Decision Support for Differences of Sex Development

Project start date and end date: 2021 - Present


Medical education and theory now embrace the concept of patient-centered care -- of which shared decision making (SDM) and informed consent are cornerstones; however, difficulties with fully implementing SDM in clinical settings are common. Barriers to implementation include misperceptions regarding what SDM is and is not, lack of knowledge about what the active components are, and clinician perception that SDM is already commonplace or that they are “already doing it” when observations of clinician behavior demonstrate the contrary.


Given several barriers to incorporation of SDM within the clinical context exist, this proposal seeks to target one at the very base: perceptions and misperceptions about what SDM is and how it is accomplished. Specifically, we propose to create a web-based training module on SDM that centers on a parent (i.e., patient surrogate) and provider discussion.

Research Topics & Methods:

Develop and disseminate educational materials focusing on SDM processes and skills. The objectives of these materials will be to:

  1. Provide a conceptual framework for understanding SDM
  2. Enable participants to expand their knowledge and practice of SDM to include surrogate decision-makers as well as the patient
  3. Develop video and written vignettes to represent critical challenges in proxy-mediated SDM
  4. Assess learning and attitude change through knowledge tests, attitudes questionnaires, self-reflective exercises, and case-based vignettes.


The GME Innovations vision is stated to involve “inspiring and promoting work that leads to pioneering education of future physicians, improving the effectiveness and efficiency of GME through disruptive innovations for the benefit of healthcare.” The goal of the proposed program involves training residents to focus on a basic aspect of care that trained professionals believe they are correctly and faithfully executing, yet are not. This places the trainee at the forefront of a model of patient-centered care intended to improve long-term health outcomes.


Michigan Medicine: Graduate Medical Educational Innovations Program


Larry Gruppen, PhD

  • University of Michigan / Michigan Medicine

Dawn Stacey, RN, PhD, FCAHS, FAAN

  • Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  • School of Nursing, University of Ottawa, Ottawa, ON, Canada

For more information, please contact:

David Sandberg, PhD
Phone: 734-615-1958