Abstract

Background: Shared decision-making (SDM) between clinicians and patients is a pillar of the modern patient-centric philosophy of care. This study aims to explore SDM in trauma and emergency surgery, investigating its interpretation and the barriers and facilitators to its implementation among surgeons.

Methods: Grounded on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society’s website, and shared on the society’s Twitter profile.

Results: A total of 650 trauma and emergency surgeons from 71 countries on five continents participated in the initiative.

Fewer than half of the surgeons understood SDM, and 30% still saw value in engaging exclusively multidisciplinary provider teams without involving the patient. Several barriers to effective patient partnership in the decision-making process were identified, including limited time and the need to focus on ensuring the smooth functioning of medical teams.

Discussion: Our investigation underscores that only a minority of trauma and emergency surgeons understand SDM, and that its value may not be fully accepted in these settings. The inclusion of SDM practices in clinical guidelines may represent the most feasible and advocated solutions.

Keywords: Shared decision-making, Clinical decision-making, Patient-centric care, Trauma and emergency surgery, Survey