SHARE Approach Workshop Curriculum

Module 2—Using Patient-Centered Outcomes Research (PCOR) in Shared Decision Making: Training Guide

 Contents

Goal/Aim
Learning Objectives
Timing
Learning Methodology Checklist
Materials Checklist
Instructor Preparation
Module 2 Using PCOR in Shared Decision Making (3 minutes)
     Slide 1. Cover Slide
     Slide 2. Module 2
     Slide 3. Module 2—Learning objectives
Patient-Centered Care (10 minutes)
     Slide 4. What is patient-centered care?
     Slide 5. Patient-centered care
     Slide 6. Step 2—Help your patient explore and compare treatment options
     Slide 7. Group discussion
What is PCOR? (15 minutes)
     Slide 8. What Is PCOR?
     Slide 9. What is Patient Centered Outcomes Research?
     Slide 10. Group discussion
     Slide 11. Patient-centered outcomes
     Slide 12. Patient-centered outcomes
     Slide 13. Primary aim of PCOR
     Slide 14. Informing health care decisions
     Slide 15. PCOR—"Tools, not rules"
     Slide 16: What PCOR is NOT
     Slide 17. Major sponsors of PCOR
     Slide 18: Getting the information out
     Slide 19: Major sponsors supporting dissemination of PCOR
AHRQ's Effective Health Care Program (25 minutes)
     Slide 20: AHRQ's Effective Health Care Program
     Slide 21: Effective Health Care Program activities
     Slide 22: Effective Health Care Program Comparative Effectiveness reports
     Slide 23: AHRQ's Evidence-Based Practice Centers (EPCs)
     Slide 24: Topics
     Slide 25: Which of these broad topics may be relevant to your patients?
     Slide 26: Topic nomination
     Slide 27: Topic selection
     Slide 28: Stakeholder involvement in the Effective Health Care Program
     Slide 29: Effective Health Care Program activities
     Slide 30: Image of Effective Health Care Program products
     Slide 31: Effective Health Care Products
     Slide 32: Clinician resources
     Slide 33: Clinician research summaries
     Slide 34: Clinician research summaries
     Slide 35: Clinician CME/CE Activities
     Slide 36: Clinician faculty slides and resources
     Slide 37: Patient resources
     Slide 38: Patient resources use health literacy principles
     Slide 39: Patient resources use health literacy principles, cont.
     Slide 40: PCOR resources for patients to promote shared decision making
     Slide 41: Using AHRQ's PCOR resources
     Slide 42: AHRQ's interactive decision aids promote shared decision making
     Slide 43: AHRQ's interactive decision aids
     Slide 44: How might you use these consumer summaries?
     Slide 45: Examples of how AHRQ's PCOR resources have been used
     Slide 46: Why Use PCOR Tools and Resources?
     Slide 47: Sharing decision aids with patients improves patient care and outcomes2
     Slide 48: Sharing decision aids with patients improves patient care and outcomes2
Accessing Effective Health Care Program Products (15 minutes)
     Slide 49: Accessing Effective Health Care Program Products
     Slide 50: Image of the Effective Health Care Program Web site home page
     Slide 51: Are you familiar with AHRQ's Effective Health Care Program?
     Slide 52: Image of the Effective Health Care Program Web site—Research Summaries for Consumers, Clinicians and Policymakers
     Slide 53: Image of the Effective Health Care Program Web site—Research Summaries for Consumers, Clinicians and Policymakers
     Slide 54: Image of the Effective Health Care Program Web site—Landing page for the Consumer Summary titled "Choosing Medicines for High Blood Pressure: A Review of the Research on ACEIs, ARBs, and DRIs"
     Slide 55: Image of the Effective Health Care Program Web site Home page
     Slide 56: Image of the Effective Health Care Program Web site—landing page for Tools and Resources
     Slide 57: Ordering Information
     Slide 58: Sign up for email alerts
     Slide 59: Sharing Effective Health Care Program Resources and Tools
     Slide 60: Effective Health Care Program activities
     Slide 61: Effective Health Care Program activities
     Slide 62: Key takeaways
     Slide 63: Citations


Module Goal/Aim

The goal of this module is to support clinicians' efforts to provide patient-centered clinical care through shared decision making and the use of findings from patient-centered outcomes research (PCOR).

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Module Learning Objectives

At the conclusion of this activity, the participant will be able to explain or describe:

  • Patient-centered care and PCOR.
  • Attributes/advantages of PCOR in augmenting patient-centered care in the context of shared decision making.
  • How PCOR is conducted.
  • How to access AHRQ's PCOR resources for patients and clinicians.
  • AHRQ's PCOR materials appropriate to participant's practice area.
  • How to incorporate PCOR materials into shared decision making.

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Timing

This module will take 90 minutes to present (NOTE TO INSTRUCTOR: Specific breakdown of times allotted for discussion/activity will appear within the module).

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Learning Methodology Checklist

  • Large group discussion.
  • PowerPoint slide presentation.

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Materials Checklist

  • LCD projector and laptop.
  • Flip chart (with tape or sticky band) or a whiteboard.
  • Markers.
  • Internet access is recommended to demonstrate the AHRQ Effective Health Care Program Web site and AHRQ Patient Decision Aids.
  • Module 2 Participant Guide—one per participant (see details below).
  • Samples of AHRQ Consumer and Clinician Summaries to pass around the class.

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Instructor Preparation

4 weeks before training

  • Order a variety of sample AHRQ Consumer Summaries and Clinician Summaries to display or to pass around the room.

To view available topics, go to: http://effectivehealthcare.ahrq.gov/index.cfm/research-summaries-for-consumers-clinicians-and-policymakers/

To order one or more full-color print copies, call the AHRQ Publications Clearinghouse at 800-358-9295 or order online at the AHRQ Publication Clearinghouse Web site (http://ahrqpubs.ahrq.gov). Ask for the publications by the title and number and refer to order code E-8. 

2 weeks before training

  • Photocopy Module 2 materials and assemble into Module 2 Participant Guide workbooks for each participant. Include:
  • Module 2 PowerPoint slide set (3 slides per page)
  • Accessing and Navigating AHRQ's Effective Health Care Program Web Site Handout (located at the back of Module 2 in your Trainer's Guide.)

On the day of the training

  • Have the SHARE Approach screen saver showing on your computer to share with participants as they come into the classroom.
  • Have the Module 2: Using Patient-Centered Outcomes Research (PCOR) in Shared Decision Making PowerPoint file open and minimized on the computer.
  • Have the a Patient Decision Aid from the AHRQ Effective Health Care Program Web site open and minimized on the computer.  Find them at http://effectivehealthcare.ahrq.gov/tools-and-resources/patient-decision-aids/
  • Have samples of AHRQ Consumer and Clinician Summaries on a variety of topics available to pass around.

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Module 2 Using PCOR in Shared Decision Making (3 minutes)

Slide 1: Cover Slide

Slide 1: The SHARE Approach. Essential Steps of Shared Decision Making. Workshop Course.

Training Guide Script:

Do: Open PowerPoint called, Module 2: Using Patient-Centered Outcomes Research (PCOR) in Shared Decision Making.

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Slide 2: Module 2

Slide 2: Module 2, Using Patient-Centered Outcomes Research (PCOR) in Shared Decision Making

Training Guide Script:

Say: Module 2 is titled, Using Patient-Centered Outcomes Research (PCOR) in Shared Decision Making.

In this second module, we are going to learn about patient-centered outcomes research or PCOR (pronounced "PEA core") for short. We will also learn how PCOR is used in shared decision making between clinicians and their patients and caregivers.

We will also address how you can find evidence-based resources for your practice.

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Slide 3: Module 2—Learning objectives

Slide 3: Module 2—Learning objectives. At the conclusion of this activity, the participant will be able to: Define patient-centered care and patient-centered outcomes research (PCOR). Discuss attributes/advantages of PCOR in augmenting patient-centered care in the context of shared decision making. Explain AHRQ's role in PCOR and resources.   Describe how to incorporate PCOR materials into shared decision making. Explain how to access AHRQ's PCOR resources for patients and clinicians.

Training Guide Script:

Say: By the end of this module, you should be able to:

  • Define patient-centered care and patient-centered outcomes research.
  • Discuss attributes and advantages of patient-centered outcomes research in augmenting patient-centered care in the context of shared decision making.
  • Explain AHRQ's role in PCOR and resources.
  • Describe how to incorporate PCOR materials into shared decision making.
  • Explain how to access AHRQ's PCOR resources for patients and clinicians.

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Patient-Centered Care (10 minutes)

Slide 4: What is patient-centered care?

Slide 4: What is patient-centered care? Institute of Medicine (IOM). Crossing the Quality Chasm: A New Health System for the 21st Century (2001). Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions. An essential foundation for quality and patient safety.

Training Guide Script:

Say: Let's begin by going over patient-centered care. In 2001, the Institute of Medicine (called IOM for short) defined patient-centered care as providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.

Patient-centered care is an essential foundation for quality and patient safety.

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Slide 5: Patient-centered care

Slide 5: Patient-centered care. IOM report continued: Systems must be designed to serve the needs of patients; ensure patients are fully informed, retain control, and participate in care delivery whenever possible; and ensure patients receive care that is respectful of their values and preferences. Shared decision making fosters patient-centered care.

Training Guide Script:

Say: The IOM also said that systems must be designed to serve the needs of patients; to ensure that patients are fully informed, retain control, and participate in care delivery whenever possible; and they receive care that is respectful of their values and preferences.

Shared decision making—involving the patient in decisions about their care—fosters patient-centered care.

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Slide 6: Step 2—Help your patient explore and compare treatment options

Slide 6: Step 2--Help your patient explore and compare treatment options. Discuss the benefits and risks of each treatment option. Know the benefits and risks of each option. Understand how they relate to your patient's situation and condition. Use evidence-based decision-making resources to compare the treatment options. Patient-centered outcomes research can help.

Training Guide Script:

Say: As you recall, Step 2 of the SHARE Approach says to "Help your patient explore and compare treatment options." This requires you know the benefits and risks of each treatment option and understand how they relate to your patient's situation and condition. Understanding how the options compare to one another helps you to better discuss the benefits and risks of each treatment option.

Step 2 also requires having good evidence-based tools to help you explain and compare options.

Resources based on patient-centered outcomes research, or PCOR, can help with Step 2 of the SHARE Approach.

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Slide 7: Group discussion

Slide 7: Group discussion. Question: How do you keep up with the latest evidence on treatment options? How do you help your patients compare options? (Image of a white board.)

Training Guide Script:

Ask: How do you keep up with the latest evidence on treatment options? How do you help your patients compare options?

Do: Write responses on a white board.

Say: To recap, resources based on patient-centered outcomes research, or PCOR, can help with Step 2 of the SHARE Approach.

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What is PCOR? (15 minutes)

Slide 8: What Is PCOR?

Slide 8: What Is PCOR? (Also known as comparative effectiveness research).

Training Guide Script:

Say: Let's go over some fundamentals of PCOR.

To clarify, you may have also heard PCOR called comparative effectiveness research or CER (pronounced C-E-R). PCOR and CER are synonymous terms. For our module, we will be using the term PCOR or patient-centered outcomes research.

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Slide 9: What is Patient Centered Outcomes Research?

Slide 9: What is Patient Centered Outcomes Research? Assesses preventive, diagnostic, therapeutic, palliative, or health delivery system interventions. Compares the benefits and harms of interventions. Aims to find out how well interventions work in everyday practice settings, not just in clinical trial settings. Focuses on outcomes that matter to people.

Training Guide Script:

Say: PCOR can be applied to myriad of interventions, including preventive, diagnostic, therapeutic, palliative, or health delivery system interventions.

PCOR compares the benefits and harms of these interventions.

PCOR aims to find out how well interventions work in everyday practice settings, not just in clinical trials.

Ideally, PCOR looks at the effectiveness of interventions, considering variables not always tested in clinical trials. These variables may include patients who have multiple conditions, are older, or are a different gender than those included in clinical trials. As you know, these types of variables can affect how well a treatment works.

PCOR focuses on outcomes that matter to patients.

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Slide 10: Group discussion

Slide 10: Group discussion. Question: What are some outcomes that may matter to patients?

Training Guide Script:

Ask: What are some outcomes that may matter to patients?

Do: Call on one or two participants to respond.

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Slide 11: Patient-centered outcomes

Slide 11: Patient-centered outcomes. Outcomes that patients notice and care about when they make health care decisions. Each patient is different, and what matters to one may not matter to another. For example, high blood pressure and high serum cholesterol levels may not cause alarm or lifestyle change for some patients. Good shared decision making means talking with your patients about what is important to them.

Training Guide Script:

Say: Outcomes that are patient-centered are those that patients notice and care about when they make health care decisions.

Yet, as we know, each patient is different, and what matters to one may not matter to another.

High blood pressure or high serum cholesterol levels may not cause alarm to some patients because the person may not feel sick or look sick. Without noticeable symptoms, it may be difficult for a patient to know that change is needed. This patient may not be motivated to make lifestyle changes or seek treatment.

Part of good shared decision making is talking with your patients about what they feel is important.

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Slide 12: Patient-centered outcomes

Slide 12: Patient-centered outcomes. Outcomes that matter to patients may include: Quality of life, Mobility, Ability to carry out certain tasks, Ability to focus, Ability to return to work, Side effects/risks of treatment, Symptoms (e.g., pain, nausea), Survival. Consider that outcomes might be different for each patient.

Training Guide Script:

Say: Some outcomes that may matter to patients can include:

  • Quality of life.
  • Mobility.
  • Ability to carry out certain tasks.
  • Ability to focus.
  • Ability to return to work.
  • Side effects and risks of treatment.
  • Symptoms (e.g., pain, nausea).
  • Survival.

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Slide 13: Primary aim of PCOR

Slide 13: Primary aim of PCOR... To help inform patients, health care providers, and others as they make health care decisions. How? In clinical setting, use PCOR as your base in shared decision making. Help your patients compare and weigh options. Learn what is important to them. Engage in two-way communication. Evidence-based information about treatment options can help your patients be active participants in the shared decision-making process.

Training Guide Script:

Say: To review, the primary goal of PCOR is to help inform patients, health care providers, and others as they make health care decisions.

In the clinical setting, you can help your patients compare and weigh options to determine what treatment options work and which options may be better than other available options. Once you know what is important to your patient, you can engage in two-way communication using PCOR as your base.

Offering evidence-based information about treatment options can help your patients be active participants in the shared decision-making process.

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Slide 14: Informing health care decisions

Slide 14: Informing health care decisions. In other settings, PCOR can inform clinical practice guidelines and policy decisions.

Training Guide Script:

Say: In other settings, PCOR can also inform clinical practice guideline development and policy decisions.

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Slide 15: PCOR—"Tools, not rules"

Slide 15: PCOR--'Tools, not rules.' Informative - Not meant to dictate health decisions. Allows you to help your patients come to a decision that works for their lives.

Training Guide Script:

Say: PCOR can be described as "tools, not rules."

PCOR is informative, and it is not meant to dictate health decisions. PCOR allows you to offer information to help your patients come to a health decision that works for their lives.

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Slide 16: What PCOR is NOT

Slide 16: What PCOR is NOT... PCOR does NOT: Tell health providers how to practice medicine. Provide guidance by itself; PCOR is informative. Replace clinical judgment tailored to individual patients. Replace clinical practice guidelines or provide clinical recommendations.

Training Guide Script:

Say: PCOR is not intended to tell health care providers how they should be practicing medicine.

Because PCOR is only information, it cannot provide guidance by itself.

It is meant to complement, not replace clinical judgment that is tailored to individual patients.

It is not a clinical practice guideline, it does not replace clinical practice guidelines, and it does not make clinical practice recommendations.

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Slide 17: Major sponsors of PCOR

Slide 17: Major sponsors of PCOR. Primary research studies. Patient-Centered Outcomes Research Institute (PCORI) (image of PCORI logo). An independent, quasi-governmental organization that was authorized as part of the Affordable Care Act (ACA) to conduct PCOR. National Institutes of Health (NIH) (image of NIH Logo).

Training Guide Script:

Say: There are a few major players involved in funding the majority of PCOR work in the United States.

The Patient-Centered Outcomes Research Institute, also known as PCORI (pronounced "Pea-Core-E" for short) and the National Institutes of Health fund primary research studies.

PCORI is an independent, quasi-governmental organization that was authorized as part of the Affordable Care Act (ACA) to conduct PCOR.

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Slide 18: Getting the information out

Slide 18: Getting the information out. PCOR is meant to help inform patient and clinician decision making. It's important to get the research to those who need it.

Training Guide Script:

Say: Because PCOR is meant to help inform patient and clinician decision making, it is imperative that the research gets to those who need it.

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Slide 19: Major sponsors supporting dissemination of PCOR

Slide 19: Major sponsors supporting dissemination of PCOR. Dissemination of primary research. PCORI, Agency for Healthcare Research and Quality (AHRQ).

Training Guide Script:

Say: So there is a big focus on dissemination of PCOR as well. The major funders of dissemination work are PCORI and the Agency for Healthcare Research and Quality, or AHRQ.

As the sponsor of this workshop, AHRQ encourages using PCOR in shared decision making. So, for the rest of this module we will focus on AHRQ's role in PCOR dissemination and the PCOR resources available from AHRQ.

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AHRQ's Effective Health Care Program (25 minutes)

Slide 20: AHRQ's Effective Health Care Program

Slide 20: AHRQ's Effective Health Care Program. http://effectivehealthcare.ahrq.gov (Image of the Effective Health Care Program.)

Training Guide Script:

Say: AHRQ's PCOR dissemination activities occur primarily through the Effective Health Care Program.

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Slide 21: Effective Health Care Program activities

Slide 21: Effective Health Care Program activities. Evidence synthesis: Development of systematic reviews of existing evidence to compare treatment/intervention effectiveness and identifying relevant knowledge gaps. Compare the benefits and harms of treatment options. Explain what is known and what is not known.

Training Guide Script:

Say: The first step of disseminating PCOR is synthesizing all of the primary research on a particular topic.

The Effective Health Care Program conducts systematic reviews of available evidence. These reviews thoroughly compare the benefits and harms of treatment options. The reviews explain what is known—and what is not known—about health care interventions.

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Slide 22: Effective Health Care Program Comparative Effectiveness reports

Slide 22: Effective Health Care Program Comparative Effectiveness reports. Comprehensive technical reviews. Executive summary and full report. Available for free online in HTML and PDF formats. (Image of two AHRQ Comparative Effectiveness Review reports.)

Training Guide Script:

Say: Effective Health Care Program systematic reviews are called Comparative Effectiveness Reviews. They are comprehensive technical documents that are usually hundreds of pages long. Each report also includes an executive summary that summarizes the findings in about 20 to 30 pages.

These reports are available free of charge on the AHRQ Effective Health Care Web site. Visit www.effectivehealthcare.ahrq.gov to learn more.

Do: Pass some AHRQ samples out now.

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Slide 23: AHRQ's Evidence-Based Practice Centers (EPCs)

Slide 23: AHRQ's Evidence-Based Practice Centers (EPCs): Are independent research organizations and institutions. Have extensive expertise in conducting systematic reviews of literature. Conduct comparative effective reviews under contract to AHRQ. The EPC Program actively manages any conflict of interest to ensure the reviews are trustworthy and unbiased.

Training Guide Script:

Say: AHRQ's Evidence-based Practice Centers, also referred to as EPCs, conduct the comparative effectiveness reviews.

The EPCs are independent research organizations and institutions with extensive expertise in conducting systematic reviews of literature. They conduct research under contract to AHRQ.

The EPC program policies require organizations and staff to disclose any and all potential conflicts of interest prior to conducting a comparative effectiveness review. Actively managing any conflict issues ensures that the reviews are trustworthy and unbiased.

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Slide 24: Topics

Slide 24: Topics. Screen shot image of the Effective Health Care Program Web page showing the lit of topics covered, including: Brain and Nerve Conditions. Breathing Conditions. Cancer. Developmental Delays, ADHD, Autism. Diabetes. Obesity. Digestive System Conditions. Genitourinary Conditions. Gynecology. Heart and Blood Vessel Conditions. Infectious Disease and HIV/AIDs. Mental Health. Muscle, Bone, and Joint Conditions. Nonclinical Topics. Ophthalmologic Conditions. Pregnancy and Childbirth. Renal Disease.

Training Guide Script:

Say: This screen-grab shows examples of the topic areas that have undergone comparative effectiveness reviews by AHRQ's Effective Health Care Program.

The reviews address a wide variety of conditions, including common ones, such as cardiovascular diseases, diabetes, arthritis, mental health disorders, and many more. It is likely that at least some of these resources are relevant to your practice area.

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Slide 25: Which of these broad topics may be relevant to your patients?

Slide 25: Which of these broad topics may be relevant to your patients? Question: Which of these broad topics may be relevant to your patients? Arthritis? Cardiovascular Disease? Diabetes? Mental health disorders? Obesity? Pregnancy and Childbirth? Renal Disease? Others?

Training Guide Script:

Ask: Which of these broad topics are relevant to you?

Do: Call on a few people to respond.

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Slide 26: Topic nomination

Slide 26: Topic nomination. EHC Program works with stakeholders for topic nomination. Topics for review are nominated by non-Federal partners, such as: Professional societies. Health plans. Insurers. Employers. Patients. Clinicians.

Training Guide Script:

Say: The Effective Health Care Program works with a variety of stakeholders to identify priority topic areas for review to ensure they meet the needs of its users.

These stakeholders include professional societies, health plans, insurers, employers, and importantly, patients, and clinicians like you.

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Slide 27: Topic selection

Slide 27: Topic selection. Suggestions considered against a set of criteria. Priority is given to the topics that: Address clinical uncertainties. Focus on important subgroups. Will be used to inform decision making. (Screen shot image of the Effective Health Care Program Web page showing information on how research topics are selected.)

Training Guide Script:

Say: You can look on AHRQ's Effective Health Care Program Web site to see what topics have been submitted and what topics are currently in development for review.

All suggestions are carefully considered based on a set of criteria. Topics that are given priority address clinical uncertainties, focus on important subgroups, and will be used to inform decision making.

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Slide 28: Stakeholder involvement in the Effective Health Care Program

Slide 28: Stakeholder involvement in the Effective Health Care Program. To ensure each review is relevant to patients and other stakeholders: Topic selection. Review and comment on key questions and outcomes studied. Review and comment on draft report. (Screen shot image of the Effective Health Care Program Web page showing stakeholders can contribute.)

Training Guide Script:

Say: AHRQ is committed to ensuring that each review is relevant to patients and other stakeholders.

Adhering to the principles of PCOR, AHRQ engages stakeholders in all phases of PCOR research, from suggesting topics and commenting on key questions and outcomes to being actively involved in the review of all drafts products.

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Slide 29: Effective Health Care Program activities

Slide 29: Effective Health Care Program activities. Evidence synthesis: Conducting systematic reviews of existing evidence to compare treatment/intervention effectiveness and identifying relevant knowledge gaps. Translation: Translating PCOR findings into plain language resources and tools for patients, providers, and policymakers.

Training Guide Script:

Say: An important part of PCOR is ensuring that the findings are relevant to the end users. The Effective Health Care Program takes the comprehensive 200-page report gathered from evidence synthesis and creates plain language documents for patients, providers, and policymakers based on these larger evidence-based reports.

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Slide 30: Image of Effective Health Care Program products

Slide 30: Image of Effective Health Care Program products. (Image of Effective Health Care Program products.)

Training Guide Script:

Say: This slide shows some of the products that AHRQ makes available. We've been passing them around. We also have a number of these materials on display in the back of the room.

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Slide 31: Effective Health Care Products

Slide 31: Effective Health Care Products. Designed to encourage conversations between clinicians and patients. Available online for viewing and print in PDF format. Accessible on mobile devices and smart phones. Available for order for little or no cost from AHRQ's Publication Clearinghouse. Many available in Spanish.

Training Guide Script:

Say: These products are designed to encourage conversations between clinicians and patients to enhance shared decision making.

All of these resources are available for online viewing and for print in PDF format. You can also access and view these AHRQ resources on mobile devices and smart phones.

You can also order them for little or no cost from AHRQ's Publications Clearinghouse. We'll show you how to do that a little later.

Let's explore some of the clinician resources first, and discuss how they can help you with shared decision making.

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Slide 32: Clinician resources

Slide 32: Clinician resources. Can help you engage in shared decision making by helping you know the evidence. Based on systematic reviews from the Effective Health Care Program. Available in a variety of easy-to-navigate formats: Clinician research summaries. CME/CE modules. Faculty slides. Webcasts.

Training Guide Script:

Say: Let's go over the resources available for health providers.

For you and your clinician colleagues, AHRQ offers several types of clinician resources that can help you engage in shared decision making with your patients. These resources are based on the systematic reviews of the literature from the Effective Health Care Program. They are designed to help you learn about the research in a variety of easy-to-navigate formats. These include clinician research summaries, CME/CE modules, faculty slides, and Webcasts.

When you know the treatment options and how they compare to one another in terms of benefits and risk, you can help your patients make optimal treatment decisions that work for their lives.

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Slide 33: Clinician research summaries

Slide 33: Clinician research summaries. Offer Clinical Bottom Line. Highlight the strength of evidence behind the report's conclusions. Describe gaps in evidence. Over 50 in print that you can order. Also downloadable online. (Image of clinician research summaries.)

Training Guide Script:

Say: The Clinician Research Summaries offer the clinical bottom line in a few pages, highlight the strength of evidence behind the report's conclusions, and describe gaps in current evidence. There are over 50 clinician summaries in print and available online.

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Slide 34: Clinician research summaries

Slide 34: Clinician research summaries. Use them in shared decision making with your patients: Serve as quick reference/review to compare treatment options. Help you convey the evidence-based treatment options and how they compare in benefits and risks to your patients. Easy to navigate, download, and share. (Image of a patient with two health care professionals in an exam room looking at information on an electronic tablet.)

Training Guide Script:

Say: You can use these summaries in shared decision making with your patients.

You can review these as a quick reference to compare treatment options.

They can help you convey the evidence behind the treatment options and how they compare in benefits and risks to your patients.

These are easy to share with colleagues too.

Do: Pass the Clinician Research Summaries around the room or refer to the samples in the back of the room.

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Slide 35: Clinician CME/CE Activities

Slide 35: Clinician CME/CE Activities. (Screen shot image of the Effective Health Care Program Web page showing list of clinician CME/CE activities available.)

Training Guide Script:

Say: You can also participate in free online continuing education (CME/CE) from AHRQ. These courses are based on specific full Comparative Effectiveness Reviews. Credits are available for several different types of clinicians.

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Slide 36: Clinician faculty slides and resources

Slide 36: Clinician faculty slides and resources. Faculty slides. Webcasts. (Screen shot image of the Effective Health Care Program Web page showing topics for which faculty slide decks are available and a sample slide deck.)

Training Guide Script:

Say: Faculty slide sets contain prepared talks and PowerPoint slide presentations to use in grand rounds or journal clubs. The prepared slide sets help educate clinicians, researchers, and other health professionals in training.

AHRQ's Effective Health Care Program also sponsors Webcasts and conferences you can use for additional education and training activities.

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Slide 37: Patient resources

Slide 37: Patient resources. Consumer research summaries: Over 50 print, online, and audio. Patient-friendly. English and Spanish. Compare treatment options--risks and benefits. Questions to ask provider. Interactive patient decision aids: Web-based decision aids.

Training Guide Script:

Do: Pass the Consumer Research Summaries around the room.

Say: For your patients, AHRQ offers Consumer Research Summaries and Interactive Patient Decision Aids. These resources are written in consumer-friendly language and are designed for patients with certain conditions to help them think about what is important to them when talking with their clinician about treatment options.

Do: Show participants examples in the research summary, as you list the criteria below.

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Slide 38: Patient resources use health literacy principles

Slide 38: Patient resources use health literacy principles. Written in plain language for easier comprehension. Tells you from the start (inside cover) who the booklet is for. Uses large type for reading ease. Uses effective line length for optimal readability (less than 6 inches long helps the reader track the line easily).

Training Guide Script:

Say: In addition to being written in plain language writing, the Consumer Research Summaries follow effective, proven health literacy principles. They should:

  • Be written in plain language for easier comprehension.
  • Start off by stating who will benefit from the booklet.
  • Use large type for reading ease.
  • Have effective line length for optimal readability.

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Slide 39: Patient resources use health literacy principles, cont.

Slide 39: Patient resources use health literacy principles, continued. Uses headers and sub-headers to direct readers. Uses photographs that show action. List questions to ask the doctor. Often available in Spanish. Available in audio version on the Web.

Training Guide Script:

Say: They also:

  • Use headers and sub-headers to direct the reader.
  • Use photographs that show actions you hope your readers will take.
  • List questions to ask the doctor or health care provider.
  • Offer space for the reader to fill in answers and write their own questions.
  • Are often available in Spanish or in audio version.

The patient resources are available online, in print, and in audio versions.

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Slide 40: PCOR resources for patients to promote shared decision making

Slide 40: PCOR resources for patients to promote shared decision making. Aim to involve patients and family members in decision making. Inform patients and their caregivers about options. Help clarify patients' preferences for risks and benefits of options. Encourage patients and family members to discuss their preferences with their clinicians. (Image of a sample consumer summary and the table of contents of the summary.)

Training Guide Script:

Say: A key element of these patient resources, which makes them valuable for shared decision making, is that their use aims to involve patients and family members in decisions. These resources help in three ways:

  • They inform patients and their caregivers about options.
  • They clarify patients' preferences for risks and benefits of options.
  • They encourage patients and family members to discuss their preferences with their clinicians.

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Slide 41: Using AHRQ's PCOR resources

Slide 41: Using AHRQ's PCOR resources. (Three images of patients using AHRQ consumer materials. The image on the left shows a couple consulting with a physician and the physician is sharing information on an electronic tablet. The image in the middle shows a patient reading AHRQ information in the waiting room. The image on the right shows a patient reading AHRQ information at home.)

Training Guide Script:

Say: You can discuss the information in the Consumer Research Summaries with patients during clinical encounters or consultations.

Consider placing the Consumer Research Summaries in your waiting rooms and exam rooms. Offer them as take-home materials to discuss at your next visit.

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Slide 42: AHRQ's interactive decision aids promote shared decision making

Slide 42: AHRQ's interactive decision aids promote shared decision making. AHRQ's interactive decision aids: Describe the condition. Present the treatment options. Help patients assess what is important to him or her. Provide tips for talking with their clinician. (Image of AHRQ's interactive patient decision aid on screening for prostate cancer.)

Training Guide Script:

Say: AHRQ also offers Interactive Patient Decision Aids that are designed to facilitate shared decision making. You will find culturally relevant videos and slide shows to help your patients as they make important health decisions.

You can direct your patients to the Web site to view at home or in your office.

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Slide 43: AHRQ's interactive decision aids

Slide 43: AHRQ's interactive decision aids. (Image of AHRQ's interactive patient decision aid on treatments for urinary incontinence.)

Training Guide Script:

Say: Let's take a look at one interactive decision aid now.

Do: Minimize the PowerPoint presentation and go to the AHRQ Effective Health Care Web site. You should already have your browser on the following page: http://www.effectivehealthcare.ahrq.gov/ehc/decisionaids/urinary-incontinence/

Note: Show more than one interactive aid if there is time. Also, have the site up on the computer at breaks so participants can see the interactive tools.

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Slide 44: How might you use these consumer summaries?

Slide 44: How might you use these consumer summaries? Question: Can you think of other ways that you might use these resources with your patients? When might you introduce them? At the visit, to take home? (Image of a white board.)

Training Guide Script:

Ask: Can you think of other ways that you might use these resources with patients?

How would you introduce them? At the visit, to take home?

Do: Write suggestions on the white board.

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Slide 45: Examples of how AHRQ's PCOR resources have been used

Slide 45: Examples of how AHRQ's PCOR resources have been used.  Urban Health Plan (UHP), a network of New York City health centers serving more than 54,000 mostly Spanish-speaking and low-income patients in the Bronx and Queens, has ordered nearly 2,500 EHC Program summaries to support their English- and Spanish-language patient education efforts. WakeMed Health and Hospitals distributed 1,000 copies of the Treating High Cholesterol consumer research summary at a communitywide health fair. In the past year, more than 28,000 EHC Program publications have been distributed at three NAFC 'Communities Are Responding Everyday' (C.A.R.E) health clinics in Washington, DC, Charlotte, NC, and New Orleans, LA. Note: Refer to page 7, Tool 8 for other examples.

Training Guide Script:

Say: Here are some examples of how organizations have shared the patient resources. You will find other examples in Tool 8, on page 7.

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Slide 46: Why Use PCOR Tools and Resources?

Slide 46: Why Use PCOR Tools and Resources?

Training Guide Script:

Say: Now that we have talked about PCOR, and AHRQ's Effective Health Care Program as a prominent resource for practical PCOR tools and resources, you may be asking yourself, "Why should I use this information?"

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Slide 47: Sharing decision aids with patients improves patient care and outcomes

Slide 47: Sharing decision aids with patients improves patient care and outcomes. A growing body of literature shows that providing patients with decision aids regarding their health treatment or screening decisions can have positive results. Note: Refer to pages 3-4, Tool 9 for summary of evidence.

Training Guide Script:

Say: Sharing evidence-based decision aids, such as AHRQ's PCOR resources, through a coordinated effort of shared decision making with patients and their caregivers improves patient care.

A growing body of literature shows that providing patients with decision aids regarding their health treatment or screening decisions can have positive results.

You can find a nice summary of the evidence on pages 3 and 4 of Tool 9. We will talk more about this in Module 4.

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Slide 48: Sharing decision aids with patients improves patient care and outcomes

Slide 48: Sharing decision aids with patients improves patient care and outcomes. Sharing decision aids with patients: Improves patient knowledge regarding their options. Reduces patients' decisional conflict. Increases patients' active role in decision making. Improves accurate risk perceptions of possible benefits and harms among patients. Increases the likelihood that patients' choices are more consistent with their informed values. Enhances communication between patients and their clinicians.

Training Guide Script:

Say: Using decision aids can:

  • Improve patient knowledge regarding their options.
  • Reduce patients' decisional conflict.
  • Increase patients' active role in decision making.
  • Improve accurate risk perceptions of possible benefits and harms among patients.
  • Increase the likelihood that patients' choices are more consistent with their informed values.
  • Enhance communication between patients and their clinicians.

Some evidence suggests that using decision aids in shared decision making also has the potential to improve patient outcomes. For example, a number of studies have shown that it can improve treatment adherence.

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Accessing Effective Health Care Program Products (15 minutes)

Slide 49: Accessing Effective Health Care Program Products

Slide 49: Accessing Effective Health Care Program Products. http://effectivehealthcare.ahrq.gov. Note: Refer to handout 'Accessing and Navigating AHRQ's Effective Health Care Program Web site'.

Training Guide Script:

Do: Distribute the Accessing Effective Health Care Programs Product Fact Sheet

Say: Now let's spend a little bit of time talking about how you can access AHRQ Effective Health Care Program content online.

Let's refer to our handout, Accessing and Navigating AHRQ's Effective Health Care Program Web site now. You will find it at the end of Module 2 in your notebook. We'll spend a bit of time going over navigation now. We won't be going through the handout page by page, but rather highlight several areas.

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Slide 50: Image of the Effective Health Care Program Web site home page

Slide 50: Image of the Effective Health Care Program Web site home page. http://effectivehealthcare.ahrq.gov.

Training Guide Script:

Say: The best way to get familiar with the site is to visit it and begin navigating around the site when you have a few minutes to spare once you get back to your job site.

Go to http://www.effectivehealthcare.ahrq.gov. The Web address is on page 1 of the handout and also on your bookmark.

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Slide 51: Are you familiar with AHRQ's Effective Health Care Program?

Slide 51: Are you familiar with AHRQ's Effective Health Care Program? Question: Have any of you ever visited this Web site? Have you used any of these resources before?

Training Guide Script:

Ask: Have any of you ever visited this Web site? Have you used any of these resources before?

Say: All of the Effective Health Care Program materials can be obtained and viewed online.

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Slide 52: Image of the Effective Health Care Program Web site—Research Summaries for Consumers, Clinicians and Policymakers

Slide 52: Image of the Effective Health Care Program Web site--Research Summaries for Consumers, Clinicians and Policymakers. (Image of the Effective Health Care Program Web site – Research Summaries for Consumers, Clinicians and Policymakers.) Note: Refer to page 3 of handout.

Training Guide Script:

Say: Let's turn to page 3 of your handout. To find plain language materials for you and your patients, you will click on Research Summaries for Consumers, Clinicians, and Policymakers from the left-hand navigation bar.

Clicking on this link takes you to a page that highlights the varied topics for which you will find resources.

As mentioned, there are about 60 clinician summaries available on a variety of topics. Most of these have companion patient materials available in English and Spanish.

So, for example, if you select "Heart and Blood Vessel Conditions," it takes you down the page to the list of available summaries.

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Slide 53: Image of the Effective Health Care Program Web site—Research Summaries for Consumers, Clinicians and Policymakers

Slide 53: Image of the Effective Health Care Program Web site--Research Summaries for Consumers, Clinicians and Policymakers. Note: Refer to page 4 of handout.

Training Guide Script:

Say: This slide information can be found on page 4 of your handout.

The far left column shows available consumer summaries for patients. The middle column shows the corresponding clinician summary.

Now, if you select to view a particular consumer summary, for example, the one titled, "Choosing Medicines for High Blood Pressure," you will be routed to the following page.

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Slide 54: Image of the Effective Health Care Program Web site—Landing page for the Consumer Summary titled "Choosing Medicines for High Blood Pressure: A Review of the Research on ACEIs, ARBs, and DRIs"

Slide 54: Image of the Effective Health Care Program Web site--Landing page for the Consumer Summary titled 'Choosing Medicines for High Blood Pressure: A Review of the Research on ACEIs, ARBs, and DRIs'. Note: Refer to page 5 of handout.

Training Guide Script:

Say: On page 5 of the handout, you'll see you can view or print a PDF version of this patient resource in English and Spanish.

Or you can even listen to an English or Spanish audio version of this consumer summary.

If you want to see related resources or the full comprehensive report, just click on the links on the right hand side of the page as shown in this slide.

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Slide 55: Image of the Effective Health Care Program Web site Home page

Slide 55: Image of the Effective Health Care Program Web site Home page. (Image of the Effective Health Care Program Web site and how to access Tools and Resources from the left-hand navigation bar.) Note: Refer to page 8 of handout.

Training Guide Script:

Say: Now look on the far left column on page 8 in your handout. You would click "Tools and Resources" to access other tools and resources from the home page. This is how you'd view AHRQ's Interactive Patient Decision Aids or Clinician Continuing Education Modules.

Again, you can surf the Web site when you get back to the office and use this handout for a quick reference if needed.

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Slide 56: Image of the Effective Health Care Program Web site—landing page for Tools and Resources

Slide 56: Image of the Effective Health Care Program Web site—landing page for Tools and Resources. (Image of the Effective Health Care Program Web site landing page for Tools and Resources. The image shows the variety of resources available from this page, including: Patient Decision Aids, CME/CE Activities, Slide Library, Research Resources, Webcasts, Eisenberg Center Conference Series, and Resources for Getting Involved and Involving Others.) Note: Refer to page 9 of handout.

Training Guide Script:

Say: Turn to page 9 in your handout. From the "Tools and Resources" page, you will be able to click on resources that you are specifically interested in.

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Slide 57: Ordering Information

Slide 57: Ordering Information. (Image of the Effective Health Care Program Web site page with instructions on how to order print copies of AHRQ's Effective Health Care Program products.) Order copies of consumer summaries in bulk for little to no cost. Note: Refer to pages 10-12 of handout.

Training Guide Script:

Say: Pages 10-12 in your handout describe how to order print copies. You can order print copies of all Effective Health Care Program products through the AHRQ Publications Clearinghouse. For example, you may want to order bulk print copies of specific consumer summaries in English or Spanish to distribute to patients who visit your clinic. The process is easy; either order online or call the AHRQ Publications Clearinghouse.

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Slide 58: Sign up for email alerts

Slide 58: Sign up for email alerts. (Image of the Effective Health Care Program Web site page with instructions on how to subscribe to receive electronic updates about new and updated resources from the Effective Health Care Program.) Note: Refer to page 13 of handout.

Training Guide Script:

Say: Page 13 of your handout shows you how to sign up for email updates to stay updated on research and resources from the Effective Health Care Program. You can receive email alerts when new clinician and consumer summaries become available.

Note: Instructor, let group know if you have signed up for the email updates.

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Slide 59: Sharing Effective Health Care Program Resources and Tools

Slide 59: Sharing Effective Health Care Program Resources and Tools.

Training Guide Script:

Say: Let's briefly talk about further sharing these materials.

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Slide 60: Effective Health Care Program activities

Slide 60: Effective Health Care Program activities. Evidence synthesis:  Conducting systematic reviews of existing evidence to compare treatment/intervention effectiveness and identifying relevant knowledge gaps. Translation: Translating PCOR findings into plain language resources and tools for patients, providers, and policymakers. Dissemination and Implementation: Ensuring the tools and resources get into the hands of the people who need them.

Training Guide Script:

Say: The Effective Health Care Program works to ensure the PCOR findings and translation products get into the hands of the people who need them. AHRQ uses a variety of strategies and channels to do so. This workshop is one of those channels.

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Slide 61: Effective Health Care Program activities

Slide 61: Effective Health Care Program activities. Through its dissemination and implementation efforts, AHRQ and the Effective Health Care Program have distributed: More than 4 million PCOR products. Awarded more than 60,000 CME/CE certificates.

Training Guide Script:

Say: Through its dissemination and implementation efforts, AHRQ and the Effective Health Care Program have distributed more than 4 million PCOR products and awarded more than 60,000 continuing education certificates.

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Slide 62: Key takeaways

Slide 62: Key takeaways. The primary goal of PCOR is to help inform patients, health care providers, and others as they make health care decisions. AHRQ's Effective Health Care Program offers a variety of evidence-based PCOR resources for health providers and patients to support shared decision making. You can access the materials by ordering or by downloading online.

Training Guide Script:

Say: To review, in Module 2: Patient-Centered Outcomes Research we have discussed that the key information includes:

The primary goal of PCOR is to help inform patients, health care providers, and others as they make health care decisions.

AHRQ's Effective Health Care Program offers a variety of evidence-based PCOR resources for health providers and patients to support shared decision making.

And finally, you can access these resources online or by ordering them from AHRQ's Publications Clearinghouse.

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Slide 63: Citations

Slide 63: Citations, Text Description is below the image.

  • Institute of Medicine (IOM). Crossing the Quality Chasm. Crossing the Quality Chasm: A New Health System for the 21st Century. 2001. Washington, D.C: National Academy Press.
  • Stacey D, Légaré F, Col NF, et. al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2014 Jan  28;1:CD001431. PubMed PMID: 24470076.

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Return to SHARE Approach Workshop

Page last reviewed December 2014
Page originally created September 2014
Internet Citation: SHARE Approach Workshop Curriculum. Content last reviewed December 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/shareddecisionmaking/workshop/module2/shareworkshop-mod2guide.html