Improving Surgical Communication for Patients in Wisconsin

Not Applicable

Recruiting

• Conditions: Surgeons; Surgical Procedure, Unspecified

• Registration Number: NCT06647303
• Lead Sponsor: University of Wisconsin, Madison

Brief Summary

The purpose of this study is to evaluate a new training program to support communication between surgeons and their patients. The goal of the training program is to help patients get the information they need to make treatment decisions that are right for them.

Participants will complete surveys, attend a focus group, or receive training on Better Conversations, depending on the type of participant.

Detailed Description

Observational research shows that surgeons translate informed consent and shared decision-making standards into an overly complicated technical explanation of the patient's disease and treatment, and an overly simplified narrative that surgery will "fix" the patient's problem. They omit critical information about the goals and downsides of surgery and struggle to actualize the patient's role in medical decisions, while unintentionally concealing professional expertise. "Better Conversations" is a novel communication framework designed to address these problems. With this framework, surgeons provide context about clinical norms, clearly establish the goals of surgery, and comprehensively delineate the downsides of surgery as experienced by the patient to generate a deliberative space for patients to consider whether surgery is right for them. This paradigm-shifting framework meets the legal and ethical standards for informed consent, supports deliberation, and allows patients to anticipate and prepare for the experience of surgery.

The present study supports optimization of surgeon training and study procedures (Phase II) that is needed before large scale testing and dissemination (Phase III). Although this intervention is evidence based, collaborative efforts are needed to ultimately test and disseminate a major clinical shift. The long-term goal is for every surgeon to use Better Conversations with every patient, every time. The present study has two main objectives: 1) To make the education program scalable with automated assessment and feedback to surgeons using audio recordings from their clinical conversations, and 2) to evaluate patient and family reported outcome measures regarding surgeon communication.

Study Timeline

• Study First Submitted: 2024-10-16
• Study First Submitted QC: 2024-10-16
• Study First Posted: 2024-10-17
• Status Verified: 2024-11
• Study Start: 2024-11-18
• Last Update Submitted: 2024-11-19
• Last Update Posted: 2024-11-20
• Primary Completion: 2028-11
• Study Completion: 2028-11

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 580

Inclusion Criteria

Surgeons:

• Surgeons from University of Wisconsin - Madison Department of Surgery who have an outpatient surgical clinic and treat adult patients at UW Health

Surgical candidates:

• Age 18 or older
• Present to an enrolled surgeon's clinic with a surgical problem
• Decision making ability
• Speak English

Stakeholders:

• Must have previous experience with surgery (within 10 years)
• Speak English

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Exclusion Criteria

Surgeons:

• Solely treat minors (under age 18)

Surgical candidates:

• Lacking decision making capacity
• Unable to speak English

Stakeholders:

• Unable to speak English

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Effect of automated training program	Up to 4 years	Specialists will train 10 surgeons, audio recording 150 surgical consultations with surgical candidates. One hundred of these audio recordings will be used as a training set to develop an automated assessment and feedback program. Fifty of these recordings will be used to measure fidelity to the intervention with a summative assessment. Ten additional surgeons will be then trained using the automated training and researchers will audio record an additional 150 surgical consultations with surgical candidates. Automated feedback will be provided for 100 of the consultations and researchers will measure fidelity to the automated intervention with a summative assessment of 50 consultations. The effect of the automated training program will be tested by comparing summative assessments of surgeon performance between the two differently-trained groups.
Compare effectiveness of specialist-delivered training versus automated training on participant-reported measures of surgeon communication	Up to 4 years	Researchers will compare surgical candidate participant survey results between surgeons who received specialist-delivered training versus those who received automated training.
Compare the effectiveness of training on participant-reported measures of surgeon communication	Up to 4 years	Prior to training surgeons, surveys will be administered to 50 surgical candidates (5 per surgeon) to measure usual care communication. After surgeons have been trained to use Better Conversations, 50 new surgical candidates will be surveyed. The survey is a 38-item questionnaire with a Likert scale of 1-5 (1 = disagree, 5 = agree). Higher scores indicate better communication from the surgeon. These procedures will be repeated for the automated training. Researchers will compare surgical candidate participant survey results for surgeons before they received training with survey results after surgeons receive training.

Trial Locations

Locations (1)

University of Wisconsin; 🇺🇸 Madison, Wisconsin, United States