Supervised Hospital-Based Practice Versus Matched Online Activities in Cardiac Rehabilitation Training for Cardiology Residents: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 发起方
- 入组人数
- 98
- 试验地点
- 1
- 主要终点
- Post-training cardiac rehabilitation knowledge score adjusted for baseline
研究概览
简要总结
This randomized controlled trial compares supervised hospital-based practice with matched online activities as part of a common cardiac rehabilitation curriculum for cardiology residents. Ninety-eight residents will be allocated 1:1 to a blended group or an online control group. Both groups will receive the same seven-module online curriculum and the same total scheduled learning time. The blended group will complete a matched block of in-person practice in the cardiology ward, outpatient clinic, and cardiopulmonary exercise testing laboratory, whereas the control group will complete matched-duration supplementary online activities. The primary outcome is the post-training 25-item cardiac rehabilitation knowledge score adjusted for the baseline score. Key secondary outcomes are Mini-CEX and procedure-specific DOPS scores assessed by assessors blinded to allocation.
详细描述
The curriculum covers cardiac rehabilitation principles; phase I and phase II rehabilitation; cardiopulmonary exercise testing (CPET) and report interpretation; individualized exercise prescription; medication, exercise, nutrition, psychological care, and smoking-cessation prescriptions; multidisciplinary management; patient communication; and management of exercise-related acute events.
Both groups receive the same online course, syllabus, learning objectives, and approximately 12 hours of scheduled learning. The blended group replaces one matched-duration block of supplementary online learning with seven supervised in-person sessions. These sessions involve teaching with real patients who provide separate agreement, standardized cases, CPET reports, simulated acute-event scenarios, and immediate feedback. The control group completes additional online case discussions and structured self-study assignments covering the same modules.
Measurements occur at three ordered time points. Before randomization and course access, participants complete baseline information and the fixed 25-item knowledge pretest. Immediately after completion of the 7-week course and before release of assessment results, participants complete the same 25-item knowledge post-test and a separate anonymous learner-reported form. Within 7 days after course completion, two independent assessors blinded to allocation complete the Mini-CEX and DOPS ratings. The primary analysis follows the intention-to-treat principle and uses ANCOVA of the post-training knowledge score adjusted for the baseline knowledge score, with multiple imputation for missing baseline or post-training knowledge outcomes.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Single (Outcomes Assessor)
盲法说明
Residents and instructors cannot be blinded to the educational delivery mode. The two Mini-CEX and DOPS examiners do not participate in teaching and are blinded to group allocation.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Resident physician currently participating in standardized residency training
- •Undertaking a rotation in the Department of Cardiology
- •Available to attend the cardiac rehabilitation course and study assessments
- •Provides written informed consent
排除标准
- •Prior systematic cardiac rehabilitation training
- •Extensive clinical experience in a dedicated cardiac rehabilitation program
- •Unable to attend the course at the time eligibility is assessed
- •Declines participation
研究组 & 干预措施
Online control group
Participants complete the common seven-module online cardiac rehabilitation course and matched-duration supplementary online case discussions and structured self-study assignments.
干预措施: Common online cardiac rehabilitation curriculum (Other)
Online control group
Participants complete the common seven-module online cardiac rehabilitation course and matched-duration supplementary online case discussions and structured self-study assignments.
干预措施: Matched supplementary online learning (Other)
Blended learning group
Participants complete the common seven-module online cardiac rehabilitation course and replace the matched supplementary online block with seven supervised, hospital-based case and practice sessions.
干预措施: Common online cardiac rehabilitation curriculum (Other)
Blended learning group
Participants complete the common seven-module online cardiac rehabilitation course and replace the matched supplementary online block with seven supervised, hospital-based case and practice sessions.
干预措施: Hospital-based case and practice sessions (Other)
结局指标
主要结局
Post-training cardiac rehabilitation knowledge score adjusted for baseline
时间窗: Immediately after completion of the 7-week course
A fixed 25-item multiple-choice examination assesses cardiac rehabilitation fundamentals, phase I rehabilitation, phase II rehabilitation, CPET, exercise prescription, and case-based application. Each correct answer is worth 4 points; total scores range from 0 to 100, with higher scores indicating greater knowledge. The primary estimand is the adjusted between-group difference in the post-training total score from ANCOVA with the baseline total score as a covariate.
次要结局
- Mini-Clinical Evaluation Exercise total score(Within 7 days after completion of the 7-week course)
- Procedure-specific Direct Observation of Procedural Skills total score(Within 7 days after completion of the 7-week course)