Proficiency-Based Progression Training for Clinical Communication

NCT ID: NCT02886754

Last Updated: 2017-07-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

77 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-09-14

Study Completion Date

2016-09-16

Brief Summary

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Importance: Clinical communication is an important source of medical error and preventable adverse events.

Objective: To determine the effectiveness of proficiency-based progression (PBP) simulation training for ISBAR (Identify, Situation, Background, Assessment, Recommendation) communication in the deteriorating patient.

Setting: The study will be conducted in University College Cork, Ireland. Participants: Third year undergraduate nursing and fifth year medical students, who are scheduled to undertake ISBAR training as part of the National Early Warning Score (NEWS) programme.

Intervention: Participants will be prospectively randomized to one of three groups before undertaking a performance assessment of an ISBAR communication relevant to a deteriorating patient in a high fidelity simulation laboratory: HSE group (the national e-learning programme only); S group (national e- learning plus simulation training) and PBP group (national e-learning plus proficiency-based progression simulation).

Main outcome and measures: A proficiency benchmark on the performance of ISBAR communication in the context of an acutely deteriorating patient.

Detailed Description

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The first successful simulation validation study used a proficiency-based progression methodology. Since then the approach has been successfully deployed to produce superior technical skills but has not yet been validated for non-technical (communication) skills. The ISBAR (Identify, Situation, Background, Assessment and Recommendation) has been selected as the standardised tool for clinical communication in relation to an acutely deteriorating patient in many healthcare organisations worldwide, including Ireland.

The aim of this study is to explore whether proficiency-based progression (PBP) could be applied to simulation-based training for ISBAR performance to produce a superior skill set.

The study will compare performance outcomes of students, who receive the national e-learning programme only with those who receive it in combination with either standard simulation or proficiency-based progression (PBP) simulation.

Participants will be prospectively randomized to one of three training groups within their professional cohort (medicine or nursing) before undertaking a performance assessment of an ISBAR communication relevant to a deteriorating patient in a high fidelity simulation laboratory:

1. Online learning only (HSE) -the national e-learning programme only
2. Standard simulation (S) -online learning plus simulation training
3. Proficiency based progression (PBP) -online learning plus proficiency-based progression simulation.

Main outcome and measures: A proficiency benchmark on the performance of ISBAR communication in the context of an acutely deteriorating patient.

All participants will be required to demonstrate a certificate of successful completion on the national e-learning programme within the previous 4 weeks as well as supplying baseline demographic information before undertaking the training.

Performance metrics have previously been identified, operationally defined and agreed upon at a modified Delphi panel meeting consisting of medical and nursing experts for a series of paper-based simulation cases and a standardised high fidelity simulation case used as the assessment case. The proficiency benchmark for each case has been set based on the performance of experienced nursing and medical personnel on each case as a series of steps, errors and critical errors.

Outcome assessment will be scored by reviewing recordings of ISBAR performance by each participant on the standardised case in the high fidelity laboratory.

Conditions

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Clinical Communication ISBAR Simulation Proficiency-Based Progression Non Technical Skills Performance Deteriorating Patient

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The study design is a parallel group, double-blind, randomized trial
Primary Study Purpose

OTHER

Blinding Strategy

DOUBLE

Participants Outcome Assessors
Participants and outcome assessors were unaware of which intervention group subjects were allocated

Study Groups

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National e-learning programme only (HSE)

National e-learning programme only Recent successful completion the National e-learning programme by certificate will be displayed. Students then complete a student satisfaction survey and proceed directly for performance assessment to the high-fidelity simulation suite.

Group Type ACTIVE_COMPARATOR

National e-learning programme only

Intervention Type BEHAVIORAL

National e-learning programme (COMPASS)

Simulation (S)

Simulation Recent successful completion of the National e-learning e-learning programme by certificate will be displayed. Students will proceed to standard simulation using the same series of paper cases as PBP which prompt simulated phone calls but no requirement to meet a proficiency benchmark. 4 hours will be allotted to this training. Following training participants will complete the student satisfaction survey and will then proceed directly for performance assessment to the high-fidelity simulation suite.

Group Type ACTIVE_COMPARATOR

National e-learning programme only

Intervention Type BEHAVIORAL

National e-learning programme (COMPASS)

Standard simulation

Intervention Type BEHAVIORAL

Paper based simulation cases

Proficiency-Based Progression (PBP)

Recent successful completion of the National e-learning programme by certificate will be displayed. Students will proceed to PBP simulation using the same series of paper cases as S which prompt simulated phone calls. PBP students will be scored according to predefined metrics and will be required to reach proficiency benchmarks. Following training participants will complete the student satisfaction survey and proceed directly for performance assessment to the high-fidelity simulation suite.

Group Type EXPERIMENTAL

Proficiency-based progression

Intervention Type BEHAVIORAL

Use of validated metrics and performance benchmarks to simulation training

National e-learning programme only

Intervention Type BEHAVIORAL

National e-learning programme (COMPASS)

Interventions

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Proficiency-based progression

Use of validated metrics and performance benchmarks to simulation training

Intervention Type BEHAVIORAL

National e-learning programme only

National e-learning programme (COMPASS)

Intervention Type BEHAVIORAL

Standard simulation

Paper based simulation cases

Intervention Type BEHAVIORAL

Other Intervention Names

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PBP HSE Simulation S

Eligibility Criteria

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Inclusion Criteria

Third year undergraduate nursing students

Fifth year medical students

Exclusion Criteria

Lack of consent

Failure to successfully complete the National e-learning NEWS programme
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University College Cork

OTHER

Sponsor Role lead

Responsible Party

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Dorothy Breen

Specilaist in Intensive Care and Director of Education, ASSERT, Principal Invesitgator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Anthony Gallagher, PhD, DSc

Role: STUDY_DIRECTOR

University College Cork, College Rd, Cork Ireland

Locations

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University College Cork

Cork, , Ireland

Site Status

Countries

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Ireland

References

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Gallagher AG, Seymour NE, Jordan-Black JA, Bunting BP, McGlade K, Satava RM. Prospective, randomized assessment of transfer of training (ToT) and transfer effectiveness ratio (TER) of virtual reality simulation training for laparoscopic skill acquisition. Ann Surg. 2013 Jun;257(6):1025-31. doi: 10.1097/SLA.0b013e318284f658.

Reference Type BACKGROUND
PMID: 23426342 (View on PubMed)

Angelo RL, Ryu RK, Pedowitz RA, Beach W, Burns J, Dodds J, Field L, Getelman M, Hobgood R, McIntyre L, Gallagher AG. A Proficiency-Based Progression Training Curriculum Coupled With a Model Simulator Results in the Acquisition of a Superior Arthroscopic Bankart Skill Set. Arthroscopy. 2015 Oct;31(10):1854-71. doi: 10.1016/j.arthro.2015.07.001. Epub 2015 Sep 2.

Reference Type BACKGROUND
PMID: 26341047 (View on PubMed)

Van Sickle KR, Ritter EM, Baghai M, Goldenberg AE, Huang IP, Gallagher AG, Smith CD. Prospective, randomized, double-blind trial of curriculum-based training for intracorporeal suturing and knot tying. J Am Coll Surg. 2008 Oct;207(4):560-8. doi: 10.1016/j.jamcollsurg.2008.05.007. Epub 2008 Jul 14.

Reference Type BACKGROUND
PMID: 18926460 (View on PubMed)

Breen D, O'Brien S, McCarthy N, Gallagher A, Walshe N. Effect of a proficiency-based progression simulation programme on clinical communication for the deteriorating patient: a randomised controlled trial. BMJ Open. 2019 Jul 9;9(7):e025992. doi: 10.1136/bmjopen-2018-025992.

Reference Type DERIVED
PMID: 31289064 (View on PubMed)

Other Identifiers

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ISBAR

Identifier Type: -

Identifier Source: org_study_id

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