{"doi":"10.1016/j.pecinn.2024.100260","title":"Embedding an Education Intervention about Shared Decision Making into an RCT: Ensuring competency and fidelity","abstract":"Objective: To describe the outcomes of training nephrology clinicians and clinical research participants, to use the Best Case/Worst Case Communication intervention, for discussions about dialysis initiation for patients with life-limiting illness, during a randomized clinical trial to ensure competency, fidelity to the intervention, and adherence to study protocols and the intervention throughout the trial. Methods: We enrolled 68 nephrologists at ten study sites and randomized them to receive training or wait-list control. We collected copies of completed graphic aids (component of the intervention), used with study-enrolled patients, to measure fidelity and adherence. Results: We trained 34 of 36 nephrologists to competence and 27 completed the entire program. We received 60 graphic aids for study-enrolled patients for a 73% return rate in the intervention arm. The intervention fidelity score for the graphic aid reflected completion of all elements throughout the study. Conclusion: We successfully taught the Best Case/Worst Case Communication intervention to clinicians as research participants within a randomized clinical trial. Innovation: Decisions about dialysis are an opportunity to discuss prognosis and uncertainty in relation to consideration of prolonged life supporting therapy. Our study reveals a strategy to evaluate adherence to a communication intervention in real time during a clinical study.","journal":"PEC Innovation","year":2024,"id":460748,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9571,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":421133,"name":"Karlie Haug","orcid":null,"position":1,"is_corresponding":false},{"id":966088,"name":"Kyle J. Bushaw","orcid":"0000-0002-6228-1851","position":2,"is_corresponding":false},{"id":775635,"name":"Anne Buffington","orcid":null,"position":3,"is_corresponding":false},{"id":1268376,"name":"Taylor Bradley","orcid":"0000-0001-7084-3060","position":4,"is_corresponding":false},{"id":943148,"name":"Kristine L. Kwekkeboom","orcid":"0000-0003-2459-0896","position":5,"is_corresponding":false},{"id":489058,"name":"Lily Stalter","orcid":"0000-0002-9226-1667","position":6,"is_corresponding":false},{"id":504742,"name":"Bret M. Hanlon","orcid":"0000-0002-4517-1204","position":7,"is_corresponding":false},{"id":1289354,"name":"Maureen Wakeen","orcid":null,"position":8,"is_corresponding":false},{"id":943678,"name":"R. Allan Jhagroo","orcid":null,"position":9,"is_corresponding":false},{"id":1289355,"name":"Laura J. Maursetter","orcid":null,"position":10,"is_corresponding":false},{"id":1187031,"name":"Sara K. Johnson","orcid":"0000-0002-1820-2212","position":11,"is_corresponding":false},{"id":932851,"name":"Toby C. Campbell","orcid":"0000-0003-4910-1112","position":12,"is_corresponding":false},{"id":700371,"name":"Margaret L. Schwarze","orcid":"0000-0001-7063-906X","position":13,"is_corresponding":false},{"id":943147,"name":"Amy Zelenski","orcid":"0000-0002-2096-8567","position":0,"is_corresponding":true}],"reference_count":24,"raw_metadata":null,"created_at":"2026-07-19T02:04:07.925246Z","pmid":"38347862","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}