A Need for Targeted Teaching of Shared Decision-Making as Identified from an Assessment of Client-Centered Communication Skills Training with Companion Animal Veterinarians.

Abstract

Shared decision-making has been increasingly discussed as a communication practice within veterinary medicine, and it is gaining more traction for diagnostic and treatment planning conversations and specifically offering a spectrum of care. This teaching tip describes the data from an investigation of veterinarians' shared decision-making in a pre-test/post-test communication skills training intervention that used a client-centered, skills-based communication approach. Practice teams from a purposive sample of four companion animal veterinary clinics in Texas participated in a 15-month communication skills intervention, including interactive group workshops and one-on-one communication coaching. To assess the outcome of the intervention, for nine participating veterinarians, appointments recorded pre- (n = 85) and post-intervention (n =  85) were analyzed using the Observer OPTION 5 instrument to assess shared decision-making. The intervention effect was evaluated using mixed logistic regression, adjusting for appointment type. The communication intervention did not significantly impact participating veterinarians' demonstration of shared decision-making (pre = 25.42, n = 55; post = 28.03, n = 56; p = 0.36). Appointment type was significantly associated with veterinarians' OPTION 5 scores (p = .0004) and health problem appointments (OPTION 5 = 30.07) demonstrated greater shared decision-making than preventive care appointments (OPTION 5 = 22.81). Findings suggest that client-centered, skills-based training traditionally used in veterinary curricula and continuing education may not foster the use of shared decision-making, which is a higher-order communication approach that may require a dedicated process-oriented training. This teaching tip highlights the need for a targeted stepwise approach to teach shared decision-making.