82 Chapter 5 Moreover, physicians engaged in challenging patient-clinician encounters have been shown to experience higher stress levels, increased burnout, and reduced job satisfaction. [18, 19] Nonetheless, encouragingly, recent research shows that doctors trained in SDM as part of a multilevel implementation program exhibit greater appreciation for SDM and self-report improved execution, [20] which, in line with SDT theory, might be caused by increased feelings of competence. These findings suggest that aligning SDM with individual competence levels and needs, following SDT principles, may lead to higher intrinsic motivation and better execution of SDM. Considering SDM implementation’s intricacies, this study aims to investigate healthcare providers’ perceived characteristics from SDM, explicitly focusing on job satisfaction and perceived complexity. By delving into these two attributes and their interplay, we seek to gain a deeper understanding of how physicians rank SDM tasks compared to other tasks in the clinical setting. To the best of our knowledge, no existing studies have specifically examined these attributes in relation to SDM within the current literature. To address this knowledge gap, we have designed an explorative study with a novel experimental approach where doctors will rate patient-related medical scenarios. Through this investigation, we aspire to illuminate the crucial determinants for successful SDM implementation and integration into routine clinical practice. Methods We conducted a ranking study using self-developed case scenarios, called case vignettes. We asked participants to rank ten case vignettes by placing each case in one of three ordinal preference categories. Ranking occurred in two groups. Depending on group allocation, the preference categories per participant related to either job satisfaction or the complexity of the case scenarios. We used an ordinal preference elicitation method, which has some advantages over other quantitative rating methods. Generally, ranking methods are easier to understand, produce more consistent responses, and therefore are expected to reflect participants’ preferences better than quantitative ratings. [21] The ranking methodology will be discussed in more detail below. Case vignettes We described ten case vignettes in a general hospital’s gynecology and obstetrics department. We designed the vignettes purposefully as four ‘technical’ cases (TECH), which means cases dealing with medical-technical skills or knowledge, three ‘SDM’ cases (SDM), and three ‘managing emotion’ cases (EMO). All were purposefully designed to incorporate more or less difficult or potentially uncomfortable situations for doctors as we intentionally sought to address the perceived complexity of these more complex cases. Although informed about the study’s aims, participants did not know beforehand about this division in task types. To reduce framing bias, we added the EMO cases that focused on emotional outbreaks among colleagues or patients. These cases depicted instances of intense emotional displays, like anger,
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