Exploring Self-regulatory Processes in Anesthesiologists During Massive Transfusion

NCT02199210 | Unknown

• 1 other identifier: SIMPROJECT-MT
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of the project is to investigate the function of self-regulatory processes in anesthesiologists and how application of these processes influence performance in a crisis situation.The investigators intend to explore specifically the first phase of self-regulation, i.e. the forethought phase which describes processes related to strategic planning, goal setting, goal orientation, and outcome expectation. The investigators hypothesize that prompting forethought before engaging in a simulated massive transfusion crisis situation will result in better task performance in anesthesiologists.

Conditions

Self-regulation; Forethought; Performance

Keywords

Massive transfusion protocols; Self-regulatory learning; Forethought; Clinical expertise; Simulation; Education

Outcome Measures

Primary Outcomes (1)

• Performance in managing simulated massive transfusion scenario

  Task specific performance tool will be developed in the Pilot study and will be validated in Study I. Each performance will be video recorded and two independent, blinded rater will evaluate the videos and assess performance. Performance assessment tool will be numerical including a 1-5 point scale for each performance element and a Global Rating Scale. Difference between massive transfusion management performance will be compared in anesthesia residents whose forethought is prompted to residents who don't receive prompting.

  Each individual's performance will be video recorded and subsequently evaluated within 8 weeks.

Secondary Outcomes (1)

• Correlation between forethought scores and performance scores.

  Forethought scores and performance scores will be determined within 8 weeks after individuals participated in the study.

Other Outcomes (1)

• Development and validation of measurement tools for forethought, performance and a tool for prompting forethought.

  Within 4 weeks after completion of Pilot study and Study I.

Study Arms (2)

Prompting forethought

EXPERIMENTAL

A demographic questionnaire will be filled out by each participant. After randomization, participants will be presented with the background information of the simulated scenario.Subsequently: * participants forethought will be prompted and each participant will be asked to report his/her forethought, * participants then will be asked to manage a simulated massive transfusion scenario, * at completion of the scenario, each participant will undergo individualized debriefing and a syllabus on massive transfusion will be briefly discussed with them and also provided as a reading material for learning.

Other: Prompting forethought

No prompting

NO INTERVENTION

A demographic questionnaire will be filled out by each participants. After randomization, participants will be presented with the background information of the simulated scenario.Subsequently: * participants will sit and wait for a predetermined time before entering into the simulator, * participants then will be asked to manage a simulated massive transfusion scenario, * at completion of the scenario, each participant will be interviewed about their thought process before entering to the simulation room, * each participant will undergo individualized debriefing and a syllabus on massive transfusion will be briefly discussed with them and also provided as a reading material for learning.

Interventions

Prompting forethought OTHER

Participants will be asked questions which elicit specific forethought elements related to the given clinical situation. These are elements that relate to strategic planning, goal setting, goal orientation, imagery, outcome expectation. These context specific questions will be determined in the Pilot study and validated in Study I.

Prompting forethought

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Pilot study: attending anesthesiologists at St. Michael's Hospital , PGY5, PGY2 anesthesia residents at University of Toronto
• Study I: attending anesthesiologists at St. Michael's Hospital, PGY5, PGY2 anesthesia residents at University of Toronto
• Study II: PGY2, PGY3, PGY4 anesthesia residents at University of Toronto

You may not qualify if:

• Refusal to take part in the study

Sponsors & Collaborators

• Unity Health Toronto: lead
• University Health Network, Toronto: collaborator

Study Sites (1)

St. Michael's Hospital

Toronto, Ontario, M5B 1W8, Canada

RECRUITING

Related Publications (7)

• Zimmermann BJ. Development of adaptation of expertise: The role of self-regulatory processes and beliefs. In: Ericsson KA, ed. The Cambridge Handbook of Expertise and Expert Performance: Cambridge Unicersity Press 2006:705-22.

  BACKGROUND

• Ericsson KA. Protocol analysis and expert thought: concurrent verbalisations of thinking during experts' performance on representative tasks. In: Ericsson KA, ed. The Cambridge Handbook of Expertise and Expert Performance: Cambridge University Press 2006:223-41.

  BACKGROUND

• Artino AR Jr, Cleary TJ, Dong T, Hemmer PA, Durning SJ. Exploring clinical reasoning in novices: a self-regulated learning microanalytic assessment approach. Med Educ. 2014 Mar;48(3):280-91. doi: 10.1111/medu.12303.

  PMID: 24528463 BACKGROUND

• Cleary TJ, Sandars J. Assessing self-regulatory processes during clinical skill performance: a pilot study. Med Teach. 2011;33(7):e368-74. doi: 10.3109/0142159X.2011.577464.

  PMID: 21696270 BACKGROUND

• Brydges R, Nair P, Ma I, Shanks D, Hatala R. Directed self-regulated learning versus instructor-regulated learning in simulation training. Med Educ. 2012 Jul;46(7):648-56. doi: 10.1111/j.1365-2923.2012.04268.x.

  PMID: 22691145 BACKGROUND

• Dzik WH, Blajchman MA, Fergusson D, Hameed M, Henry B, Kirkpatrick AW, Korogyi T, Logsetty S, Skeate RC, Stanworth S, MacAdams C, Muirhead B. Clinical review: Canadian National Advisory Committee on Blood and Blood Products--Massive transfusion consensus conference 2011: report of the panel. Crit Care. 2011;15(6):242. doi: 10.1186/cc10498. Epub 2011 Dec 8.

  PMID: 22188866 BACKGROUND

• Cotton BA, Dossett LA, Au BK, Nunez TC, Robertson AM, Young PP. Room for (performance) improvement: provider-related factors associated with poor outcomes in massive transfusion. J Trauma. 2009 Nov;67(5):1004-12. doi: 10.1097/TA.0b013e3181bcb2a8.

  PMID: 19901661 BACKGROUND

MeSH Terms

Conditions

Self-Control

Condition Hierarchy (Ancestors)

Social Behavior; Behavior

Study Officials

• John G Laffey, MD, FCARCSI

  St. Michael's Hospital, University of Toronto

  PRINCIPAL INVESTIGATOR

• Charlotte Ringsted, PhD

  The Wilson Center, University Health Network, University of Toronto

  PRINCIPAL INVESTIGATOR

Central Study Contacts

John G Laffey, MD, FCARCSI

CONTACT

(416) 864-5071; laffeyj@smh.ca

Maya J Contreras, PhD, FCARCSI

CONTACT

(416) 864-5071; contrerasm@smh.ca

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 21, 2014
• First Posted: July 24, 2014
• Study Start: August 1, 2014
• Primary Completion: August 1, 2016
• Study Completion: August 1, 2016
• Last Updated: August 10, 2016

Record last verified: 2016-08

Locations

CA (1)