This study was conducted by Renata West Yen and published in Sussex Research Online (University of Sussex). SDM knowledge was high among medical students in all four countries (Canada, Netherlands, UK, and US), but US students had the highest SDM knowledge scores (86.2%, 95% CI 84.8%-87.6%). However, the mean score for knowledge about risk communication was 57.4%. Attitudes were positive, but 46% believed SDM could only succeed with better-educated patients, while 80.9% disagreed that physician payment should be linked to SDM performance.