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EXACKTE(2): exploiting the clinical consultation as a knowledge transfer and exchange environment: a study 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 - Implement Sci (2009)

Bottom Line: Our proposed model, EXACKTE(2), is aimed at advancing the science of KTE based on a relationship process when decision-making has to take place.It fosters a new KTE paradigm by putting forward a relationship-centered perspective and has the potential to reveal unknown mechanisms that underline effective KTE in clinical contexts.This will result in better understanding of the mechanisms that may promote a new generation of knowledge transfer strategies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Research Center of the Centre Hospitalier Universitaire de Québec, Québec, Canada. france.legare@mfa.ulaval.ca

ABSTRACT

Background: While the evidence suggests that the way physicians provide information to patients is crucial in helping patients decide upon a course of action, the field of knowledge translation and exchange (KTE) is silent about how the physician and the patient influence each other during clinical interactions and decision-making. Consequently, based on a novel relationship-centered model, EXACKTE(2) (EXploiting the clinicAl Consultation as a Knowledge Transfer and Exchange Environment), this study proposes to assess how patients and physicians influence each other in consultations.

Methods: We will employ a cross-sectional study design involving 300 pairs of patients and family physicians from two primary care practice-based research networks. The consultation between patient and physician will be audio-taped and transcribed. Following the consultation, patients and physicians will complete a set of questionnaires based on the EXACKTE(2) model. All questionnaires will be similar for patients and physicians. These questionnaires will assess the key concepts of our proposed model based on the essential elements of shared decision-making (SDM): definition and explanation of problem; presentation of options; discussion of pros and cons; clarification of patient values and preferences; discussion of patient ability and self-efficacy; presentation of doctor knowledge and recommendation; and checking and clarifying understanding. Patients will be contacted by phone two weeks later and asked to complete questionnaires on decisional regret and quality of life. The analysis will be conducted to compare the key concepts in the EXACKTE(2) model between patients and physicians. It will also allow the assessment of how patients and physicians influence each other in consultations.

Discussion: Our proposed model, EXACKTE(2), is aimed at advancing the science of KTE based on a relationship process when decision-making has to take place. It fosters a new KTE paradigm by putting forward a relationship-centered perspective and has the potential to reveal unknown mechanisms that underline effective KTE in clinical contexts. This will result in better understanding of the mechanisms that may promote a new generation of knowledge transfer strategies.

No MeSH data available.


Generic Actor-Partner Interdependence analytical Method (APIM) for physician and patient.
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Related In: Results  -  Collection

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Figure 2: Generic Actor-Partner Interdependence analytical Method (APIM) for physician and patient.

Mentions: We have proposed a novel relationship-centered model, EXACKTE2 (EXploiting the clinicAl Consultation as a Knowledge Transfer and Exchange Environment) (Figure 1), where we foresee the consultation as an opportunity to exploit dyadic interaction, embedded in ongoing physician-patient relationships. It operationalizes the expected relationship phenomena between physicians and patients in consultations dealing with KTE using the essential elements of SDM and the analytical approach of the actor-partner interdependence model (APIM) (Figure 2) [14,15]. Relationship phenomena can be defined as phenomena 'pertaining to interpersonal dynamics that are more than the summation of the characteristics of the individuals interacting with each other.'[16]. In other words, based on EXACKTE2, the physician-patient interaction is an interpersonal system in which those involved relate to each other and not only to themselves.


EXACKTE(2): exploiting the clinical consultation as a knowledge transfer and exchange environment: a study 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 - Implement Sci (2009)

Generic Actor-Partner Interdependence analytical Method (APIM) for physician and patient.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2663542&req=5

Figure 2: Generic Actor-Partner Interdependence analytical Method (APIM) for physician and patient.
Mentions: We have proposed a novel relationship-centered model, EXACKTE2 (EXploiting the clinicAl Consultation as a Knowledge Transfer and Exchange Environment) (Figure 1), where we foresee the consultation as an opportunity to exploit dyadic interaction, embedded in ongoing physician-patient relationships. It operationalizes the expected relationship phenomena between physicians and patients in consultations dealing with KTE using the essential elements of SDM and the analytical approach of the actor-partner interdependence model (APIM) (Figure 2) [14,15]. Relationship phenomena can be defined as phenomena 'pertaining to interpersonal dynamics that are more than the summation of the characteristics of the individuals interacting with each other.'[16]. In other words, based on EXACKTE2, the physician-patient interaction is an interpersonal system in which those involved relate to each other and not only to themselves.

Bottom Line: Our proposed model, EXACKTE(2), is aimed at advancing the science of KTE based on a relationship process when decision-making has to take place.It fosters a new KTE paradigm by putting forward a relationship-centered perspective and has the potential to reveal unknown mechanisms that underline effective KTE in clinical contexts.This will result in better understanding of the mechanisms that may promote a new generation of knowledge transfer strategies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Research Center of the Centre Hospitalier Universitaire de Québec, Québec, Canada. france.legare@mfa.ulaval.ca

ABSTRACT

Background: While the evidence suggests that the way physicians provide information to patients is crucial in helping patients decide upon a course of action, the field of knowledge translation and exchange (KTE) is silent about how the physician and the patient influence each other during clinical interactions and decision-making. Consequently, based on a novel relationship-centered model, EXACKTE(2) (EXploiting the clinicAl Consultation as a Knowledge Transfer and Exchange Environment), this study proposes to assess how patients and physicians influence each other in consultations.

Methods: We will employ a cross-sectional study design involving 300 pairs of patients and family physicians from two primary care practice-based research networks. The consultation between patient and physician will be audio-taped and transcribed. Following the consultation, patients and physicians will complete a set of questionnaires based on the EXACKTE(2) model. All questionnaires will be similar for patients and physicians. These questionnaires will assess the key concepts of our proposed model based on the essential elements of shared decision-making (SDM): definition and explanation of problem; presentation of options; discussion of pros and cons; clarification of patient values and preferences; discussion of patient ability and self-efficacy; presentation of doctor knowledge and recommendation; and checking and clarifying understanding. Patients will be contacted by phone two weeks later and asked to complete questionnaires on decisional regret and quality of life. The analysis will be conducted to compare the key concepts in the EXACKTE(2) model between patients and physicians. It will also allow the assessment of how patients and physicians influence each other in consultations.

Discussion: Our proposed model, EXACKTE(2), is aimed at advancing the science of KTE based on a relationship process when decision-making has to take place. It fosters a new KTE paradigm by putting forward a relationship-centered perspective and has the potential to reveal unknown mechanisms that underline effective KTE in clinical contexts. This will result in better understanding of the mechanisms that may promote a new generation of knowledge transfer strategies.

No MeSH data available.