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Exackte 2: Exploiting the Clinical Consultation as a Knowledge Transfer and Exchange Environment



Shared decision making requires two basic elements: the patient being actively involved in decisions pertaining to his or her health, and knowledge to be adequately transferred from the healthcare worker to the patient. The transfer and exchange of knowledge through clinician–patient interactions requires both parties sharing information, being sensitive to the others' preferences and positions, and coming to an agreement about tests and treatments that influence healthcare outcomes. Even if brief, a consultation can affect the other person's emotions and behavior.

In order to improve the effectiveness of knowledge translation interventions in clinical encounters, our study aims to use a SDM model to explore how patients and clinicians influence one another.

Using a longitudinal design, with 400 clinician–patient pairs, our study will unfold in three phases:

1. development and validation of a set of reciprocal measures;

2. performance of a series of statistical analyses that explore how patients and clinicians influence one another during the translation and exchange of knowledge within the SDM model;

3. use of the results of these analyses as reference material for designing new knowledge translation interventions for clinical encounters.

The acceptability and feasibility of these interventions will be tested during a pilot study with focus groups of patients and clinicians. This project emphasizes the "exchange" aspect of knowledge translation and exchange during clinician–patient interactions.

Published protocol:

Légaré F, Stewart M, Frosch D, Grimshaw J, Labrecque M, Magnan M, Ouimet M, Rousseau M, Stacey D, van der Weijden T, Elwyn G. EXACKTE(2): Exploiting the clinical consultation as a knowledge transfer and exchange environment: a study protocol. Implement Sci. 2009 Mar 13;4:14.


Légaré F, Turcotte S, Robitaille H, Stewart M, Frosch D, Grimshaw J, Labrecque M, Ouimet M, Rousseau M, Stacey D, van der Weijden T, Elwyn G. J Clin Some but not all dyadic measures in shared decision making research have satisfactory psychometric properties.  J Clin Epidemiol. 2012 Dec;65(12):1310-20. 

Pellerin MA, Elwyn G, Rousseau M, Stacey D, Robitaille H, Légaré F. Toward shared decision making: using the OPTION scale to analyze resident-patient consultations in family medicine.  Acad Med. 2011 Aug;86(8):1010-8. 

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