This collaborative project will be developed by an interdisciplinary team composed of researchers from Canada, France, Germany, Switzerland, the United Kingdom, and the United States. Ongoing research activities may cause researchers from countries not yet represented to join the project. Canadian team members will be responsible for coordinating the study, fostering communication among members of the international team, coordinating the environmental scan, inventorying CPD programs and their critical appraisals, and hosting the final workshop. Team members from other countries will provide expertise in implementing SDM through CPD, sharing their experiences and standpoints on the problems and/or challenges involved in this process. They will also help build the inventory of CPD programs for translating SDM in clinical practice and contribute to the research agenda.
An environmental scan is an efficient, organised means for an institution to collect information about its internal and external surroundings [27–29]. Continuing professional educators can also use a scan to identify current and potential learning needs and trends. Conducting a scan thus distinguishes areas in need of improvement, identifies the resources necessary to make those improvements, and ultimately, enhances decision making. In this study, we will perform an environmental scan to identify information about effective CPD programs and related activities for translating SDM into primary care, and to analyse the gaps in the knowledge base.
The literature describes various methodologies and sources for collecting and analysing information for an environmental scan . With help from our research team network and a private firm that specialises in business intelligence and strategic watches, we will begin by identifying professional organisations, academic institutions, and experts in the fields of CPD and SDM. We will contact each one individually and--because we plan to favour sensitivity--inquire about any SDM training programs and/or activities, any published or unpublished evaluations of these programs and/or activities, and any other organisations or experts that may help us to find as many SDM training programs and/or activities as possible.
After having identified SDM training programs and/or activities, we will contact CPD organisations (planners and providers) and invite them to participate in a semi-structured interview. This interview will focus on the organisation of CPD activities geared towards fostering SDM in clinical practice and will be modified in light of interviewees' responses following the first step of the environmental scan.
Identification of eligible CPD programs
We understand a CPD activity to be an educational activity that serves to maintain, develop, or increase the knowledge, skills, and professional performance of a licensed healthcare professional who provides services to patients, the public, or the profession (e.g., educational meetings and material, audit and feedback, academic detailing) . In this project, a CPD program in SDM is defined of a set of procedures that links clients' needs (healthcare professionals' need to be trained in SDM), activities (a given educational activity), necessary resources (human and material), and immediate and long-term outcomes (licensed healthcare professionals sharing decisions with their patients, and patients' health outcomes). Such a program must comprise at least one CPD activity whose aim is to maintain, develop, or increase the knowledge, skills, and professional performance used by licensed healthcare professionals to share decisions with their patients in a given clinical context.
We expect to identify CDP programs in SDM that meet our inclusion criteria and include at least one CPD activity. It is also possible that we will identify single, isolated SDM CPD activities that are not part of a CPD program in SDM. For each eligible CPD program and/or activity identified, we will ask authors to provide material and a published or unpublished description. All programs and/or activities thus identified will be included in the inventory, independent of the language in which the material was written. A private firm and team members will consider the merits of translating the material into English for our critical appraisal. This work will lay the foundation for the initial inventory, and will ensure that the relevant literature has been appraised and evaluated.
For each eligible CPD program and/or activity included in the initial inventory, two reviewers (members of the research team) will independently extract characteristics of the SDM CPD program and related activities using a standardised data extraction form. Inspired by the Workgroup for Intervention Development and Evaluation Research (WIDER) reporting guidelines for behavioural interventions, this form will be discussed with all team members and will be adapted to the needs of the study . The two reviewers' extractions will be compared and disagreements resolved through consensus or appeal to the principal investigator. Findings will be entered into a matrix to facilitate comparing the performance of various CPD activities with respect to the characteristics of interest.
Characteristics that will be extracted include the following: identifiers of the training activity (e.g., title, authors, year, country, language); types of healthcare professionals targeted (e.g., physicians, nurses, social workers, health psychologists); accreditation and provision of continuing medical education/CPD credits by an official continuing medical education/CPD organisation; objectives of the program; level of the Kirkpatrick model of educational outcomes addressed by the study (e.g., reaction, learning, behaviour, results) ; essential elements of the integrated model of SDM addressed by the study; mode of delivery (e.g., on-line, on site); instructional methods (e.g., didactic lectures, workshops, case studies, demonstrations); material available (e.g., videos, card games, decision support tools, simulated patients, trainer and/or trainee booklets); duration and frequency of the program; the human and material resources needed to conduct the program; the program's estimated cost; methods and tools to assess how the program impacts participants; empirical data about the efficacy of the program; the transferability of the program to other healthcare professionals and contexts; and updates, modifications, and revisions.
Inventory of CPD programs for translating SDM in clinical practice
A summary of each CPD program will be accessible online. Each summary will include the title, the author, the author's website, and other pertinent information.
Results from the environmental scan and the critical appraisal will be synthesized and the empirical data used to facilitate discussions and identify knowledge gaps during a two-day workshop to be attended by the members of the international collaboration in Quebec City, Canada. This consensus meeting will be critical to distilling the information. When information is presented in a straightforward and precise manner, it becomes possible for experts to assimilate the concepts, discuss the results, and draw logical conclusions. The goal is that research team members will share their unique knowledge and perspectives on translating SDM into primary care through effective CPD and will reach unanimous agreement on the topics discussed. The consensus meeting will be led by a facilitator who is not a team member. This will allow a neutral party to moderate discussions and will ensure that participants respect the time allotted for each topic. Team members will be expected to achieve consensus regarding the gaps in the knowledge and the elements to include in the research agenda. We will produce a brief report summarizing the outcomes of the consensus meeting. The last step of our project goes beyond our research team and involves validating a summary of the study by CPD stakeholders through electronic communication.
The representatives of CPD organisations whom we will interview will be asked to complete consent forms. Ethical approval for the project was received from the Research Ethics Board Committee of the Centre Hospitalier Universitaire de Québec (CHUQ) on 21 June 2010.