126 Chapter 7 In designing future SDM training initiatives, adhering to educational quality standards rooted in established educational theories such as experiential and reflective learning is essential. Developing a robust educational evaluation framework will guide educators in designing, implementing, and evaluating their interventions, ultimately enhancing the reproducibility of positive results. While such a framework does not exist, future research should be dedicated to its development. Evaluation studies should incorporate the assessment of skills transfer from training to workplace settings since this is where behavior change needs to be effectuated. SDM training content should shift away from the 4-step consultation technique and instead focus on the intricacies of understanding individual patients and how to connect with them. Future research should be dedicated to developing training methods that prepare clinicians to effectively navigate the inherent uncertainties that arise when managing the distinctive circumstances of each patient, as addressing this aspect, particularly handling uncertainty, is a notable gap in contemporary training programs. The re-invention of SDM training initiatives provides a unique opportunity to involve patients as partners in these training methods. However, involving patients should go beyond showcasing their involvement and truly integrate patients as valuable sources for training and reflection. Mentors and supervisors should also be trained to facilitate these reflections to enhance trainees’ reflective practice within formal training initiatives and during everyday workplace experiences. Furthermore, educators should be challenged to incorporate SDM training into lifelong learning programs using reflective practice principles. Particular attention should be given to engaging seasoned professionals who may resist change. Reflective practice should not be confined to standalone training interventions but should be integrated into the everyday medical workplace as a defining part of medical culture. These insights result from our research efforts, incorporating a diverse array of disciplines such as psychology, sociology, anthropology, and change and education theories. Our transdisciplinary approach serves as a blueprint for shaping future research in the field. This suggests a departure from the current overly simplified perspective on behavior change and implementation within the field of medicine. Instead a wholehearted embrace of the wealth of knowledge residing within the social sciences is proposed. As a consequence, future research on implementation strategies should be firmly rooted in these rich theoretical foundations, employing transdisciplinary research methodologies. Strengths and limitations One of the standout strengths of this thesis lies in our comprehensive reevaluation of SDM utilization. We took a critical stance, examining its theoretical foundations and real-world implementation. Rather than romanticizing SDM as an inherently flawless principle, we
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