Background: Pediatric shared decision making (SDM) involves clinicians working with children and families to make health care decisions that reflect their values and preferences. Existing pediatric SDM programs are highly variable and rely on frameworks designed for adults. While efforts have been made to identify SDM competencies in adult care, this has not happened in pediatrics. Objective: To establish consensus-based core competencies enabling clinicians to effectively implement SDM with pediatric patients and their families. Methods: We conducted a modified Delphi study with pediatric clinicians, SDM researchers, ethicists, and medical educators. In round 1, panelists listed essential SDM competencies. In rounds 2 and 3, panelists rated the importance of each competency using a 4-point Likert scale. Consensus was defined as ≥80% of panelists rating an item as “important” or “very important,” a median score ≥3.5, and interquartile range ≤1. Results: Forty professionals were invited; 22 panelists participated in round 1, suggesting 176 competencies, which were merged with 170 from prior literature. After refinement, 42 competencies were rated in round 2 ( n = 21 panelists). During this round, 17 competencies reached consensus, and 8 required modifications. In round 3 ( n = 20 panelists), an additional 15 competencies reached consensus. The final framework includes 32 competencies organized into 6 domains: Fundamentals of SDM, Unique Aspects of Pediatric SDM, Communication and Information-Sharing, Eliciting and Integrating Preferences and Values, Collaboration and Consensus Building, and Providing Evidence-Based Recommendations. Conclusions: This study defines the knowledge, skills, values, and attitudes pediatric health care professionals need to engage children and families in SDM effectively. The framework supports competency-based education and guides curriculum development and assessment to strengthen SDM practice in pediatrics. Highlights: This study is the first to develop pediatric-specific SDM competencies using a Delphi approach. The final list includes 32 competencies across knowledge, skills, attitudes, and values. These competencies provide a foundation for designing SDM training within a competency-based education approach in pediatrics.

Background: Duchenne muscular dystrophy (DMD) is a genetic disorder characterized by progressive muscle weakness, a decline in quality of life, and premature mortality. This study aims to evaluate the perceived quality of healthcare and the experience of DMD patients and their caregivers in Mexico, comparing governmental and non-profit healthcare institutions using a newly designed assessment instrument. Methods: In a cross-sectional study, data were gathered from 91 participants through an online self-administered questionnaire informed by the Donabedian model and six dimensions of healthcare quality. Results: Analysis revealed two key mediating factors: perceived quality of healthcare and patient experience. The Mann–Whitney U test showed that non-profit organizations were perceived to provide superior quality care in both aspects (p < 0.05), notably regarding healthcare professionals’ preparedness and other domains of quality. However, the patient-centered care domain indicated that the importance of quality domains may vary according to cultural and social contexts. In Mexico, the humanistic approach of healthcare professionals appeared to compensate for shortcomings in timely diagnosis and other quality domains. This emphasizes the necessity for enhanced patient education and healthcare evaluation, and it highlights that patient satisfaction does not always correlate with high-quality healthcare. The developed instrument can further aid in understanding the experiences of DMD patients across different countries and cultures.