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SUMMARY: Background: Shared decision making (SDM), whereby patients and clinicians work collaboratively to make health care decisions, brings multiple benefits. It has, however, been slow to integrate into clinical practice. There are some examples of SDM being embedded and evaluated within medical undergraduate curricula but, despite role models being important in promoting students' patient‐centred attitudes, these examples do not involve students reflecting on clinicians' use of SDM in practice. Methods: We undertook a qualitative evaluation of a small group educational intervention. A key element was the students' use of a structured reflective template, drawing on the SHARE (seek, help, assess, reach, evaluate) SDM tool, to analyse examples of clinicians using SDM in practice critically. We undertook a thematic analysis of students' completed templates and evaluated their engagement with the SHARE tool. Findings: A total of 44 templates were analysed. Four main themes were identified, including new learning about SDM, noticing and deconstructing SDM, participants' responses to SDM and struggles in learning. Students were positive about SHARE and used it to critique experiences and suggest specific ways that clinicians could have improved SDM. Discussion: A structured training intervention that promotes critical reflection on clinical role models can help to shift undergraduate medical students' understanding of, and attitudes towards, SDM. The ethical arguments for SDM, evidence for its benefits and the alignment of SDM with participants' own core values appeared to help achieve student 'buy in'. Students struggled with notions of power, risk and time constraints, and empathised with both patients and clinicians. They highlighted the scarcity of SDM in practice. [ABSTRACT FROM AUTHOR]

ABSTRACT Background and Purpose. Body position can play an important role in an infant's recovery from respiratory disease, but few studies have accounted for sleep state which is known to have a direct influence on the control of respiratory muscles as well as on metabolic and circulatory changes. The purpose of this study was to examine the influence of body position on respiratory function in pre-term infants whilst accounting for sleep state. Method. Thoraco-abdominal motion was assessed using respiratory inductance plethysmography (RIP) to provide measures of relative rib cage (RC) and abdominal (AB) movement in ten non-ventilated pre-term infants. Continuous measurements of oxygen sat-uration (SaO 2 ), pulse and heart rate (HR), were made and sleep state was recorded using behavioural criteria and electro-oculogram (EOG) measurements. Results. The results showed a significant increase in HR in supine, but no significant difference in SaO 2 as a function of position, compared to the prone position where a significant reduction was found in thoraco-abdominal asynchrony for both groups and a reduction in variability in both HR and SaO 2 . Intra-subject variability of thoraco-abdominal motion as a function of position demonstrated no significant difference on return to supine or on return to prone, illustrating good repeatability of measures. Conclusions. Prone positioning of pre-term infants recovering from respiratory disease may improve respiratory function. As measured, the improvement in respiratory synchrony in prone position brings pre-term infants' breathing pattern into line with that expected in term infants. [ABSTRACT FROM AUTHOR]

Investigates the effect of positioning on the stability of oxygenation and respiratory synchrony in pre-term infants. Increase of heart rate on supine positioning; Reduction in asynchrony on prone positioning; Observation of intra-subject variability on thoraco-abdominal motion.