Fig. 1
Concept mapping of a PowerPoint on the management of URTI that is at odds with EBM and SDM frameworks. Implicit messages are shown with the corresponding themes. T1: Pathophysiological reasoning, T2: Unexplained variations in clinical care, T3: Use of EBM mimics; T4: Defensive medicine, T5: Unrealistic portrayal of benefits, and T6: Paternalism. Variations of this approach were common. Pathophysiological reasoning links diagnosis, etiology and clinical management. Viral infections are presented as self-limited and harms of antibiotics can be used to convince patients to avoid taking them. Bacterial infections, however, may lead to complications and antibiotics are needed to “cure” these patients; antibiotics are therefore presented as safe
Fig. 2
Concept mapping of a PowerPoint on the management of URTI that is consistent with SDM and EBM frameworks. Implicit messages are shown with the corresponding themes. This approach was rarely used and never in its entirety. T1: Emphasizing management reasoning over diagnostic binning and pathophysiological thinking, T2: Addressing uncertainties to explain variations in clinical care by using probabilistic approaches and by discussing the validity of the evidence, T3: Using appropriate EBM terminology, T4: Justifying choices of investigations and management plans by quantifying pre- and post-test probabilities and the benefits and harms of interventions, T5: Using event rates in the placebo and control groups to present harms and benefits in an unbiased way, T6: Explicitly mentioning the options that a patient has and the importance of his/her values and preferences
