Optimizing Video Communication Assessment for Teaching Error Disclosure Skills
NCT ID: NCT06234085
Last Updated: 2024-01-31
Study Results
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Basic Information
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COMPLETED
NA
154 participants
INTERVENTIONAL
2022-07-01
2023-06-30
Brief Summary
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\- Is the intervention of providing reports with personal performance feedback and recommendations for effective error disclosure associated with higher ratings of resident error disclosure skills?
Participants will perform simulated error disclosure with a software tool called the Video-based Communication Assessment (VCA). Participants will be randomized to receive feedback reports (intervention) or not (control). Participants receiving the intervention will be asked to review their feedback and all participants will use the VCA again approximately 4 weeks later with different patient cases.
Detailed Description
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Residents who completed the VCA at Time 1 were randomized in 1:1 fashion to either receive feedback before Time 2 (intervention) or after Time 2 (control). Intervention residents received emails when their feedback was available, instructing them to review it in the app before the next teaching session and VCA practice. Feedback was typically provided two weeks after VCA use to allow for completion of rating and data quality checks. Reports presented an interactive feedback display within the VCA app for each vignette.
Residents provided audio responses to each vignette through the VCA software. Audio responses were bundled into rating tasks on MTurk for raters who were US residents over 18 years old and able to speak and read English. Raters answered demographic questions, read a vignette description in lay language, viewed the patient video, and listened to resident responses. They rated each response on six items covering domains of error disclosure. We averaged ratings across items and raters to create an overall rating of each response. We then averaged response ratings across all 7 vignettes at Time 1 to create an overall Time 1 score, and across all 6 vignettes at Time 2 to create a Time 2 score.
Residents completed questionnaires in the VCA application before proceeding to cases. The survey at Time 1 asked about age, gender, race, the number of times the resident had personally participated in disclosure of a harmful error to a patient or family, and the highest level of involvement they've had during disclosure of a harmful medical error. Before Time 2, residents who had received feedback were asked "approximately how many minutes did you spend reviewing your feedback" (response options in 5-min ranges), and "how many of your own responses did you replay", "how many of the exemplar (highly rated peer) responses did you play", (response options of none, 1-2, 3-4, 5 or more). Residents responded to four additional items (Table 2) about the usefulness of each feedback component (scores, personal recordings, exemplar recordings, learning points) using a 5-point scale with labels from "not at all" to "extremely"
To address our primary study question about the effect of the intervention, i.e., access to VCA feedback, we conducted a factorial analysis of covariance (ANCOVA) examining the impact that the intervention and prior disclosure exposure had on Time 2 scores, while adjusting for Time 1 scores. We used logistic regression to investigate whether Time 1 scores could predict the likelihood participants returned for Time 2.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
OTHER
SINGLE
Study Groups
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Intervention
Participants will be provided with access to a feedback report in the VCA app that contains 1) crowdsourced ratings of their error disclosure communication, 2) access to recordings of their responses to the completed VCA cases, 3) a recording of a highly-rated peer response and 4) learning points summarizing what laypeople would like the doctor to say in response to the case.
VCA feedback report available
Access to feedback report described in the intervention
Control
Participants will not have access to a feedback report.
No interventions assigned to this group
Interventions
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VCA feedback report available
Access to feedback report described in the intervention
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
18 Years
ALL
Yes
Sponsors
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The National Board of Medical Examiners
OTHER
University of Washington
OTHER
Responsible Party
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Andrew Austin White
Professor: School of Medicine
Principal Investigators
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Andrew A White, MD, SFHM
Role: PRINCIPAL_INVESTIGATOR
University of Washington
Locations
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University of Washington at Boise
Boise, Idaho, United States
University of Massachussets
Worcester, Massachusetts, United States
Beaumont Health
Dearborn, Michigan, United States
Washington University in St. Louis
St Louis, Missouri, United States
Dartmouth Hitchcock Medica Center
Lebanon, New Hampshire, United States
Washington State University at Everett
Everett, Washington, United States
University of Washington
Seattle, Washington, United States
Countries
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References
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White AA, King AM, D'Addario AE, Brigham KB, Bradley JM, Gallagher TH, Mazor KM. Crowdsourced Feedback to Improve Resident Physician Error Disclosure Skills: A Randomized Clinical Trial. JAMA Netw Open. 2024 Aug 1;7(8):e2425923. doi: 10.1001/jamanetworkopen.2024.25923.
Other Identifiers
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STUDY00015707
Identifier Type: -
Identifier Source: org_study_id