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Objective To participate in shared decision making (SDM), patients need to understand their options and develop trust in their own decision-making abilities. Two experiments investigated the potential of decision aids (DAs) in preparing patients for SDM by raising awareness of preference-sensitivity (Study 1) and showing possible personal motives for decision making (Study 2) in addition to providing information about the treatment options. Methods Participants (Study 1: N = 117; Study 2: N = 217) were put into two scenarios (Study 1: cruciate ligament rupture; Study 2: contraception), watched a consultation video and were randomized into one of three groups where they received additional information in the form of (a) narrative patient testimonials; (b) non-narrative decision strategies; and (c) an unrelated text (control group). Results Participants who viewed the patient testimonials or decision strategies felt better prepared for a decision (Study 1: P η P 2 = 0.43; Study 2: P η P 2 = 0.57) and evaluated the decision-making process more positively (Study 2: P η P 2 = 0.13) than participants in the control condition. Decision certainty (Study 1: P η P 2 = 0.05) and satisfaction (Study 1: P η P 2 = 0.11; Study 2: P = .003, d = 0.29) were higher across all conditions after watching the consultation video, and certainty and satisfaction were lower in the control condition (Study 2: P η P 2 = 0.05). Discussion Decision aids that explain preference-sensitivity and personal motives can be beneficial for improving people's feelings of being prepared and their perception of the decision-making process. To reach decision certainty and satisfaction, being well informed of one's options is particularly relevant. We discuss the implications of our findings for future research and the design of DAs.

Making decisions based on their own evaluation of relevant information and beliefs is very challenging for patients. Many patients feel that they lack the knowledge to make a decision and expect a recommendation by their physician. We conducted an experimental study to examine the impact of physicians' recommendations on the decision-making process. N = 194 medical laypeople were placed in a hypothetical scenario where they suffered from a cruciate ligament rupture and were faced with the decision about a treatment (surgery or physiotherapy). In a 3 × 2 between-group design we investigated the impact of physicians' recommendations (for surgery, for physiotherapy, no recommendation) and reasoning style (scientific, narrative) on treatment preference, certainty and satisfaction regarding treatment preference, and attitudes. We found that the recommendation had a significant influence on treatment preference and attitudes toward both treatments. Additionally, we found a significant increase in certainty and satisfaction after the intervention, independently of whether they received a recommendation. This finding suggested that a recommendation was not required to strengthen participants' confidence in their decision. There were no effects of reasoning style. We discuss the implications and suggest that physicians should be careful with recommendations in situations in which patients' preferences are important.

Successful shared decision making (SDM) in clinical practice requires that future clinicians learn to appreciate the value of patient participation as early as they can in their medical training. Narratives, such as patient testimonials, have been successfully used to support patients’ decision-making process. Previous research suggests that narratives may also be used for increasing clinicians’ empathy and responsiveness in medical consultations. However, so far, no studies have investigated the benefits of narratives for conveying the relevance of SDM to medical students. In this randomized controlled experiment, N = 167 medical students were put into a scenario where they prepared for medical consultation with a patient having Parkinson disease. After receiving general information, participants read either a narrative testimonial of a Parkinson patient or a fact-based information text. We measured their perceptions of SDM, their control preferences (i.e., their priorities as to who should make the decision), and the time they intended to spend for the consultation. Participants in the narrative patient testimonial condition referred more strongly to the patient as the one who should make decisions than participants who read the information text. Participants who read the patient narrative also considered SDM in situations with several equivalent treatment options to be more important than participants in the information text condition. There were no group differences regarding their control preferences. Participants who read the patient testimonial indicated that they would schedule more time for the consultation. These findings show that narratives can potentially be useful for imparting the relevance of SDM and patient-centered values to medical students. We discuss possible causes of this effect and implications for training and future research. Trial registration: The study was pre-registered on the pre-registration platform AsPredicted (aspredicted.org) before data collection began (registration number: #29,342). Date of registration: 17 October 2019.

Objective Two randomized controlled experiments investigated if writing a narrative text about a fictional person who shows disapproved of behavior in the Covid-19 pandemic influenced empathy, perspective-taking, attitude, and attribution of causes regarding that person’s behavior. Methods In both studies, a fictional scenario was described, and participants answered questions regarding empathy, perspective-taking, attitude, and attribution regarding a fictional person’s disapproved of behavior (pre-post-measurement). Participants were randomly assigned to one of two conditions. In the experimental condition, they wrote a narrative text about the fictional person. In the control condition, they wrote about an unrelated topic. Results We found that writing a narrative text increased empathy more strongly than writing about an unrelated topic; Study 1: p = 0.004, part.η2 = 0.06, Study 2: p < .001, part.η2 = 0.19. This did not apply to perspective-taking; Study 1: p = 0.415; Study 2: p = 0.074. We also found that writing a narrative text about a fictional person resulted in a more positive attitude toward this person; Study 1: p = 0.005, part.η2 = 0.06; Study 2: ppart.η2 = 0.10. Finally, in Study 2 we found that participants who wrote a narrative text attributed the person’s behavior to internal causes to a lesser degree; p = 0.007, part.η2 = 0.05. Conclusion Our findings indicate that empathy and attitude are positively modifiable through narrative writing tasks. Empathy training could potentially prevent discrimination related to Covid-19. Trial registration The studies presented in this article were pre-registered on the pre-registration platform AsPredicted (aspredicted.org) before we began data collection; registration numbers and URL: #44754 https://aspredicted.org/vx37t.pdf (Study 1), and #44753 https://aspredicted.org/ig7kq.pdf (Study 2).

BACKGROUND Shared decision making is particularly important in situations with different treatment alternatives. For the treatment of idiopathic Parkinson disease, both pharmacological and surgical approaches can be applied. OBJECTIVE In this research project, a series of studies will be conducted to investigate how decision aids for patients with idiopathic Parkinson disease should be designed in order to support the decision-making process. METHODS In Study 1a, qualitative interviews will be conducted to determine which needs frequently occur for patients with idiopathic Parkinson disease. In Study 1b, the identified needs will then be rated for personal relevance by an independent group of patients in an online survey. In Study 2, a randomized controlled trial will be used to pretest different decision aids in a sample group of people who do not have a medical background and who do not have Parkinson disease. In Study 3, a randomized controlled trial will be used to investigate the effect of the decision aids that had been evaluated as positive in Study 2 with patients who have idiopathic Parkinson disease. RESULTS This series of studies received ethical approval in January 2020. As of June 2020, data collection for Study 1a has started, and it is estimated that Studies 1a, 1b, 2, and 3 will take approximately 4, 4, 6, and 6 months to complete, respectively. It is planned to present the results and analyses at international conferences and to submit the results to peer-reviewed journals for publication, once the studies have been completed. The findings will also be shared with clinicians and patients through presentations at information events. CONCLUSIONS This series of studies is intended to result in an evidence-based decision aid for patients with idiopathic Parkinson disease in order to support the informed and reflected shared decision-making process. We further intend to contribute to a deeper understanding of the individual preferences of patients with idiopathic Parkinson disease and the impact of those preferences on treatment decisions. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/17482

Background Shared decision making is particularly important in situations with different treatment alternatives. For the treatment of idiopathic Parkinson disease, both pharmacological and surgical approaches can be applied. Objective In this research project, a series of studies will be conducted to investigate how decision aids for patients with idiopathic Parkinson disease should be designed in order to support the decision-making process. Methods In Study 1a, qualitative interviews will be conducted to determine which needs frequently occur for patients with idiopathic Parkinson disease. In Study 1b, the identified needs will then be rated for personal relevance by an independent group of patients in an online survey. In Study 2, a randomized controlled trial will be used to pretest different decision aids in a sample group of people who do not have a medical background and who do not have Parkinson disease. In Study 3, a randomized controlled trial will be used to investigate the effect of the decision aids that had been evaluated as positive in Study 2 with patients who have idiopathic Parkinson disease. Results This series of studies received ethical approval in January 2020. As of June 2020, data collection for Study 1a has started, and it is estimated that Studies 1a, 1b, 2, and 3 will take approximately 4, 4, 6, and 6 months to complete, respectively. It is planned to present the results and analyses at international conferences and to submit the results to peer-reviewed journals for publication, once the studies have been completed. The findings will also be shared with clinicians and patients through presentations at information events. Conclusions This series of studies is intended to result in an evidence-based decision aid for patients with idiopathic Parkinson disease in order to support the informed and reflected shared decision-making process. We further intend to contribute to a deeper understanding of the individual preferences of patients with idiopathic Parkinson disease and the impact of those preferences on treatment decisions.

BACKGROUND Patients need to be educated about possible treatment choices in order to make informed medical decisions. As most patients are medical laypeople, they find it difficult to understand complex medical information sufficiently to feel confident about a decision. Multimedia interventions such as videos are increasingly used to supplement personal consultations with medical professionals. Former research has shown that such interventions may have a positive effect on understanding, decision making, and emotional reactions. However, it is thus far unclear how different features of videos influence these outcomes. OBJECTIVE We aimed to examine the impact of visualization formats and basic navigational options in medical information videos about cruciate ligament surgery on recipients’ knowledge gain, emotions, attitude, and hypothetical decision-making ability. METHODS In a between-group randomized experiment (Study 1), 151 participants watched 1 of 4 videos (schematic vs realistic visualization; available vs unavailable navigational options). In a separate online survey (Study 2), 110 participants indicated their preference for a video design. All participants were medical laypeople without personal experience with a cruciate ligament rupture and were presented with a fictional decision situation. RESULTS In Study 1, participants who used navigational options (n=36) gained significantly more factual knowledge (P=.005) and procedural knowledge (P CONCLUSION Our study indicates that the perception of medical information videos is influenced by their design. Schematic videos with navigational options are the most helpful among all videos to avoid negative emotions and support knowledge acquisition when informing patients about an intervention. The visualization format and navigational options are important features that should be considered when designing medical videos for patient education. CLINICALTRIAL Deutsches Register Klinischer Studien DRKS00016003; https://www.drks.de/drks_web/ navigate.do?navigationId= trial.HTML&TRIAL_ID=DRKS00016003 (Archived by WebCite at http://www.webcitation.org/746ASSAhN)

Zusammenfassung. Fragestellung: Ziel der vorliegenden Arbeit ist die Überprüfung der kurz- und mittelfristigen Wirksamkeit einer vorschulischen Förderung der phonologischen Bewusstheit und der Buchstaben-Laut-Verknüpfung bei Kindern mit einem Risiko für die Entwicklung einer Lese-Rechtschreibstörung (LRS). Es soll die Frage geklärt werden, ob durch das Training spätere Defizite im Lesen und Rechtschreiben vermindert werden können. Methodik: 25 Risikokinder für die Entwicklung einer LRS wurden mit den Programmen Hören, Lauschen, Lernen 1 und 2 ( Küspert & Schneider, 2008 ; Plume & Schneider, 2004 ) von Erziehern in den Kindergärten gefördert und 60 ungeförderten Risikokindern gegenübergestellt. Ergebnisse: Hinsichtlich der kurzfristigen Wirksamkeit konnte ein deutlicher Zuwachs bei den trainierten gegenüber den untrainierten Risikokindern in den Leistungen der phonologischen Bewusstheit verzeichnet werden. Es zeigte sich jedoch keine Überlegenheit der Trainingsgruppe in Bezug auf phonologische Bewusstheit, Lesen und Schreiben im ersten Schuljahr. Nur im Hinblick auf die Leseschwächen der Erstklässler war eine Verringerung in der Trainingsgruppe relativ zur Kontrollgruppe erkennbar. Schlussfolgerungen: Für eine bessere Identifikation von gefährdeten Kindern für die Entwicklung einer LRS sollten zukünftig neben der phonologischen Bewusstheit zusätzliche Prädiktoren aufgenommen werden. Um einer LRS vorzubeugen, müssten über die phonologische Bewusstheit hinaus zusätzlich als bedeutsam erkannte Defizite der Kinder diagnostiziert, trainiert und die entsprechenden Effekte evaluiert werden.

This study assesses the short-term and intermediate effects of preschool training stimulating phonological awareness and letter-sound correspondence for children at risk of developing dyslexia. Moreover, we examined whether training reduced the frequency of subsequent dyslexic problems.25 children at risk of developing dyslexia were trained with Hören, Lauschen, Lernen 1 und 2 (KüspertSchneider, 2008; PlumeSchneider, 2004) by their kindergarten teachers and were compared with 60 untrained at-risk children.The training revealed a significant short-term effect: The phonological awareness of trained at-risk children increased significantly over that of untrained at-risk children. However, there were no differences in phonological awareness, spelling, and reading ability between the first-graders in the training and control group. Furthermore, reading problems were reduced in the training group.In the future, phonological awareness as well as additional predictors should be included when identifying children vulnerable to developing dyslexia. Moreover, in order to prevent dyslexia, additional prerequisite deficits need to be identified, alleviated, and their effects evaluated.