Analyzing Challenging Clinical Discussions in Orthopaedics

NCT03058393 | Terminated

• 1 other identifier: Pro00079809
• Study Type: interventional
• Target: 7
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this study is to analyze patient:provider communication surrounding the discussion of difficult clinical conversations such as knee replacement options. This study will also examine how using the teach-back communication technique can improve communication between patients and providers. Orthopedic residents, fellows, physician assistants, and attendings that agree to participate will be consented. Patients, who are likely to engage in a difficult clinical conversation, such as those who have a clinical indication for a Total Knee Replacement or a Partial Knee Replacement, will be recruited from participating providers clinical schedules. Patient:provider interactions will be recorded and then the providers will attend a 1 hour education lecture about how to use teach-back. After attending the lecture, additional patient:provider interactions will be recorded and analyzed via a qualitative approach. Additionally, providers will participate in a semi-structured interview to capture their perceptions of teach-back and what challenges and benefits they may derive from using it.

Conditions

Teach-Back Communication; Arthritis; Knee Osteoarthritis; Knee Arthropathy

Outcome Measures

Primary Outcomes (2)

• Provider's uninterrupted utterances

  We will assess this outcome directly from audio-recorded conversations. A coding scheme will then be developed that captures the average length of provider utterance without asking a question or an interruption from a patient

  End of discussion with patient, 20 minutes

• Patient/provider talking ratio

  This outcome will also be assessed from audio-recorded conversations. The transcript will be coded and the coding scheme will compare how often and how long patients talk compared to provider talking.

  End of discussion with patient, 20 minutes

Secondary Outcomes (2)

• Providers perceptions about teach-back

  End of semi-structured interview, one hour

• Providers belief of future use of teach-back

  End of semi-structured interview, one hour

Study Arms (1)

Teach-Back Group

EXPERIMENTAL

A teach-back lesson will be provided to physician participants (Teach-Back Group), who are participating in challenging clinical discussions with patients

Other: Teach-Back Lesson

Interventions

Teach-Back Lesson OTHER

A teach-back lesson will be given to providers (teach-back group) who have challenging clinical discussions with patients

Teach-Back Group

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 18 years and older
• Clinical indication for multiple treatment options

You may not qualify if:

• Non-English speaking
• Minors or non-consenting other individuals (spouses, friends, family members, children) in the patient room during the clinical visit
• Age 18 years and older
• A resident, fellow, physician assistant, or attending in the Duke Department of Orthopaedic Surgery
• Non-English speaking

Sponsors & Collaborators

• Duke University: lead

Study Sites (1)

Duke University Health System

Durham, North Carolina, 27710, United States

Location

MeSH Terms

Conditions

Teach-Back Communication; Arthritis; Osteoarthritis, Knee

Condition Hierarchy (Ancestors)

Communication; Behavior; Joint Diseases; Musculoskeletal Diseases; Osteoarthritis; Rheumatic Diseases

Study Officials

• Richard C Mather III, MD, MBA

  Duke University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 14, 2017
• First Posted: February 20, 2017
• Study Start: April 17, 2017
• Primary Completion: November 7, 2018
• Study Completion: November 7, 2018
• Last Updated: December 17, 2019

Record last verified: 2018-06

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)