Crisis Resource Management Improvement Through Intellectual Questioning of Authority

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

25 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-03-11

Study Completion Date

2020-11-20

Brief Summary

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This is a randomized controlled trial examining the effectiveness of a teaching intervention on residents' and medical students' ability to challenge clearly wrong decisions by a superior during a simulated life-threatening crisis. Participants will be randomly allocated into the control or intervention arm. The intervention arm will receive education on crisis resource management (CRM) and teaching targeting the cognitive skills required to monitor and challenge a superior's decision, and conflict resolution tools. Participants will then take part in a simulation scenario 2 to 4 weeks later and will be assessed based on 6 challenge points, followed by a debrief session.

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Detailed Description

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Conditions

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Medical Education, Simulation, Crisis Resource Management

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Deliberate deception (by not informing of the aim of assessing for ability to challenge authority) will be used to blind the participants. However, open disclosure and explanation of the rationale for deception will be conducted during the debriefing sessions and participants will be extensively counselled.

The confederate specialist will also be blinded to the allocation of the control or intervention arm of participants.

All sessions will be video recorded and assessed in random order by two independent raters blinded to group allocation, using the modified Advocacy-Inquiry Score (mAIS).

Study Groups

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Control

Subjects allocated to the control arm will receive standard didactic interactive session on Advanced Cardiac Life Support (ACLS) principles, as part of their regular teaching schedule.

Group Type PLACEBO_COMPARATOR

Standard ACLS Training

Intervention Type OTHER

Standard didactic interactive session on Advanced Cardiac Life Support (ACLS) principles.

Intervention

Subjects allocated to the intervention arm will receive education on crisis resource management (CRM) and teaching targeting the cognitive skills required to monitor and challenge a superior's decision, and conflict resolution tools, in addition to standard didactic interactive session on Advanced Cardiac Life Support (ACLS) principles.

Group Type EXPERIMENTAL

Crisis Resource Management Skill Training

Intervention Type OTHER

Focused crisis resource management training which targets at the cognitive skills needed to monitor and challenge a superior's decision.

Interventions

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Crisis Resource Management Skill Training

Focused crisis resource management training which targets at the cognitive skills needed to monitor and challenge a superior's decision.

Intervention Type OTHER

Standard ACLS Training

Standard didactic interactive session on Advanced Cardiac Life Support (ACLS) principles.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Medical officers or Internal medicine, surgical and emergency medicine residents who are in their 2nd post-graduate year of training, or
* Phase V medical students from Yong Loo Lin School of Medicine, National University of Singapore