Optimizing Medical "Teaming" on Resident Based Teams

NCT05213117 | Completed

• 1 other identifier: Protocol #: 2019P000534
• Study Type: interventional
• Target: 33
• Locations: 1 country
• Sites: 1

Brief Summary

The main objective of this study is to evaluate the colocalization of internal medicine residents on one clinical inpatient hospital floor for all general medicine block rotations during the 2019-2020 academic year. Specifically, the aims of the study are to determine if co-localization improves familiarity with nursing staff, which in turn, improves team work, psychological safety, patient care and reduces burnout. The investigators' hypothesis is that co-localization will increase familiarity between residents and nurses and result in improved psychological safety, team work and patient outcomes.

Conditions

Inter-professional Relations

Outcome Measures

Primary Outcomes (2)

• Teamwork assessed by Simulation about Shortness of Breath

  Simulation of an inpatient clinical scenario will be conducted. This simulation about shortness of breath will be run with teams consisting of two residents and two nurses. These interdisciplinary teams will be asked to manage a patient together. All residents and nurses in the study will be asked to participate in the simulation. The simulations will be recorded. Blinded reviewers will view these simulations later and will score the team's performance using an published Oxford NOTECH simulation teamwork assessment tool. The assessment tool is designed to identify higher functioning teams by evaluating leadership, communication, shared mental models and utilization of resources.

  This simulation will be conducted at 6 months in this 12month study

• Teamwork assessed by Simulation about Negotiation with Angry Patient

  Simulation of an inpatient clinical scenario will be conducted. This simulation about negotiating with an angry patient will be run with teams consisting of two residents and two nurses. These interdisciplinary teams will be asked to manage a patient together. All residents and nurses in the study will be asked to participate in the simulation. The simulations will be recorded. Blinded reviewers will view these simulations later and will score the team's performance using an published Oxford NOTECH simulation teamwork assessment tool. The assessment tool is designed to identify higher functioning teams by evaluating leadership, communication, shared mental models and utilization of resources.

  This simulation will be conducted at 12 months in this 12month study

Secondary Outcomes (3)

• Psychological Safety

  Residents and Nurses will be surveyed at 6 months in this 12 month study

• Psychological Safety

  Residents and Nurses will be surveyed at 12 months in this 12 month study

• Communication between Nurses and Interns

  Observation will start at 6 months in this 12 month study and continue through study completion, an average of 6 months

Study Arms (2)

Co-localized Residents

EXPERIMENTAL

Investigators plan to randomize 15 PGY-1 residents in internal medicine from the possible 74 PGY-1 incoming residents who agree to partake in the study, to one general medicine clinical floor for the academic year. These co-localized residents will complete 16-20 weeks of scheduled rotation time on White 9

Behavioral: Co-Localization with Nursing

Normally Schedule Residents

NO INTERVENTION

The control arm will consist of 18 PGY-1 residents who are scheduled by the residency program's algorithm in the usual fashion to complete general medicine rotations on 5 difference clinical floors. The 18 active comparator participants will be selected based on completing one of four general medicine rotation on the control floor White 8. These participants will then be followed while completing the remaining general medicine rotations on all clinical floors.

Interventions

Co-Localization with Nursing BEHAVIORAL

Co-localize 15 residents to one of 6 general medical floors to complete all 8 weeks of general medicine on this floor

Co-localized Residents

Eligibility Criteria

• Age: 24 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• All incoming PGY-1 residents who volunteer to be randomized

You may not qualify if:

• Any incoming PGY-1 resident who declines to be randomized

Sponsors & Collaborators

• Massachusetts General Hospital: lead

Study Sites (1)

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

Location

Related Publications (1)

• Iyasere CA, Wing J, Martel JN, Healy MG, Park YS, Finn KM. Effect of Increased Interprofessional Familiarity on Team Performance, Communication, and Psychological Safety on Inpatient Medical Teams: A Randomized Clinical Trial. JAMA Intern Med. 2022 Nov 1;182(11):1190-1198. doi: 10.1001/jamainternmed.2022.4373.

  PMID: 36215043 DERIVED

MeSH Terms

Interventions

Nursing

Intervention Hierarchy (Ancestors)

Professional Practice; Organization and Administration; Health Services Administration

Study Officials

• Kathleen F Finn, MD

  Massachusetts General Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Senior Associate Program Director for Resident Development

Model Details: The investigators plan to randomize 16-18 Post Graduate Year (PGY)-1 residents in internal medicine at Massachusetts General Hospital from the possible 74 PGY-1 incoming residents who agree to partake in the study to one general medicine clinical floor for the academic year. These co-localized residents will complete 16-20 weeks of scheduled rotation time on White 9. Similarly, the investigators plan to randomize 6-8 PGY-2 residents from a possible group of 64 PGY-2 residents who agree to participate in the study to one general medical clinical floor for the academic year. These participants will complete 4-6 weeks of scheduled rotation time on White 9. Rotations will be completed in the normal 2 or 4 week block rotations, randomly assigned throughout the academic year.

Study Record Dates

• First Submitted: December 13, 2021
• First Posted: January 28, 2022
• Study Start: June 25, 2019
• Primary Completion: June 24, 2020
• Study Completion: December 13, 2021
• Last Updated: January 28, 2022

Record last verified: 2022-01

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR
• Time Frame: Data will be published in 2022
• Access Criteria: Plan to publish in 2022

Locations

US (1)