Background: The objective of this study was to ascertain the importance rankings of factors affecting the implementation of shared decision-making (SDM) in medical students in China and determine whether these factors were consistent across the respondents' individual characteristics.
Method: Students studying clinical medicine were recruited from three medical universities in China. A cross-sectional online survey using best-worst object scaling with a balanced incomplete block design was adopted to investigate their preference towards implementing SDM in China. Count analysis, multinomial logit analysis and mixed logit analysis were used to estimate the preference heterogeneity of the SDM factors among respondents.
Results: A total of 574 medical students completed the online survey. The three most important factors for implementing SDM were trust and respect, (providing) high-quality medical information and multi-disciplinary collaboration. The mixed logit regression model identified significant heterogeneity in SDM preferences among respondents, and sub-group analysis showed that some heterogeneities varied in respondents by sex, study programs and their experience of visiting doctors.
Conclusion: The importance rankings provide rich information for implementing SDM and facilitate the reform of education in medical schools in China. However, the heterogeneities in SDM preference need further explorations.
Keywords: Best-worst scaling; China; Medical students; Preference heterogeneity; Shared decision-making.