Deliberate Practice With Validated Metrics Improves Skills Acquisition

NCT ID: NCT03154372

Last Updated: 2018-05-02

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

18 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-09-20

Study Completion Date

2018-02-28

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Purpose:

The aim of this study was to compare the effects of deliberate vs. self-guided practices on acquiring needling skills by novice learners.

Methods:

Eighteen medical students were randomized to deliberate or self-guided practices groups. Following a learning phase, subjects attempted to perform a predefined task, which entitled advancing a needle towards a target on a phantom gel under ultrasound guidance. Subsequently, all subjects practiced performing the task using previously validated metrics. Subjects in the deliberate practice group were coached by an expert anesthesiologist and practiced each metric until it was satisfactorily performed based on the supervising anesthesiologist assessment. Immediately after completing the practice, all subjects attempted to perform same task, and on the following day, made two further attempts in succession. Two trained consultant anesthesiologists will use the metrics to independently score the video-recorded performances.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Safe performance of ultrasound-guided peripheral nerve blocks (PNB) requires competence across a range of technical and nontechnical skills. Correct placement of a needle close to a nerve or plexus is critical to safe and successful procedure performance. Failure to maintain needle visibility while in forward motion may cause iatrogenic injury to nerves and surrounding structures, and is a "quality compromising" behavior in the early part of novice learning curve. Skills related to needle guidance are difficult to learn, as they require integration of multiple cognitive and psychomotor elements.

The objective of this study was to compare the effects of expert supervised deliberate practice with validated metrics vs. self-guided practice on novice needling skill acquisition as evaluated by the number of steps completed and errors made.

Methods

Having obtained informed written consent from each, eighteen 3rd and 4th year medical students with no previous experience of ultrasound-guided procedures were recruited. Each student provided demographic information on his or her age, gender and handedness. All subjects will attend a didactic lecture (learning phase) delivered in standard fashion by one investigator. This included outlines of ultrasound physics, scanning and practical techniques.

Subsequently, subjects will be randomly allocated using computer generated random numbers to one of two groups; self-guided practice (SP) and deliberate practice (DP). Approximately 24 hours after completion of the learning phase each subject will attempt to perform the following set of tasks (baseline assessment).

Task description (i) Perform ultrasonography of the phantom provided to identify embedded objects.

(ii) Identify verbally the structure at the 8 O'clock position (in reference to the ultrasound training block model) and surrounding structures.

(iii) Once the ultrasound image is deemed optimal, advance a 50 mm, 20 gauge block needle provided under ultrasound guidance towards the object at the 8 O'clock position.

(iv) Once the needle tip is deemed close enough to the object, inject 0.5 ml of saline.

Following the first set of tasks (baseline assessment), all subjects were allowed to practice the task using the list of metrics and according to their random group allocation.

Methods of practice allowed SP Group: An investigator will provide subjects in this group a list of metrics (steps and errors) extracted from a previously validated tool. They will be allowed to practice the task using the metrics list. When the subject declares readiness to progress to the assessment, training will be complete.

DP Group: A trained consultant anesthesiologist (expert in ultrasound-guided PNB and who regularly undertakes training of novices in these procedures) will supervise deliberate practice to each subject in this group using the metrics list. Subjects in this group will practice each item of the metric list until it is satisfactorily performed as assessed by the supervising anesthesiologist at which time training is deemed complete.

Immediately after completion of either self-guided practice or deliberate practice (training phase), all subjects in both groups will attempt the same task above (assessment 1). All subjects will also attempt the same task twice in succession on the following day (assessment 2 and 3).

All performances (baseline and 1- 3) will be videotaped using a head-mounted camera placed on subject's head. The first person video and ultrasound images record concurrently (time synchronized).

Two consultant anesthesiologists (each expert in performing PNB and who regularly train novices) will independently score the videos using the composite metrics list for number of steps completed and number of errors made (primary outcome).

Data and Statistical Analysis Differences in performances between the two groups for both primary and secondary outcomes will be examined for significance with one-factor analyses of variance (ANOVA).

The inter rater reliability (IRR) will be calculated according to proportionate agreement between the two video assessors "number of agreements/number of \[agreements+disagreements\]". IRR is considered to be acceptable if it was ≥ 0.8. Scores from both video assessors will be averaged to calculate the number of steps completed and number of errors made (primary outcome).

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Educational Problems

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

deliberate practice

expert supervised practice with validated metrics

Group Type OTHER

Expert supervised practice with validated metrics

Intervention Type OTHER

self-guided practice

self guided practice with validated metrics

Group Type OTHER

self guided practice with validated metrics

Intervention Type OTHER

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Expert supervised practice with validated metrics

Intervention Type OTHER

self guided practice with validated metrics

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* 3rd and 4th year medical students

Exclusion Criteria

* previous performance of ultrasound guided procedures
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University College Cork

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Osman Ahmed

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

27th April, 2016.

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Carpal Tunnel Release Efficacy Trial
NCT06934187 NOT_YET_RECRUITING NA