Shared Decision Making training improves confidence in clinicians to facilitate collaborative decisions in musculoskeletal physiotherapy


In collaboration with Making Choices Together (Improvement Cymru), ABUHB Musculoskeletal Physiotherapy service aimed to deliver a training and support package to embed SDM knowledge and skills into practice and evaluate its initial feedback from clinical staff and service users.

76% of attendees
reported an increase in confidence relating to Shared Decision Making after attending training.


Two four-hour training SDM knowledge and skills sessions were developed based on resources provided by Making Choices Together and Cardiff University and delivered by physiotherapists who had attended the Train the Trainer events. The SDM-Q-Doc (Scholl et al 2012) was used to establish the attendee’s experience of SDM in practice alongside a likert confidence rating scale pre and one month post-training. Further observed practice events and SDM promotion were continued post-training. The collaboRATE tool (Elwyn et al 2013) was used to provide a patient-reported measure of SDM in clinical encounters post-training.


Results: Eight SDM sessions were delivered to 54 clinicians between March and June 2019. The SDM-Q-Doc demonstrated an average improvement of 3.73 points from pre to post training. 76% (41/54) of attendees reported an increase in confidence of between 1 and 2 points on a likert scale relating to SDM after attending training. The collaboRATE tool was completed by 81 patients post training with an average score of 9.9/10.

Conclusion(s): ABUHB musculoskeletal physiotherapy service have risen to the national call to incorporate SDM into clinical practice by delivering a successful knowledge and skills training programme. On brief evaluation, this has been well received by clinicians and service users, supporting the ongoing desire to improve and deliver person-centred care. Future aspirations are to further embed SDM in musculoskeletal practice, consider further value-based evaluation and deliver training to other staff groups within ABUHB and NHS Wales.

Cost and savings

No further data 


Providing the opportunity to improve SDM knowledge and skills is an important aspect of promoting the values and culture of person-centred care across the service and organisation. Consistent engagement and partnership working between clinicians and service users that supports collaborative decisions, has the potential to improve the efficiency, effectiveness and experience of both musculoskeletal physiotherapy and the wider health care service.

Top three learning points

No further data 

Funding acknowledgements

Making Choices Together (Improvement Cymru) funded a two-day train the trainer event for six ABUHB musculoskeletal physiotherapy clinicians. No other funding was received to support the delivery and outcomes of this project