtreatments.org_2013_03_25_toma-2Dde-2Ddecisiones-2Dcompartida_&d=CwMF-g&c=clK7kQUTWtAVEOVIgvi0NU5BOUHhpN0H8p7CSfnc_gI&r=O_Kvr476MsrFpXIToT3nBQ&m=0evK6O4pw3U2RCBxxBaqaUlbMksA124DREeAPnjJKMo&s=bfjIOgnc6CCSdGokTrwUoIiycCVc6NxsjJgKaVw1JcY&e=> Victor Montori in Spanish https://www.youtube.com/watch?v=_1RJnYJnPPM<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.youtube.com_watch-3Fv-3D-5F1RJnYJnPPM&d=CwMF-g&c=clK7kQUTWtAVEOVIgvi0NU5BOUHhpN0H8p7CSfnc_gI&r=O_Kvr476MsrFpXIToT3nBQ&m=0evK6O4pw3U2RCBxxBaqaUlbMksA124DREeAPnjJKMo&s=6QSyotcOULwmCSC4gO9aRhBpZwgam1WEZYlzaNHe0r8&e=> Information for patients and records of patients' experiences Healthtalk online http://www.healthtalk.org<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.healthtalk.org&d=CwMF-g&c=clK7kQUTWtAVEOVIgvi0NU5BOUHhpN0H8p7CSfnc_gI&r=O_Kvr476MsrFpXIToT3nBQ&m=0evK6O4pw3U2RCBxxBaqaUlbMksA124DREeAPnjJKMo&s=xXqwZWC-vRt1Hd5I_3forCL-EHcG3eIvux9SQqYLPxk&e=> Consultation skills in general for family physicians/GPs with recorded consultations Youtube, search for CSA RCGP Dr Kev (Kevork) Hopayian, MD FRCGP General Practitioner, Suffolk, Hon Sen Lecturer, Norwich Medical School, University of East Anglia Primary Care Tutor, East Suffolk RCGP Clinical Skills Assessment examiner RCGP International Adviser http://www.angliangp.org<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.angliangp.org&d=CwMF-g&c=clK7kQUTWtAVEOVIgvi0NU5BOUHhpN0H8p7CSfnc_gI&r=O_Kvr476MsrFpXIToT3nBQ&m=0evK6O4pw3U2RCBxxBaqaUlbMksA124DREeAPnjJKMo&s=Ytr0jc9ltPFSLOC4feT1P-QeFqRtd7TrRfuyUpY1HO0&e=>