Table 4 Summary of review findings for clinician-related factors
Summary of review findings for additional clinician-related factors Illustrative quote | CERQual assessment of confidence in the evidence |
|---|---|
Intentions: | |
Predetermined treatment decision A number of clinicians decide on the treatment plan before engaging in decision-making conversations, with the intention of “selling” the patient on the treatment they have selected for them “In most cases, the physicians made the treatment decisions. Either one physician made the treatment decision by himself or several physicians made medical decisions jointly (especially in inpatient wards). For example, one observer noted, …‘Most decisions during ward rounds [at inpatient wards] are taken in front of the computer before entering the patient’s room’.” [53] | High confidence |
Beliefs about Consequences: | |
Negative Outcomes Clinicians reported not engaging in SDM when they are concerned about the potential of a negative outcome, sometimes this is due to the acuity of the decision or the potential risks “[Interviewer: Tell about times you don’t use SDM?] ‘STEMIs [ST segment elevation myocardial infarction], I’m not asking a lot of questions, I’m going forward.’” [56] | High confidence |