Junqiang(John) Zhao

Shared Decision-Making. A Primer for Clinicians - Journal of General Internal Medicine Importance Shared decision-making is a widely promoted approach, yet clinicians, typically supportive in principle, find it difficult to implement because of concerns and barriers they commonly encounter in practice. Objective To generate a primer that describes shared decision-making from the perspective of clinicians. Methods We collaborated with clinicians, patient representatives, and health service researchers. We invited members of the International Society of Shared Decision Making to co-produce a primer for clinicians using a series of jointly edited online documents. We shared drafts with other clinicians and patients. Finally, we integrated the contributions until we had arrived at a consensus. Findings Twenty-five people from 13 countries contributed; 9 had medical qualifications, 4 had nursing qualifications, and 12 others had a range of backgrounds. A total of 30 patients and clinicians provided further comments. The description differs from previous versions because it addresses the barriers that clinicians frequently mention. It describes how to overcome common challenges by emphasizing the importance of a clear invitation at initiation; it suggests how to manage patients’ resistance to shouldering decisional responsibility; reinforces the need to allow time for deliberation, especially with other stakeholders; and reassures clinicians that consensus, albeit welcome, need not be the goal of shared decision-making. Conclusions and Relevance This primer portrays a reflective clinician who is aware of power asymmetry, patient vulnerability, risk communication, health literacy, agenda setting, and goal clarification. It envisages a clinician who is curious about personal perspectives and who can offer collaborative, iterative, and deliberative steps.

Shared decision making: a primer for clinicians

link.springer.com/article/10.1...

Hi #impsci friends! Are you looking for free and easy to use toolkits on Causal Pathway Diagrams, Prioritizing Implementation Barriers, Rapid Ethnographic Assessment, or Rapid Evidence Synthesis? Look no further than ImpSciMethods.org!

Systematic reviews of non-RCT evidence: building dry stone walls To bake good cookies, start with good cookie dough. To use a different metaphor, to build a brick wall, take a large collection of bricks—all the same size and in perfect shape—and line them up neatly...

In the excitement over our new review of PAs, I forgot to tell you about the OTHER paper published in BMJ today, my commentary on the challenges of doing systematic reviews of evidence when there's no RCTs and most of the primary studies were unique and non-standardised.🧪
www.bmj.com/content/388/...

Generalizing from qualitative data: a case example using critical realist thematic analysis and mechanism mapping to evaluate a community health worker-led screening program in India - Implementation ... Background A central goal of implementation science is to generate insights that allow evidence-based practices to be successfully applied across diverse settings. However, challenges often arise in p...

Hot off the press for holiday reading! 🤓

We apply #criticalrealist #thematicanalysis to identify #mechanisms driving #implementation of a #CHW screening program. #Qualitative data can and should produce generalizable insights!

#impsci

implementationscience.biomedcentral.com/articles/10....

#impsci folks. Worth reading and reflection on this default barrier/ enabler analysis approach in our doing of implementation research