Projects

Project Description

Shared decision-making is often considered the gold standard for quality in patient care. However, there has been limited insight into how shared decision-making manifests in practice and documented discrepancies in whether providers, patients, and families prefer or use this approach. Further, Additionally, few studies have characterized high-stakes, complex decision-making in pediatric contexts that typically involve, at minimum, a Patient-Caregiver-Provider triad with varying goals, values, and priorities. Moreover, it is well established that 70-90% of clinical decision-making takes place via communication that takes place between patients and clinicians. In pediatric urology contexts, clinicians are faced with the challenge of providing sufficient and compelling information when presenting with surgical treatment plans to caregivers. In this conversation analysis study, a team of researchers (including pediatric urologists, medical educators, and social science researchers)are collecting actual interactions that take place in a pediatric urology clinic. These interactions include child-patients, clinicians, and caregivers. The analysis will generate specialized transcripts that include both what is said and how, allowing for a close examination of the interactional practices that clinicians might use to improve quality of care and patient adherence to treatment plans.

Technology or Computational Component

The technology used to support the development of the specialized transcripts is DOTE. This is a new and emerging technology designed to produce specialized multi-modal transcripts. In addition, MAXQDA -- a qualitative data analysis software package -- will also be leveraged to support the development of verbatim transcripts.