1.2.h Why do Providers Hesitate?
Let us explore some of the perceived barriers to person-centred decision making, and what the evidence says about these impediments (4, 6, 10, 11).
1) “It would take too much time to do all that”
Several studies have shown that providers trained in some of these skills do not take significantly longer to conduct care. Learning to use a logical sequence can help save time; since a conversation is already taking place, person-centred decision making simply alters the nature of that conversation.
You will get lots of experience in this course applying skills that will help you to share decision making, which can be transferred easily to your clinical setting. For this course, we have chosen contexts where time is often of the essence. Shared decision making processes are typically taught in non-urgent scenarios such an office visit. Often, issues brought up in a birthing context are more imminent or urgent. In this course, you will learn how to share decision making in both urgent and non-urgent scenarios.
2) “I already do that”
Evidence shows that providers and people do not always communicate well. People who are receiving clinical care rarely give direct feedback about communication problems. This may encourage providers to believe that there is no need to change or improve. In this course, you will practice giving and receiving feedback to a number of people to develop your verbal and non-verbal communication style. You will develop your self-awareness and learn the importance of verbal and non-verbal language when communicating. Person-centred decision making requires knowledge of key communication techniques, such as paraphrasing, summarizing, reflecting, open questioning, and sending messages. You will learn and practice these communication skills in this course.
3) “What about people who don’t want to be involved in their care?”
Sometimes people may feel uncomfortable with making a health care decision simply because they have never had the opportunity to do so before. It is a provider’s responsibility to encourage autonomy in decision making, which includes sharing necessary information about treatment and listening to what is important to the client. In this course, you will learn how to avoid making cultural and professional assumptions about people; these assumptions prohibit dialogue and strain relationships.
Health care providers also need to able to facilitate dialogue about people’s values, beliefs, and preferences because these often guide health care decision making. This is true for everyone who shares in the decision making process. You will learn how to identify and articulate the values, beliefs and preferences held by yourself and by your patient/client.
4) “There are too many barriers to interprofessional shared decision making”
Research shows that power differences attributed to gender, stereotypes, and social status affect collaboration. In this course, we will provide tools for interprofessional collaboration, team functioning, and conflict management.