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ISSN: 1356-1820 (print), 1469-9567 (electronic)

J Interprof Care, 2014; 28(5): 453–459

! 2014 Informa UK Ltd. DOI: 10.3109/13561820.2014.911157

ORIGINAL ARTICLE

A systematic process for creating and appraising clinical vignettes to

illustrate interprofessional shared decision making
Dawn Stacey1, Nathalie Brière2, Hubert Robitaille3, Kimberly Fraser4, Sophie Desroches5 and France Légaré6
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1
School of Nursing, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada, 2Centre de Santé et de Services Sociaux de la Vieille-
Capitale, Quebec City, Canada, 3Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec City, Quebec, Canada, 4Faculty of
Nursing, University of Alberta, Edmonton, Alberta, Canada, 5Department of Food Science and Nutrition, Université Laval, Quebec City, Quebec,
Canada, and 6Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, Quebec, Canada

Abstract Keywords
Vignettes and written case simulations have been widely used by educators and health services Continuing education, health services
researchers to illustrate plausible situations and measure processes in a wide range of practice research, interprofessional learning,
settings. We devised a systematic process to create and appraise theory-based vignettes for interprofessional education,
illustrating an interprofessional approach to shared decision making (IP-SDM) for health patient-centered practice, shared decision
professionals. A vignette was developed in six stages: (1) determine IP-SDM content elements; making, work-based learning
(2) choose true-to-life clinical scenario; (3) draft script; (4) appraise IP-SDM concepts illustrated
J Interprof Care 2014.28:453-459.

using two evaluation instruments and an interprofessional concept grid; (5) peer review script History
for content validity; and (6) retrospective pre-/post-test evaluation of video vignette by health
professionals. The vignette contained six scenes demonstrating the asynchronous involvement Received 23 July 2013
of five health professionals with an elderly woman and her daughter facing a decision about Revised 20 February 2014
location of care. The script scored highly on both evaluation scales. Twenty-nine health Accepted 30 March 2014
professionals working in home care watched the vignette during IP-SDM workshops in English Published online 28 April 2014
or French and rated it as excellent (n ¼ 6), good (n ¼ 20), fair (n ¼ 0) or weak (n ¼ 3). Participants
reported higher knowledge of IP-SDM after the workshops compared to before (p50.0001).
Our video vignette development process resulted in a product that was true-to-life and as part
of a multifaceted workshop it appears to improve knowledge among health professionals. This
could be used to create and appraise vignettes targeting IP-SDM in other contexts.

Introduction Freeth, & Zwarenstein, 2013). By improving the quality of

decision support provided by team-based healthcare practices,
An interprofessional approach to shared decision-making
there is a better fit between what clients prefer and what they
(IP-SDM) involves two or more health professionals collaborating
receive. However, neither SDM nor IP-SDM is routinely used
with the client in identifying best options, clarifying client
in clinical practice (Llewellyn-Thomas & Légaré, 2011).
preferences and enabling clients and/or family caregivers to be
Interventions to enhance adoption of SDM in clinical practice
more involved in making health decisions (Légaré et al., 2011a–c).
need to target healthcare professionals and clients (Légaré et al.,
Interprofessional care, involving collaboration among various
2010, 2012). From a client-reported perspective, one systematic
health professionals (Oandasan & Reeves, 2005) and shared
review of 21 trials found that in the three trials that improved
decision-making (SDM), which engages clients as partners in their
SDM, a patient-mediated intervention (e.g. a patient decision aid)
own care, are increasingly seen as two key elements of high-quality
was combined with an intervention targeting health professionals
and cost-effective healthcare services (Dagone, 2009). Combining
such as educational sessions about SDM. A Cochrane review of
interprofessional care with SDM is thus a logical and coherent way
five trials reporting from an observer’s perspective found that the
to integrate both these key elements into healthcare. It is more
two trials that improved SDM both used patient decision aids, and
likely to result in decisions made with clients that are acceptable,
one also used educational sessions on SDM and performance
feasible and, ultimately, more likely to be carried out.
feedback. However, the latter was limited to SDM training alone
Interventions promoting IP-SDM have the potential to improve
and not training for SDM in an IP team (Légaré et al., 2010).
healthcare. IP-SDM bridges gaps among the various health
Interprofessional education (IPE) is regarded by many educa-
disciplines, as well as between the various healthcare profes-
tors, policy makers and health care practitioners (e.g. nurses,
sionals and their clients and families, thereby breaking down the
occupational therapists and physicians), as an important activity
silos within the healthcare system (Reeves, Perrier, Goldman,
for enhancing the quality of teamwork and client care (Reeves,
Goldman, & Oandasan, 2007). Research has repeatedly indicated
Correspondence: Dawn Stacey, School of Nursing, Ottawa Hospital that interprofessional collaboration can be problematic, however,
Research Institute, University of Ottawa, 451, Smyth Road (RGN Room often due to poor knowledge of how to work effectively within
1118), Ottawa, Ontario, K1H 8M5, Canada. E-mail: dstacey@uottawa.ca health care teams (e.g. Campion-Smith, Austin, Criswick,
 454 D. Stacey et al.
Dowling, & Francis, 2011; Cook, 2005; Reeves et al., 2013;
Suter et al., 2012; Zwarenstein, Reeves, & Perrier, 2005). To be
effective, IPE should be based on interactive learning methods
such as seminar-based discussions, joint visits to clients, problem-
based learning, role play, simulated clinical learning environ-
ments and interprofessional clinical placements (Hanbury,
Wallace, & Clark, 2009; Helitzer et al., 2011; Reeves et al., 2007).
Vignettes and written case simulations have been widely
used by educators and health services researchers to illustrate
plausible situations and measure processes in a wide range of
practice settings. The central principle is that the behavior
of interest demonstrated in a simulated situation by those for
whom the vignette is intended (e.g. health professionals) will
closely resemble their actual behavior in a clinical situation
(Dresselhaus, Peabody, Luck, & Bertenthal, 2004; Jones, Gerrity,
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& Earp, 1990). Vignettes are often used as an effective and
cheaper alternative to standardized patients (Colliver & Swartz,
1997; Colliver, Vu, Marcy, Travis, & Robbs, 1993) or direct
observation (Glassman, Rolph, Petersen, Bradley, & Kravitz,
1996; Peabody, Luck, Glassman, Dresselhaus, & Lee, 2000).
For many years, clinical vignettes have been seen as a useful tool
for continuing professional development (Mettes et al., 2010).
Despite the popularity of vignettes and their use in a variety
of settings, little is known about the way they are developed
or validated except in other fields such as behavioral and
social sciences (Campbell, Ford, Campbell, & Quinkert, 1998;
Cazale et al., 2006; Pham et al., 2009; Piano et al., 2013; Sriram
et al., 1990).
J Interprof Care 2014.28:453-459.
Figure 1. The IP-SDM model.
J Interprof Care, 2014; 28(5): 453–459
We therefore designed a multi-phase process to develop and
test a theory-based clinical vignette illustrating an IP-SDM
approach for use in training health professionals, and kept a
detailed report of our process (Michie, Fixsen, Grimshaw, &
Eccles, 2009). To test whether the script of our vignette reflected
IP-SDM concepts, we used formal evaluation tools frequently
used in clinical research for rating real-life SDM- and IP-related
situations. We used the peer review process to validate that the
vignette was true-to-life and accurately depicted IP-SDM con-
cepts, and retrospective pre-/post-test questionnaires to test the
final product on clinicians.This study was part of a larger study
designed to assess the feasibility of implementing an IP-SDM
approach in home care (Légaré et al., 2011a, 2013).
Methods
Our systematic process consisted of six stages, as described
below.
Determine IP-SDM content elements
The IP-SDM conceptual model we used to determine essential
elements of the script has two axes (Figure 1). The vertical axis
is the SDM process that occurs over time. The process starts
with explicitly identifying the decision to be made and continues
with discussing evidence-based information available about the
options, clarifying patients’ values, considering the feasibility
of each option and reaching consensus on the best option.
The horizontal axis presents the key factors involved in the
 DOI: 10.3109/13561820.2014.911157
SDM process, those in the patient team (i.e. patient with or
without significant others) and in the healthcare team (i.e. two
or more healthcare professionals), with the patient in the centre
of the process. This conceptual model was developed by an
interdisciplinary and international team based on an extensive
review of the literature combined with theory analysis (Légaré
et al., 2011b,c; Stacey, Légaré, Pouliot, Kryworuchko, & Dunn,
2010). One of the four underlying assumptions is that involving
patients in the SDM process is essential for achieving patient-
centered care and reaching decisions that are informed and based
on individual patient values. Second, by achieving a common
understanding of the essential elements of the SDM process
by the interprofessional team and recognizing the influence of the
various individuals on this process, there will be improved success
in reaching a shared decision. Third, achieving an interprofes-
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sional approach to SDM may occur synchronously (e.g. family
conferences in the intensive care unit) but more often occurs
asynchronously and thereby require a shared framework with this
common understanding. Fourth, family or significant others are
important stakeholders involved or implicated in the decision and
their values and preferences may not be consistent with those of
the patient.
Choose theme of scenario
We met with home care managers to choose the theme of the
vignette. The context we chose to illustrate was a client and family
member making a decision about location of care for a frail
J Interprof Care 2014.28:453-459.
elderly person in the process of losing autonomy. We chose this
context because a shared decision-making approach in home care
often includes family members who are in a direct care-giving
role, a supportive role or perhaps a surrogate decision-maker role.
It is well documented that family members provide a significant
amount of care, are key players in care plan implementation
and consequently have a role to play in clients achieving positive
health outcomes (Gallant, Spitze, & Phohaska, 2007; Martire &
Schulz, 2007).
Draft the vignette script
We drafted the initial script based on key concepts of SDM and IP
collaboration and illustrated the temporal continuity of IP-SDM,
as it occurs asynchronously (Légaré et al., 2011a,b). The need to
find a realistic and practical exemplar of an IP-SDM situation
was essential. We selected a decision about location of care
including possible relocation of an elderly person as the focus of
the vignette because it typically would involve a client, the family
and several professionals from different disciplines. This exem-
plar also allowed us to illustrate an IP-SDM approach in home
care. We attempted to integrate all the key IP-SDM concepts
while portraying a true-to-life clinical scenario.
We used plain language and a descriptive tone to illustrate
the various stages of the decision-making process and the
sequence of events that occurred. For each scene, we focused
on a limited number of concepts and tried to be as succinct as
possible. However, we struggled to achieve the right balance in
the length of the video: it had to be long enough to adequately
cover the key concepts of IP-SDM yet short enough that observers
would not tune out or forget important concepts. Members of the
research team tested the script by reading through each part
of it aloud.
Appraise the vignette using formal evaluation tools
The development team appraised the vignette script using the
OPTION scale (Elwyn et al., 2003), the Decision Support
Analysis Tool (DSAT; Guimond et al., 2003; Melbourne et al.,
Creating vignettes for IP-SDM training 455
2011; Stacey, Taljaard, Drake, & O’Connor, 2008) and a concept
grid to measure the IP relationship (D’Amour, Ferrada-Videla,
San Martin Rodriguez, & Beaulieu, 2005). The OPTION scale
is a 12-item tool designed to measure the extent to which
clinicians involve patients in decision making (Elwyn et al.,
2003). DSAT is a 10-item scale developed as a research tool to
evaluate practitioners’ use of decision support during a clinical
encounter (Stacey et al., 2008). The research team created a
concept grid to measure IP relationships based on key concepts
identified through a literature review (D’Amour et al., 2005).
Peer review of the vignette script
To check for content validity, we emailed the script to five experts
representing different disciplines and professional roles com-
monly found in a home care context to ensure that the vignette
was accurate, true-to-life, relevant to the target audience and that
the language was convincingly idiomatic (Dresselhaus et al.,
2004; Peabody et al., 2000). The experts were a program leader
in rehabilitation, a social worker, a program manager in nursing,
an occupational therapist and a clinical coordinator. Then we
collated and reviewed the feedback to establish consensus on
changes required and revised it. As some experts said a physician
would not be involved in the situation, we justified the physician’s
role by adding deterioration in the client’s health to the decision-
making context. We also made explicit that changes made earlier
to the client’s home on her discharge from the rehabilitation
centre were no longer adequate to meet her needs, and a review
of her situation by the IP team (nurse, physiotherapist and
occupational therapist) was therefore necessary. Finally, we edited
the social worker’s dialogue so that she was less directive in the
decision making. The revised version of the vignette script was
used for filming. We asked five experts to further validate the
script content in English and to suggest the changes needed to
reflect the differences between the Alberta and Quebec healthcare
systems. Members of the research team acted in the French
version, and professional actors in the English version, which was
produced by a film company.
Evaluation of the final video vignette by clinicians
We used a retrospective pre-/post-test design to evaluate the video
vignette within the context of two 3.5-hour IP-SDM skills-
building workshops for healthcare professionals working in home
care. The first workshop was presented in French with an IP team
of health professionals who routinely collaborate in clinical
practice in a single home care program in the Centre de Santé et
Services Sociaux de la Vieille-Capitale in the Quebec City area.
The second workshop was held in English in Edmonton, Alberta
with a group of diverse healthcare professionals with Alberta
Health Services working predominantly as case managers, case
manager educators or supervisors in home care programs in the
Edmonton area. The clinical vignette was presented to illustrate
the key concepts of IP-SDM as one part of a multi-faceted training
workshop which also included a PowerPoint presentation of the
IP-SDM approach, group discussions and role play with specific
decision support tools. Participants completed a workshop
evaluation survey to rate their satisfaction with its content,
information clarity, interaction and group discussions, exercises
and role play, the video vignette and facilitators’ knowledge of
topics. After the workshop, participants were asked to rate their
knowledge of IP-SDM both before and after the workshop on a
scale of 0–10 (none to extremely strong) using a retrospective
pre/post intervention method (Yank, Laurent, Plant, & Lorig,
2013). Finally, participants were asked to rate their confidence
in using an IP-SDM approach in their clinical practice on a scale
of 0–10 (none to extremely strong).
 456 D. Stacey et al. J Interprof Care, 2014; 28(5): 453–459

Ethics
Participants were selected and ethics approval was obtained from
the research ethics boards of the Centre de Santé et Services
Sociaux de la Vieille-Capitale in Quebec (REB 2010-2011-13)
and the Alberta Health Services (Pro00027503).
Results
Our development process took place over a 2-month period
(January–February, 2011) resulting in a 14-min clinical video
vignette illustrating IP-SDM. The appraisal indicated that the
clinical vignette met 12 out of the 12 criteria in the OPTION tool,
10 out of 10 DSAT criteria and all eight IP concepts (Table I).
Our final vignette illustrates a sequence of events associated
with making a decision about location of care with a 76-year-old
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presenting the options; (2) Discussion among the health care
professionals and their individual assessments of the client’s
situation; (3) Monitoring and follow-up by the health profes-
sionals; (4) Meeting with the client and the physiotherapist
to discuss what matters to the patient most about the options
(values and preferences); (5) Validation and consensus among the
healthcare professionals; and (6) Reaching a shared decision
between the client and the social worker. The final decision is thus
made between the client and one healthcare professional, with the
latter having been involved in a consensus reached behind
the scenes with the other healthcare professionals who have all
encountered the patient at different times and in different
places (e.g. the clinic, the rehab centre). In each scene, the
vignette includes concepts identified in our literature review as
integral to an IP-SDM approach, such as common goals among

woman living alone at home. She is receiving home care
following discharge from hospital for a stroke nine months ago.
She also has support from her family. Her safety is of concern to
her daughter and the healthcare professionals, given that she fell
recently in her home. In the vignette, she is presented with two
options: (a) consider relocation to a long-term care facility where
she can receive more care and monitoring; (b) continue to live at
home alone with more help from home care and have her condo
fitted with additional physical aids. The vignette includes six
scenes: (1) Introduction: meeting with the client and a social
worker to make explicit that a decision needs to be made, and
J Interprof Care 2014.28:453-459.
the healthcare professionals, collaborative relationships and
symmetry of power (Table I).
Evaluation of the clinical vignette video in the workshops
involved a total of 29 health professionals from a home care team
in Quebec City, Quebec, Canada (in French; n ¼ 11) and in
Edmonton, Alberta, Canada (in English; n ¼ 18). The participants
included physicians, nurses, social workers, occupational therap-
ists, dietitians, managers, physiotherapists and an ethicist
(Table II). Overall, participants rated the workshop as excellent
(23/27) or good (4/27) (Table III). The video vignette was rated
as good (20/29), excellent (6/29) or weak (3/29). There was a

Table I. Key concepts for assessing interprofessionalism within the IP-SDM vignette.

Concepts Assessment criteria

1 Group of professionals
2 Common goal
3 Collaborative relationship
4 Integrated/cohesive care
5 Symmetry of power
6 Sharing knowledge
7 Continuous/evolving interaction
8 Organizational aspects
Involved more than one health professional supporting patient participation in making the target
decision
Health professionals were focused on the goal of making the decision with the patient
Interactions within the interprofessional team were collegial, authentic, constructive, respectful and
their individual contributions were valued
Interactions within the interprofessional team and with the patient indicate a focus on the patient’s
decision making needs
Health professionals encourage the patient to share their perspectives on the decision and use active
listening without directing the patient to choose one particular option
Health professionals exchange information on options (including benefits and harms) within their
team as well as with the patient
Health professionals communicate through face to face meetings, telephone calls, and/or by
documentation in the health record
Organizations support interactions between health professionals and make the structure favorable to
communication and exchange

Table II. Workshop participants’ characteristics.

IP-SDM Workshop participants’ characteristics

Quebec City (n ¼ 11) Edmonton (n ¼ 18)
Women 10/11 17/18
Age (years) [median (range)] 35.5 (27–55)* 38 (25–54)
Occupation
Case Manager – Practice Leader 4 9
Registered Nurse 1 2
Physiotherapist 1 2
Clinical Ethicist 0 1
Area Manager – Practice Integration Home Living Program 1 1
Manager 0 1
Palliative Case Manager 0 1
Occupational Therapist 1 1
Social Worker 1 0
Dietitian 1 0
Physician 1 0
Years of practice [median (range)] 4.5 (2–12)* 5 (0.33–24)

*N ¼ 6 due to missing data.

 DOI: 10.3109/13561820.2014.911157 Creating vignettes for IP-SDM training 457
Table III. Health professionals’ assessment of clinical vignette in IP-SDM training workshops.

IP-SDM Workshop Survey

Quebec City (n ¼ 11) Edmonton (n ¼ 18)
Weak Good Excellent Weak Good Excellent
Course organization and content 0/10* 3/10* 7/10* 0/18 1/18 17/18
Interaction and group discussion 0/11 3/11 8/11 0/18 2/18 16/18
Information clarity 0/11 3/11 8/11 0/18 1/18 17/18
Exercises: role play 0/10* 7/10* 3/10* 0/18 9/18 9/18
Exercise: video vignette 2/11 9/11 0/11 1/18 11/18 6/18
Facilitators’ knowledge of topic 0/11 1/11 10/11 0/18 0/18 18/18
Overall 0/9* 3/9* 6/9* 0/18 1/18 17/18

*Change in denominators due to missing data.

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Table IV. Knowledge of and confidence in using IP-SDM among health professionals.

Quebec City (n ¼ 11) Edmonton (n ¼ 18)

Median scorey (range) Median scorey (range)
Confidence in using IP-SDM in clinical practice after the workshop 8.0 (5–10) 8.0 (6–10) p50.0001*
Level of knowledge of IP-SDM approach before the workshop 5.0 (0–7) 3.0 (1–7)
Level of knowledge of IP-SDM approach after the workshop 8.0 (7–9) 9.0 (7–10)
Change in knowledge 3.0 6.0

yRated on a scale of 0 ¼ extremely weak to 10 ¼ extremely strong.

*Non-parametric Wilcoxon test.

statistical difference in participants’ self-reported IP-SDM know- improving clinical performance in routine practice and are
J Interprof Care 2014.28:453-459.

ledge after the workshop compared to before (median 5/10
pre-workshop to 8/10 post-workshop; p50.0001; Table IV).
Post-workshop participants rated their confidence in using IP-
SDM in their clinical practice as 8/10 (range 5–10). Qualitative
comments from participants indicated the video was a good visual
tool for learning about the IP-SDM approach but there could be
clearer portrayal of the concepts integral to an IP-SDM approach.
Discussion
Our multi-phase, multi-prong development process resulted in a
video vignette for training health professionals in an IP approach
to SDM that was both true-to-life and illustrated the theoretical
elements of IP-SDM. To create the script, we drew on a validated
IP-SDM model. We rated the vignette using a variety of formal
evaluation tools that each targeted certain elements of IP-SDM,
as few existing tools target IP-SDM interventions specifically.
These tools included the OPTION and DSAT scales, an eight-item
concept chart relating specifically to qualities of IP relationships,
submission of the script to peer review and a retrospective pre-/
post-test questionnaire. Few published intervention evaluations
document the content and delivery of an intervention or are
reported in enough detail to replicate them (Michie et al., 2009).
We therefore described the process we used so that it would be
replicable in the development and evaluation of other clinical
video vignettes. To the best of our knowledge, this is the first
detailed description of a process using multiple research evalu-
ation tools to create a theory-based, true-to-life video vignette for
healthcare professionals.
Our results indicate that this process can lead to the creation
of a promising educational tool to be used as one element of a
multi-faceted education program to implement an IP-SDM
approach in home care. Feedback from the workshop participants
was very positive. The systematic process of developing and
appraising a vignette as described in this study could also be used
for developing video vignettes in other clinical areas.
Vignettes watched in group educational settings followed
by performance feedback may be effective interventions for
probably an efficient way to standardize the intervention for use
across workshops (Campbell et al., 1998). Illustrating IP-SDM
in educational training aimed at enhancing these behaviors is
a complex task, since IP involves interactions among many
individuals which often occur asynchronously (Jones et al., 1990;
Reeves et al., 2007, 2013), and the clinical vignette is an efficient
and effective way to illustrate scenarios of such complexity.
Vignettes have been used to illustrate a variety of other
complex teamwork situations, including battlefield scenes
(Campbell et al., 1998).
One of our other studies focusing on implementing IP-SDM
revealed that although the intention of health professionals in a
home care service to adopt an IP-SDM approach was relatively
high, many participants indicated that IP-SDM was not practiced
in their local care network (Légaré et al., 2013). These findings
are consistent with other studies indicating that few health
professionals have implemented SDM in their practice (Pellerin
et al., 2011). One of the key barriers to implementation of SDM in
clinical practice is the fact that health professionals do not know
how to perform SDM (Légaré, Ratte, Gravel, & Graham, 2008;
Légaré, et al., 2011b). This barrier is amplified when health
professionals are asked to take an IP-SDM approach, as they must
introduce both SDM and interprofessional collaboration into an
existing organizational context that may be unfamiliar with
both. When there are opportunities for capacity building within
organizations, clinical vignettes can be valuable tools for
supporting the implementation of both approaches at once.
An IP-SDM vignette could also be helpful in identifying
factors that might facilitate or hinder implementation of IP-SDM
in clinical practice (Graham et al., 2006; Légaré et al., 2008). It is
often hard to assess such barriers and facilitators when health
professionals do not fully know what is involved in the new
behavior. This is particularly the case with SDM, given that most
health professionals think they already engage their clients in
SDM when they clearly do not meet the criteria for SDM (Couet
et al., 2013). After watching the vignette during the IP-SDM
workshops, many participants pointed out barriers to implement-
ing IP-SDM in their own clinical contexts (Légaré et al., 2013).
 458 D. Stacey et al.
This clinical vignette could thus be a tool for identifying what an
organization needs in order to implement the IP-SDM approach to
clinical practice and to assess health professionals’ practice
variations (Peabody et al., 2000; Veloski, Tai, Evans, & Nash,
2005).
Our study has two main potential limitations. First, the number
of participants who responded to the invitation to evaluate the
vignette at the educational workshop was limited to those who
were exposed to the other parts of an IP-SDM skills-building
workshop, and so there is the potential for response bias. We also
acknowledge that the retrospective pre-/post-survey design used to
assess the level of participants’ knowledge about IP-SDM has
some inherent limitations: it has been argued that this type of
survey overestimates the real increase between pre- and post-
survey (Howard, 1980; Howard, Millham, Slaten, & Odonnell,
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1981; Pratt, McGuigan, & Katzev, 2000; Yank et al., 2013).
However, the pre-/post-test design is one part of a study that was
designed to assess not only the effectiveness of a clinical vignette
but also each stage of its development process and adjust it
accordingly. In addition to the pre-/post-test used to evaluate the
final product, we also evaluated it during its development process
using multi-disciplinary peer review. The pre-test revealed that
the participants perceived that they had acquired some knowledge
during the workshop, which included the video.
Concluding comments
As described above, we used a systematic process to develop a
J Interprof Care 2014.28:453-459.
clinical vignette for illustrating an IP approach to SDM in clinical
practice. The process established content validity with respect to
organizational managers, healthcare professionals, clients and
their family members. When used as part of a multi-faceted IP-
SDM educational program, health professionals rated the video
vignette as acceptable.
Given the clinical vignette was developed and evaluated for
use by home care professionals working in two different Canadian
healthcare systems, we anticipate that our systematic vignette
development process will be useful in other contexts and
jurisdictions. Our process should also be useful for other
researchers, educators and organizations interested in designing
new clinical vignettes to illustrate IP-SDM or other clinical
behaviors.
Acknowledgements
We would like to acknowledge the work of Carol Puma in coordinating
the development and evaluation of the video vignette. Dawn Stacey
holds a University Research Chair in Knowledge Translation to Patients.
France Légaré holds the Canada Research Chair in Implementation
of Shared Decision Making in Primary Care. Sophie Desroches holds a
New Investigator Award from the Canadian Institutes of Health Research.
Declaration of interest
The authors report no conflicts of interest. The authors alone were
responsible for the writing and content of this paper. This study was
supported by a grant from the Canadian Institutes of Health Research
(CIHR, 213236).
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