Simulation Training in Emergency Department Imaging 2

NCT05427838 | Completed

• 1 other identifier: 310995
• Study Type: interventional
• Target: 173
• Locations: 1 country
• Sites: 6

Brief Summary

Background and study aims: Computerised Tomography (CT) head scans are frequently requested by Emergency Department (ED) clinicians as one of the investigations for their patients. This often causes a delay when waiting for specialist radiologists to report the findings of the scan. The purpose of this study is to see if online training can improve the ability of ED clinicians to interpret the scans themselves, to a level sufficient to make clinical decisions based on their findings and to explore what aspects of this process they find most challenging. Participants: Emergency Department clinicians who are working in the Emergency Departments of participating sites between April to September 2022 (inclusive), who request CT Head scans as part of their routine clinical practice. What does the study involve?: 180 ED clinicians will be recruited across 6 hospital sites in the United Kingdom. All will undertake a baseline online assessment to measure their accuracy in interpreting CT head scans. One group will then undertake an online training module, with a subsequent assessment immediately afterwards, then over the following 3 months will record interpretations for 30 CT head scans. Head images encountered in participants' routine clinical practice, and their findings, will be compared with the radiology reports for each scan. Participants will then undertake further online assessments 3 and 6 months after the start of the study. Their overall results will be compared with a control group, who will undergo the same process, but undertake the online training after they have tried to interpret 30 scans in their clinical practice. Participants will continue to base their clinical decisions on radiologist reports, not their own interpretations, so patient care will not be affected by this study.

Conditions

Stroke; Skull Fractures; Intracranial Bleed; Brain Tumor; Brain Herniation

Outcome Measures

Primary Outcomes (1)

• Accuracy of ED clinicians reporting CT head scans

  Accuracy of ED clinicians in reporting non-contrast CT head scans (sensitivity and specificity) measured using online assessment at pre/post-training, 3 months, 6 months post-training

  6 months

Secondary Outcomes (8)

• Self-reported confidence scale at pre/post-training, 3 months, 6 months post-training. The self reported confidence scale has a minimum value of "not confident at all" and a maximum value of "really confident". A higher or lower score does

  6 months

• Time difference between ED clinician interpretation and final radiology report measured using recorded report times at 3 months post-training

  3 months

• Diagnostic accuracy of ED clinicians in reporting non-contrast CT head scans during clinical practice

  3 months

• Ability of clinicians to retain newly acquired CT reporting skills

  6 months post-training

• Factors that influence clinicians' reporting accuracy

  6 months

Study Arms (2)

Intervention (training)

EXPERIMENTAL

Users will access an online training module on the RAIQC simulation platform, featuring didactic tutorials and interactive case-based simulations on CT head pathologies such as haemorrhage, infarction, mass effect, and hydrocephalus. The training, designed to take 2-4 hours, is completed during protected non-clinical time. After training, users complete a post-training assessment with 50 different CT cases to evaluate immediate learning gain, followed by a second assessment. Over the next 3 months, users interpret at least 30 CT scans each during clinical shifts, recording their interpretations, the time scans were performed and reviewed, radiology report findings, and report issue times. At the end of 3 months, they repeat the assessment to measure performance, and again after a further 3 months to assess retention of any improvements.

Other: Online training

Control (no Training)

NO INTERVENTION

To serve as a control for comparing the benefits of the online training and clinical interpretation phases on reporting performance, 30 participants (6 clinicians per site) will be randomized to complete the clinical interpretation phase before the training module. These subjects will not undergo online CT head interpretation training initially.

Interventions

Online training OTHER

Participants in the intervention group completed a bespoke online training module hosted on the RAIQC simulation platform (www.raiqc.com). The training module included a series of didactic tutorials and interactive case-based simulations covering a range of CT head pathologies, including haemorrhage, infarction, mass effect, and hydrocephalus. Training was designed to take approximately 2-4 hours and was completed during protected non-clinical time. A post-training assessment involving a different set of 50 CT cases was completed to evaluate immediate learning gain

Intervention (training)

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Emergency department clinicians who review CT head scans as part of their clinical practice.
• Working in the relevant ED during the clinical phase of the project.

You may not qualify if:

• Previous formal postgraduate CT reporting training.
• Previous career to registrar level in radiology/neurosurgery.
• Staff in Emergency Department post for less than 4 months.

Sponsors & Collaborators

• Oxford University Hospitals NHS Trust: lead

Study Sites (6)

NHS Frimley Health Foundation Trust

Frimley, Berkshire, GU167UJ, United Kingdom

Location

Royal Berkshire Hospital

Reading, Berkshire, RG15AN, United Kingdom

Location

Milton Keynes University Hospital

Milton Keynes, Buckinghamshire, MK65LD, United Kingdom

Location

Stoke Mandeville Hospital

Stoke Mandeville, Buckinghamshire, HP218AL, United Kingdom

Location

Horton General Hospital

Banbury, Oxfordshire, OX169AL, United Kingdom

Location

John Radcliffe Hospital

Oxford, Oxfordshire, OX3 9DU, United Kingdom

Location

MeSH Terms

Conditions

Skull Fractures; Stroke; Intracranial Hemorrhages; Brain Neoplasms

Condition Hierarchy (Ancestors)

Craniocerebral Trauma; Trauma, Nervous System; Nervous System Diseases; Fractures, Bone; Wounds and Injuries; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Hemorrhage; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Central Nervous System Neoplasms; Nervous System Neoplasms; Neoplasms by Site; Neoplasms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: DIAGNOSTIC
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Primary Investigator

Study Record Dates

• First Submitted: June 7, 2022
• First Posted: June 22, 2022
• Study Start: April 7, 2022
• Primary Completion: October 31, 2025
• Study Completion: December 31, 2025
• Last Updated: February 4, 2026

Record last verified: 2025-11

Locations

GB (6)