Hilary A. Llewellyn-Thomas, Ph.D.
117 Strasenburgh Hall
Director, Program in Health Decision Research
Time/Date: Winter Term
Thursdays: Jan. 6 - Mar. 10, 2005
This course introduces the basic strategies used for fundamental and applied investigations into patients' health care decision making. There are three major topical areas. The first area begins with the clinical concept of decisional conflict, and then focuses on the challenges of designing, evaluating, and implementing patients' decision aids as one approach to providing effective decision support in various clinical contexts. The second involves the cognitive theories, study designs, and measurement methods most commonly used to elicit patients' preferences for health states, treatment processes, time periods, levels of risk, and participation in decision making. The third area pervades the course; it involves helping students gain awareness of the broader scientific, philosophical, and socio-political issues inherent in studying patients' decision making. The course will be built around selected weekly reading and application exercises, as well as the research interests of the individual students. By the conclusion of the course, the student will have outlined a proposal that addresses a particular research problem in this field.
The course will help students to:
- Systematically explore and critically appraise the cognitive theories, study designs, and measurement strategies that are currently most commonly used to elicit patients' preferences and expectations;
- Identify a key research question in a decision problem of particular theoretical, methodological, or clinical interest to the individual student;
- Draft a proposed strategy for addressing the research questions of particular interest to the student; and
- Gain awareness of the broader scientific, philosophical, and socio-political issues inherent in studying patients' decision making.
The course content is built around the organizational framework outlined in: Llewellyn-Thomas HA. Presidential Address -- Patients' health care decision making: a framework for descriptive and experimental investigations. Medical Decision Making 1995;15(2):101-106. Students explore some aspects of this framework in greater depth than others, depending upon individual background and interests. The course is offered in a seminar format. Each week, prior to class, students read and critique relevant empirical and review articles, and engage with selected application exercises. An extensive background reading list is also provided for those students who wish to explore particular aspects in greater depth.
Course comprehension is determined through a combination of skills that include written, oral and group participation.
Students will receive a single grade for the course, using Dartmouth's standard grading for graduate level courses.
Download Annotated Bibliography: The Principles of Shared Decision Making