Trial Outcomes & Findings for Developing a Deliberate Practice Intervention to Recalibrate Physician Heuristics in Trauma Triage (NCT NCT05168579)
NCT ID: NCT05168579
Last Updated: 2023-04-05
Results Overview
A summary of the number of trainees who signed up for coaching sessions and completed all three sessions as assigned.
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
72 participants
Primary outcome timeframe
3 week intervention period
Results posted on
2023-04-05
Participant Flow
A single email invitation was sent to 633 physicians who had previously participated in research (with valid contact information), asking them to forward the invitation to two colleagues. 78 responses were received. Five were excluded because they lived outside the contiguous 48 US States (e.g., in Canada or Puerto Rico) and one was excluded for refusing to consent to videotaping.
Participant milestones
| Measure |
Deliberate Practice
Trainees will be paired with a coach, and will meet, once per week for thirty minutes, over a three week period. During the training session, coach-trainee dyads will play a puzzle video game, and will discuss contextual cues that should inform triage decisions. At the completion of the three weeks, trainees will complete a semi-structured, debriefing interview and a virtual simulation to assess triage performance.
Deliberate practice: As above
|
Control
Participants in the control group will complete a virtual simulation.
|
|---|---|---|
|
Overall Study
STARTED
|
36
|
36
|
|
Overall Study
COMPLETED
|
30
|
21
|
|
Overall Study
NOT COMPLETED
|
6
|
15
|
Reasons for withdrawal
| Measure |
Deliberate Practice
Trainees will be paired with a coach, and will meet, once per week for thirty minutes, over a three week period. During the training session, coach-trainee dyads will play a puzzle video game, and will discuss contextual cues that should inform triage decisions. At the completion of the three weeks, trainees will complete a semi-structured, debriefing interview and a virtual simulation to assess triage performance.
Deliberate practice: As above
|
Control
Participants in the control group will complete a virtual simulation.
|
|---|---|---|
|
Overall Study
Lack of Consent
|
1
|
0
|
|
Overall Study
Conflicts with time
|
2
|
0
|
|
Overall Study
Time slots were full
|
3
|
0
|
|
Overall Study
Lost to Follow-up
|
0
|
15
|
Baseline Characteristics
Developing a Deliberate Practice Intervention to Recalibrate Physician Heuristics in Trauma Triage
Baseline characteristics by cohort
| Measure |
Deliberate Practice
n=36 Participants
Trainees will be paired with a coach, and will meet, once per week for thirty minutes, over a three week period. During the training session, coach-trainee dyads will play a puzzle video game, and will discuss contextual cues that should inform triage decisions. At the completion of the three weeks, trainees will complete a semi-structured, debriefing interview and a virtual simulation to assess triage performance.
Deliberate practice: As above
|
Control
n=36 Participants
Participants in the control group will complete a virtual simulation.
|
Total
n=72 Participants
Total of all reporting groups
|
|---|---|---|---|
|
Age, Categorical
<=18 years
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Age, Categorical
Between 18 and 65 years
|
35 Participants
n=5 Participants
|
35 Participants
n=7 Participants
|
70 Participants
n=5 Participants
|
|
Age, Categorical
>=65 years
|
1 Participants
n=5 Participants
|
1 Participants
n=7 Participants
|
2 Participants
n=5 Participants
|
|
Sex: Female, Male
Female
|
13 Participants
n=5 Participants
|
15 Participants
n=7 Participants
|
28 Participants
n=5 Participants
|
|
Sex: Female, Male
Male
|
23 Participants
n=5 Participants
|
21 Participants
n=7 Participants
|
44 Participants
n=5 Participants
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
1 Participants
n=5 Participants
|
3 Participants
n=7 Participants
|
4 Participants
n=5 Participants
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
35 Participants
n=5 Participants
|
33 Participants
n=7 Participants
|
68 Participants
n=5 Participants
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
0 Participants
n=5 Participants
|
1 Participants
n=7 Participants
|
1 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Asian
|
10 Participants
n=5 Participants
|
7 Participants
n=7 Participants
|
17 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Black or African American
|
0 Participants
n=5 Participants
|
3 Participants
n=7 Participants
|
3 Participants
n=5 Participants
|
|
Race (NIH/OMB)
White
|
26 Participants
n=5 Participants
|
25 Participants
n=7 Participants
|
51 Participants
n=5 Participants
|
|
Race (NIH/OMB)
More than one race
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Region of Enrollment
United States · Northeast
|
10 Participants
n=5 Participants
|
9 Participants
n=7 Participants
|
19 Participants
n=5 Participants
|
|
Region of Enrollment
United States · Southeast
|
10 Participants
n=5 Participants
|
9 Participants
n=7 Participants
|
19 Participants
n=5 Participants
|
|
Region of Enrollment
United States · Midwest
|
4 Participants
n=5 Participants
|
5 Participants
n=7 Participants
|
9 Participants
n=5 Participants
|
|
Region of Enrollment
United States · Southwest
|
3 Participants
n=5 Participants
|
5 Participants
n=7 Participants
|
8 Participants
n=5 Participants
|
|
Region of Enrollment
United States · West
|
9 Participants
n=5 Participants
|
8 Participants
n=7 Participants
|
17 Participants
n=5 Participants
|
|
ATLS Certification
|
31 Participants
n=5 Participants
|
33 Participants
n=7 Participants
|
64 Participants
n=5 Participants
|
|
Specialty
Emergency Medicine
|
29 Participants
n=5 Participants
|
30 Participants
n=7 Participants
|
59 Participants
n=5 Participants
|
|
Specialty
Family Practice
|
3 Participants
n=5 Participants
|
1 Participants
n=7 Participants
|
4 Participants
n=5 Participants
|
|
Specialty
Internal Medicine
|
1 Participants
n=5 Participants
|
2 Participants
n=7 Participants
|
3 Participants
n=5 Participants
|
|
Specialty
Other (e.g. general surgery)
|
3 Participants
n=5 Participants
|
3 Participants
n=7 Participants
|
6 Participants
n=5 Participants
|
PRIMARY outcome
Timeframe: 3 week intervention periodPopulation: Board-certified emergency physicians who triage and treat adult patients in the emergency department of either a non-trauma center or a Level III/IV trauma center in the United States.
A summary of the number of trainees who signed up for coaching sessions and completed all three sessions as assigned.
Outcome measures
| Measure |
Deliberate Practice
n=36 Participants
Trainees will be paired with a coach, and will meet, once per week for thirty minutes, over a three week period. During the training session, coach-trainee dyads will play a puzzle video game, and will discuss contextual cues that should inform triage decisions. At the completion of the three weeks, trainees will complete a semi-structured, debriefing interview and a virtual simulation to assess triage performance.
Deliberate practice: As above
|
Control
n=36 Participants
Participants in the control group who enrolled in the trial.
|
|---|---|---|
|
Percentage of Participants Who Signed up for the Intervention That Completed All 3 Coaching Sessions.
Completed 3 coaching sessions
|
28 Participants
|
0 Participants
|
|
Percentage of Participants Who Signed up for the Intervention That Completed All 3 Coaching Sessions.
Completed 2 coaching sessions
|
2 Participants
|
0 Participants
|
|
Percentage of Participants Who Signed up for the Intervention That Completed All 3 Coaching Sessions.
Completed 1 coaching session
|
0 Participants
|
0 Participants
|
|
Percentage of Participants Who Signed up for the Intervention That Completed All 3 Coaching Sessions.
Not assigned to coaching sessions
|
6 Participants
|
36 Participants
|
SECONDARY outcome
Timeframe: 3 weeks post-intervention (deliberate practice) or 3 weeks post-enrollment (control)Population: Physicians who used the virtual simulation. We excluded physicians enrolled in the trial but who did not provide outcome data for analysis.
Proportion of severely injured patients NOT transferred to trauma centers/total number of severely injured patients evaluated during a validated virtual simulation
Outcome measures
| Measure |
Deliberate Practice
n=21 Participants
Trainees will be paired with a coach, and will meet, once per week for thirty minutes, over a three week period. During the training session, coach-trainee dyads will play a puzzle video game, and will discuss contextual cues that should inform triage decisions. At the completion of the three weeks, trainees will complete a semi-structured, debriefing interview and a virtual simulation to assess triage performance.
Deliberate practice: As above
|
Control
n=26 Participants
Participants in the control group who enrolled in the trial.
|
|---|---|---|
|
Under-triage
|
0.85 proportion of patients under-triaged
Standard Deviation 0.36
|
0.51 proportion of patients under-triaged
Standard Deviation 0.50
|
SECONDARY outcome
Timeframe: 2- weeks post interventionPopulation: Participants assigned to receive the deliberate practice intervention who completed an interview after the training sessions.
Derived from semi-structured interviews conducted by members of the investigative team at the conclusion of the 3 week training period. These interviews will focus on participant perceptions of the acceptability of the intervention.
Outcome measures
| Measure |
Deliberate Practice
n=36 Participants
Trainees will be paired with a coach, and will meet, once per week for thirty minutes, over a three week period. During the training session, coach-trainee dyads will play a puzzle video game, and will discuss contextual cues that should inform triage decisions. At the completion of the three weeks, trainees will complete a semi-structured, debriefing interview and a virtual simulation to assess triage performance.
Deliberate practice: As above
|
Control
n=36 Participants
Participants in the control group who enrolled in the trial.
|
|---|---|---|
|
Number of Participants Who Describe Coaching as Acceptable.
Participants received the intervention and who described it acceptable
|
26 Participants
|
0 Participants
|
|
Number of Participants Who Describe Coaching as Acceptable.
Participants who received the intervention and did not describe it as acceptable.
|
2 Participants
|
0 Participants
|
|
Number of Participants Who Describe Coaching as Acceptable.
Participants who received the intervention but did not complete an interview
|
2 Participants
|
0 Participants
|
|
Number of Participants Who Describe Coaching as Acceptable.
Participants who did not receive the intervention
|
6 Participants
|
36 Participants
|
Adverse Events
Deliberate Practice
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Control
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place