257 Navigating a shift: healthcare professionals’ attitudes towards learning to practice shared decision-making

Introduction Successful implementation of Shared Decision-Making (SDM) depends highly on the attitude of healthcare professionals towards SDM. This study aimed to explore their experiences of learning when practicing SDM using the 'Decision Helper', an in-consultation decision aid. This tool adheres to Elwyn's 'three-talk model', designed to facilitate the learning process in achieving SDM. Methods We investigated the professionals' experiences and attitudes towards learning to practice SDM sup- ported by the Decision Helper, collecting 20 semi-structured interviews with professionals at four Danish radiotherapy departments. Purposive sampling was used to include: nurses and physicians, female and male with different levels of experience with SDM and clinical work in oncology. The analysis was an iterative process using firstly inductive and secondly, deductive coding, drawing on Schön & Argyris' theory of 'Double-loop learning'. Results The professionals experienced this new approach in consultations as a disruption in their professional way of thinking about the dialogue with the patients in the consultations. This disruption created a new awareness of their approach. Some turned this disruption into real double-loop learning, experiencing that a dialogue about pros and cons and patients' preferences provided them with 'peace of mind' and a heightened 'conscientiousness' in their work life. Discussion Professionals found the SDM approach – using an in-consultation Decision Helper - disruptive to their normal professional mindset, but on the other hand, as they tried it, they thought differently about their practice. They described a meaningful shift in mindset from 'a right and wrong decision' to 'the right decision for this patient at this time'. Conclusion When professionals learned to practice SDM using an in-consultation Decision Helper it was initially experienced as a disruptive element to their everyday practice but SDM as a mindset had the potential for individualized patient engagement in decision-making, which the professionals welcomed.