The FAIL CT Study: Facilitating Adaptive Expertise in Learning Computed Tomography, a Multi-center Randomized Controlled Trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Stanford University
- Enrollment
- 150
- Locations
- 1
- Primary Endpoint
- Percent correct on an assessment of transfer of skills (adaptive expertise)
Study Overview
Brief Summary
The main objective of this study is to demonstrate that Error Management Training improves adaptive expertise in head computed tomography interpretation. The investigators will conduct a randomized controlled trial comparing two learning strategies, Error Management Training vs Error Avoidance Training, in emergency medicine residents. The investigators 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.
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, the investigators need further evidence for its efficacy with cognitive skills in residency training. The investigators aim to demonstrate that Error Management Training improves adaptive expertise in a cognitive skill, using head computed tomography interpretation as a model.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Double (Participant, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
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
Arms & Interventions
Error Management Training (Difficult)
Participants receive the learning strategy Error Management Training and encounter difficult questions.
Intervention: Error Management Training (Difficult) (Other)
Error Management Training (Easy)
Participants receive the learning strategy Error Management Training and encounter easy questions.
Intervention: Error Management Training (Easy) (Other)
Error Avoidance Training
Participants receive the learning strategy Error Avoidance Training.
Intervention: Error Avoidance Training (Other)
Outcomes
Primary Outcomes
Percent correct on an assessment of transfer of skills (adaptive expertise)
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 Outcomes
- Effect of post-graduate year level on post-test performance(Immediately after instructional session (up to 60 minutes to complete the assessment))
- Mediation effect of errors on performance on the adaptive expertise cases(Number of errors will be measured during the educational intervention)
- Percent correct on an assessment of post-session proficiency for learning objectives (routine expertise)(Immediately after instructional session (up to 60 minutes to complete the assessment))
Investigators
Leonardo Aliaga
Clinical Instructor, Department of Emergency Medicine
Stanford University