shared decision making professor michelle leech deputy dean medicine monash university...
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Shared Decision Making
Professor Michelle Leech
Deputy Dean Medicine Monash University
Deputy-Director Monash Health Rheumatology
What do we teach and assess ?
Communication.
Communication regarding procedures and medication, consent
Patient-centred care
Evidence-based practice/ assessing risk
Communicating risk
Teaching patient-centred care How does it happen?
teaching by instruction
teaching by example
the patient comes first
communication is everything
embedded in course design
Teaching patient-centred care - examples Monash MBBS Final Year Student learning objectives
an understanding of the acute, chronic, ambulatory and psycho-social contexts of illness and how these influence the clinical presentation and management;
an understanding of the ‘continuum of care’ in patient management across diverse settings including rural health;
an ability to work as an effective member of a multidisciplinary health care team;
effective communication skills, advocacy skills and social understanding with patients of all ages and their families within diverse and multicultural contexts;
appropriate written and verbal communication skills with members of the health care team;
appropriate professional, ethical and gender competent behaviour with patients and members of the health care team;
familiarity with the medico-legal responsibilities of being an intern;
an awareness of health care quality improvement activities
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For patients, issues can be very different and not always uncovered
“I can never remember”
“Did Itake it?”
“The internet said…”
“The medication makes me feel worse”
“I keep losing it”
“I think the doctor has it wrong”
“I’m afraidof needles”
“I feel better”
UnintentionalNon-Adherence
IntentionalNon-AdherenceBeliefs and perceptions about treatment and disease