From training to practice: a qualitative study of GPs’ shared decision-making experiences

Background: Although shared decision-making (SDM) is key to delivering patient-centred care, there are barriers to general practitioners (GPs) implementing SDM in practice. SDM training is undergoing development by organisations, including the Royal College of General Practitioners. However, GPs’ perceptions of the delivery of SDM training in general practice remain largely unexplored. Aim: To explore GPs’ perceptions of teaching methods in SDM training. Design and Setting: A qualitative study of GPs with teaching roles at the University of Exeter Medical School was conducted. Method: Purposive sampling recruited 14 GPs. Semi-structured interviews explored their SDM educational experiences. Data were analysed using thematic framework analysis. Results: Three themes were identified. The GPs described role-play, receiving feedback, and on-the-job learning as modes of delivering SDM training that positively informed their SDM in clinical practice. Learning from knowledgeable individuals and using realistic patient cases were perceived as beneficial components of SDM learning, though most learning occurred implicitly through reflections on their clinical experiences. The GPs identified the incorporation of the uncertainty that is present in general practice consultations; targeting of individual GPs’ SDM learning needs and explanation of the potential benefits of SDM on consultation outcomes as important methods to facilitate the implementation of SDM in practice. Conclusion: This is the first UK study to explore GPs’ perceptions of SDM training and provide recommendations for practice. As SDM occurs in partnership with patients, further research should obtain and incorporate patients' views alongside those of GPs in the evaluation of future programmes.