Crisis Resource Management Improvement Through Intellectual Questioning of Authority

Not Applicable

Completed

• Conditions: Medical Education, Simulation, Crisis Resource Management
• Interventions: Other: Standard ACLS Training; Other: Crisis Resource Management Skill Training

• Registration Number: NCT03707964
• Lead Sponsor: National University Hospital, Singapore

Brief Summary

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.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2018-10-12
• Study First Submitted QC: 2018-10-15
• Study First Posted: 2018-10-16
• Study Start: 2019-03-11
• Primary Completion: 2020-09-20
• Study Completion: 2020-11-20
• Status Verified: 2021-03
• Last Update Submitted: 2021-03-02
• Last Update Posted: 2021-03-03

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 25

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

Exclusion Criteria

• Refusal for informed consent, or
• Refusal for video recording during simulation sessions

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Control	Standard ACLS Training	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.
Intervention	Crisis Resource Management Skill Training	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.

Primary Outcome Measures

Name	Time	Method
Effect of a teaching intervention on participants' ability to challenge clearly wrong decisions by a superior during a simulated life-threatening crisis	20 minutes	Comparison of the best modified Advocacy-Inquiry Score (mAIS) responses of the 6 challenge opportunities between the intervention and control groups. The mAIS is a modification of the Advocacy-Inquiry method which includes five scoring levels with the addition of a sixth level when a trainee attempts to take over management of the case.

Secondary Outcome Measures

Name	Time	Method
Influence of the confederate's gender on participant's ability to challenge incorrect decisions	20 minutes	Comparison of the median modified Advocacy-Inquiry Score (mAIS) responses between the subjects exposed to male versus female confederate specialist. The mAIS is a modification of the Advocacy-Inquiry method which includes five scoring levels with the addition of a sixth level when a trainee attempts to take over management of the case.

Trial Locations

Locations (1)

National University Hospital, Singapore; 🇸🇬 Singapore, Singapore