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Facilitating Adaptive Expertise in Learning Computed Tomography (FAIL CT)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT05284838
Recruitment Status : Not yet recruiting
First Posted : March 17, 2022
Last Update Posted : March 17, 2022
Sponsor:
Collaborators:
Brown University
Alameda Health System
Ohio State University
University of Alabama at Birmingham
University of California, Davis
University of California, Los Angeles
University of California, San Francisco
University of Chicago
University of Michigan
University of Oklahoma
The University of Texas Health Science Center, Houston
University of Wisconsin, Madison
Vanderbilt University
Information provided by (Responsible Party):
Leonardo Aliaga, Stanford University

Study Description
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Brief Summary:
The main objective of this study is to demonstrate that Error Management Training improves adaptive expertise in head computed tomography interpretation. We will conduct a randomized controlled trial comparing two learning strategies, Error Management Training vs Error Avoidance Training, in emergency medicine residents. We hypothesize that Error Management Training, as compared to Error Avoidance Training, will improve adaptive expertise, as measured by skills transfer, when used to teach head computed tomography interpretation to emergency medicine residents.

Condition or disease Intervention/treatment Phase
Adaptive Expertise Error Management Training Other: Error Management Training (Difficult) Other: Error Management Training (Easy) Other: Error Avoidance Training Not Applicable

Detailed Description:
Adaptive expertise is the ability to apply existing skills to novel situations. Adaptive expertise enables physicians to reduce preventable medical errors when managing clinical scenarios not encountered during training. However, residency curricula rarely address this learning outcome. Error Management Training improves transfer of skills to new contexts and develops adaptive expertise. Although this methodology has been shown to improve adaptive expertise in procedural skills, its impact on cognitive skills in medical training remains underexplored. Error Management Training promises to improve patient care by developing emergency physicians' adaptive expertise. However, we need further evidence for its efficacy with cognitive skills in residency training. We aim to demonstrate that Error Management Training improves adaptive expertise in a cognitive skill, using head computed tomography interpretation as a model.
Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 240 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: The FAIL CT Study: Facilitating Adaptive Expertise in Learning Computed Tomography, a Multi-center Randomized Controlled Trial
Estimated Study Start Date : July 2022
Estimated Primary Completion Date : January 2023
Estimated Study Completion Date : June 2023

Resource links provided by the National Library of Medicine

MedlinePlus related topics: CT Scans

Arms and Interventions
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Arm Intervention/treatment
Experimental: Error Management Training (Difficult)
Participants receive the learning strategy Error Management Training and encounter difficult questions.
 Other: Error Management Training (Difficult)
Error Management Training is used to teach head computed tomography interpretation. Participants encounter difficult questions.
Experimental: Error Management Training (Easy)
Participants receive the learning strategy Error Management Training and encounter easy questions.
 Other: Error Management Training (Easy)
Error Management Training is used to teach head computed tomography interpretation. Participants encounter easy questions.
Active Comparator: Error Avoidance Training
Participants receive the learning strategy Error Avoidance Training.
 Other: Error Avoidance Training
Error Avoidance Training used to teach head computed tomography interpretation.


Outcome Measures
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Primary Outcome Measures :
  1. Percent correct on an assessment of transfer of skills [ Time Frame: Immediately after instructional session (up to 60 minutes to complete the assessment) ]
    Participants will have to demonstrate transfer of head computed tomography interpretation skills by interpreting novel radiology cases different from those used in the instructional session. Performance will be assessed by percent score on a head computed tomography interpretation test using novel radiology content not addressed in the instructional session. Score range is 0-100%.


Secondary Outcome Measures :
  1. Percent correct on an assessment of post-session proficiency for learning objectives [ Time Frame: Immediately after instructional session (up to 60 minutes to complete the assessment) ]
    Participants will have to demonstrate direct application of the intervention's learning objectives by interpreting radiology cases similar to those used in the instructional session. Performance will be assessed by percent score on a head computed tomography interpretation test using radiology content similar to that used in the instructional session. Score range is 0-100%.

  2. Percent correct on an assessment of transfer of skills [ Time Frame: Three months after instructional session (up to 60 minutes to complete the assessment) ]
    Participants will have to demonstrate transfer of head computed tomography interpretation skills by interpreting novel radiology cases different from those used in the instructional session. Performance will be assessed by percent score on a head computed tomography interpretation test using novel radiology content not addressed in the instructional session. Score range is 0-100%.

  3. Percent correct on an assessment ofpost-session proficiency for learning objectives [ Time Frame: Three months after instructional session (up to 60 minutes to complete the assessment) ]
    Participants will have to demonstrate direct application of the intervention's learning objectives by interpreting radiology cases similar to those used in the instructional session. Performance will be assessed by percent score on a head computed tomography interpretation test using radiology content similar to that used in the instructional session. Score range is 0-100%.


Eligibility Criteria
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Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Study participation will be available to all current emergency medicine residents at Stanford and at thirteen external sites.

Exclusion Criteria:

  • Adults unable to consent
  • Pregnant women
  • Individuals who are not yet adults (infants, children, teenagers)
  • Prisoners
  • Medical students
  • Residents from specialties other than emergency medicine
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05284838


Contacts
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Contact: Leonardo Aliaga, MD 773-655-6705 aliagal@stanford.edu

Sponsors and Collaborators
Stanford University
Brown University
Alameda Health System
Ohio State University
University of Alabama at Birmingham
University of California, Davis
University of California, Los Angeles
University of California, San Francisco
University of Chicago
University of Michigan
University of Oklahoma
The University of Texas Health Science Center, Houston
University of Wisconsin, Madison
Vanderbilt University
Investigators
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Principal Investigator: Leonardo Aliaga, MD Stanford University
More Information
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Publications:

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Responsible Party: Leonardo Aliaga, Clinical Instructor, Department of Emergency Medicine, Stanford University
ClinicalTrials.gov Identifier: NCT05284838    
Other Study ID Numbers: 64099
First Posted: March 17, 2022    Key Record Dates
Last Update Posted: March 17, 2022
Last Verified: March 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: No current plan to share data.

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No