Best practice: Creating a DVD and learning booklet based on real encounters between patients and their GPs to show patients making shared decisions with their doctors about their care.

Who did it: Martin Wilkinson, Director of Postgraduate GP Education; Julia Holding, Communications Lead; Sukvinder Kaur, Project Manager; Dr Mike Deighan, Deputy Director GP Education, and Bianca Nichols, Administrator, all from NHS West Midlands, together with Connie Wiskin from the Interactive Studies Unit, Kirsty Protherough, GP Registrar, both from the University of Birmingham, and Richard da Costa, Director of Dramatic Solutions.

As part of a national initiative, our team was awarded a £35,000 grant to develop a shared decision learning tool.

Most such projects elsewhere have concentrated on shared decisions for hospital treatment, but we thought it was important to focus on where most patients interact with the NHS - which is primary care - and develop a tool to help teach GP registrars, their trainers and established GPs.

Shared decisions between doctor and patient about treatment improves both patient satisfaction and medical outcomes. Often, shared decisions are cheaper, as some patients opt for self-management and thus require fewer consultations.

However, GPs with poor consulting skills find it difficult to engage in shared decision-making. So, using a pool of West Midland GPs, we generated a number of consultations based on real patient encounters that involved shared decisions being made between patients and their doctors.

These were turned into 12 vignettes, which were filmed using GPs trainers and actors playing the role of the patients. We created 10-minute clips followed by a "talking head" in which the patient gives a 30-second assessment of what they thought about the doctor and the shared decision. Filming, by Dramatic Solutions, took place at Bellevue Medical Centre in Edgbaston, Birmingham.

The result is a DVD and learning booklet with educational exercises for individual doctors and trainers and as part of our schemes.

The booklet includes advice and tips from a communication specialist, an experienced GP and from the perspective of an RCGP examiner. 

For further information, contact Martin Wilkinson, Director of Postgraduate GP Education, at Martin.wilkinson@wm.hee.nhs.uk