Developing a Deliberate Practice Intervention to Recalibrate Physician Heuristics in Trauma Triage

NCT05168579 | Completed Results

• 2 other identifiers: STUDY20120026R21AG072072
• Study Type: interventional
• Target: 72
• Locations: 1 country
• Sites: 1

Brief Summary

The objective of this study is to test the feasibility of using deliberate practice - goal-oriented training in the presence of a coach who can provide personalized, immediate feedback - to increase engagement. The research design involves recruitment of a national convenience sample of board-certified emergency physicians who will serve as trainees (n=30), pairing of the trainees with a coach, delivery of three 30-minute coaching sessions using the existing games as the training task, and assessment of the effect of the combined intervention on performance in the laboratory. The specific aims are:

1. 1.To assess the fidelity of intervention delivery by measuring coaching skill acquisition, coaching skill drift and protocol adherence.
2. 2.To assess the potential effect size of the intervention by comparing trainee performance on a validated virtual simulation with a control group of physicians (n=30).
3. 3.To assess the acceptability of the intervention by using a mixture of validated instruments and semi-structured debriefing interviews with trainees to assess their engagement with the intervention.

Conditions

Trauma Injury

Outcome Measures

Primary Outcomes (1)

• Percentage of Participants Who Signed up for the Intervention That Completed All 3 Coaching Sessions.

  A summary of the number of trainees who signed up for coaching sessions and completed all three sessions as assigned.

  3 week intervention period

Secondary Outcomes (2)

• Under-triage

  3 weeks post-intervention (deliberate practice) or 3 weeks post-enrollment (control)

• Number of Participants Who Describe Coaching as Acceptable.

  2- weeks post intervention

Study Arms (2)

Deliberate practice

EXPERIMENTAL

Trainees will be paired with a coach, and will meet, once per week for thirty minutes, over a three week period. During the training session, coach-trainee dyads will play a puzzle video game, and will discuss contextual cues that should inform triage decisions. At the completion of the three weeks, trainees will complete a semi-structured, debriefing interview and a virtual simulation to assess triage performance.

Behavioral: Deliberate practice

Control

NO INTERVENTION

Participants in the control group will complete a virtual simulation.

Interventions

Deliberate practice BEHAVIORAL

As above

Deliberate practice

Eligibility Criteria

• Age: 25 Years - 70 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Board certified physicians who work at non-trauma centers in the United States

You may not qualify if:

• Physicians without board certification (i.e., residents). Physicians who work only at trauma centers in the US.

Sponsors & Collaborators

• University of Pittsburgh: lead
• National Institute on Aging (NIA): collaborator

Study Sites (1)

University of Pittsburgh

Pittsburgh, Pennsylvania, 15213, United States

Location

Related Publications (2)

• Mohan D, Elmer J, Arnold RM, Forsythe RM, Fischhoff B, Rak K, Barnes JL, White DB. Testing a Novel Deliberate Practice Intervention to Improve Diagnostic Reasoning in Trauma Triage: A Pilot Randomized Clinical Trial. JAMA Netw Open. 2023 May 1;6(5):e2313569. doi: 10.1001/jamanetworkopen.2023.13569.

  PMID: 37195666 DERIVED

• Mohan D, Elmer J, Arnold RM, Forsythe RM, Fischhoff B, Rak K, Barnes JL, White DB. Testing the feasibility, acceptability, and preliminary effect of a novel deliberate practice intervention to reduce diagnostic error in trauma triage: a study protocol for a randomized pilot trial. Pilot Feasibility Stud. 2022 Dec 12;8(1):253. doi: 10.1186/s40814-022-01212-y.

  PMID: 36510328 DERIVED

MeSH Terms

Conditions

Accidental Injuries

Condition Hierarchy (Ancestors)

Wounds and Injuries

Limitations and Caveats

First, we used a passive rather than an active control as the comparator, which may have magnified the effect of the intervention. Second, the differential rate of attrition for completing the virtual simulation in the control and intervention groups could introduce bias, if missingness was not random. Third, we used a simulation to assess behavior, albeit one with evidence of criterion validity, which limited inference about the efficacy of the intervention.

Results Point of Contact

• Title: Dr. Deepika Mohan
• Organization: University of Pittsburgh

dem73@pitt.edu

404-375-9325

Study Officials

• Deepika Mohan, MD

  University of Pittsburgh

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Allocation to treatment v. control group will be masked to the person doing the analysis until the data is locked.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Surgery

Model Details: two arm randomized trial

Study Record Dates

• First Submitted: December 8, 2021
• First Posted: December 23, 2021
• Study Start: December 15, 2021
• Primary Completion: March 11, 2022
• Study Completion: December 1, 2022
• Last Updated: April 5, 2023
• Results First Posted: April 5, 2023

Record last verified: 2023-03

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR
• Time Frame: Data will be made available at the conclusion of the analytic phase of the trial, and for 3 years thereafter.
• Access Criteria: Access will be provided to researchers and interested parties.

Locations

US (1)