365 Background: Shared decision-making is a fundamental principle of medicine where patients engage clinicians in a collaborative process to make healthcare decisions that align with their preferences, values, and goals. Many older adults with cancer report that clinicians do not engage in shared decision-making and rarely elicit their values when making treatment decisions. One cause for this deficit may be clinician education; most medical student education lacks standardized training on shared decision-making. Methods: This study evaluates the experiences of medical students who were trained to function as oncologists in a clinical trial aimed at improving shared decision-making. We recently completed a randomized trial involving 44 older adults with advanced cancer. Patients were randomized to receive a decision support tool or a communication flyer and then completed two simulated encounters: a values-based encounter and a non-values-based encounter. Medical students were trained by an oncologist in these two different strategies for the encounters. For non-values-based, they were trained to focus on treatment options without inquiring about values. For values-based encounters, they were trained to elicit and incorporate patient’s values into treatment decisions. We previously reported that patients were 71% more likely to report high quality shared decision-making in values-based encounters. Medical students completed semi-structured interviews following participation in the study. Thematic based on interpretive phenomenological analysis was conducted on the interviews. Results: Five themes emerged from thematic analysis: Students had a positive experience in engaging in shared decision-making with patients; Students valued engaging in shared decision-making with real patients in a simulated setting; Students felt the encounters helped them build confidence in communication skills; Students planned for integrating shared decision-making into their future practice; and Students desired more education within the medical school curriculum on shared decision-making. Conclusions: This study demonstrates the perceived value medical students placed on the opportunity to receive training and experience in shared decision-making as part of a randomized trial with older adults with advanced cancer and the felt need for further structured education within the medical school curriculum. This study also demonstrates the feasibility of training medical students to participate in simulated encounters and the perceived benefits they receive as part of this process.
Hamburger et al. (Wed,) studied this question.