Table 2.
Learning Objectives by Largest Increase in Confidence and Effect Size
| Objective | Session | Respondents (N) | Pre-Median | Post-Median | Median Differencea | 95% Confidence Interval | P Value | Effect Size (r) |
|---|---|---|---|---|---|---|---|---|
| Explain the 9 elements of SDM and participate with patients in SDM for kidney failure treatment options. | 2 | 25 | 5.00 | 7.00 | 2.00 | 1.50-3.00 | <0.001 | 0.84 |
| Discuss how to present ExPAND to nephrology clinician colleagues to encourage them to refer patients to ExPAND kidney disease education. | 1 | 33 | 5.00 | 6.00 | 2.00 | 1.50-2.50 | <0.001 | 0.75 |
| Deliver kidney disease education using an enriched NKF Council of APP curriculum that includes an expanded and balanced presentation of active medical care. | 2 | 25 | 5.00 | 6.00 | 2.00 | 1.50-3.00 | <0.001 | 0.75 |
| Describe evidence supporting the need to improve SDM and ExPAND. | 1 | 33 | 5.00 | 6.00 | 1.50 | 1.00-1.50 | <0.001 | 0.73 |
| Facilitate use of evidence-based patient decision aid videos that include unbiased presentations of alternative treatment plan options. | 2 | 25 | 5.00 | 7.00 | 1.50 | 1.00-3.00 | <0.001 | 0.73 |
| Apply a cultural humility and trauma-informed care lens to patient-centered care. | 2 | 25 | 6.00 | 7.00 | 1.50 | 1.00-1.50 | 0.001 | 0.68 |
| Describe stages of change theory as it applies to SDM. | 3 | 19 | 5.00 | 6.00 | 1.50 | 1.00-2.50 | 0.005 | 0.67 |
| Describe how kidney supportive care can improve patient care in real-world nephrology practices. | 1 | 33 | 6.00 | 7.00 | 1.50 | 1.00-2.00 | <0.001 | 0.65 |
| Inform patients of all alternatives to dialysis and why dialysis might not benefit older patients with comorbid conditions, frailty, and/or cognitive or functional impairment. | 1 | 33 | 6.00 | 7.00 | 1.50 | 0.50-2.50 | 0.01 | 0.45 |
| Recall a framework and best practices for SDM conversation. | 3 | 19 | 5.00 | 6.00 | 1.00 | 1.00-1.00 | <0.001 | 0.79 |
| Apply Ask-Tell-Ask with empathy to conduct a SDM conversation. | 3 | 19 | 5.00 | 6.00 | 1.00 | 1.00-1.50 | 0.003 | 0.75 |
| Respond to patient emotion and ambivalence. | 3 | 19 | 6.00 | 6.00 | 1.00 | 0.00-0.00 | 0.002 | 0.73 |
| Apply best practices for engaging patients and families. | 3 | 19 | 6.00 | 6.00 | 1.00 | 1.00-1.00 | 0.008 | 0.65 |
Abbreviations: APP, advanced practice provider; NKF, National Kidney Foundation; SDM, shared decision making.
a
Technically, a pseudomedian, a measure of centrality for non-normally distributed populations.