Simulation Training in Emergency Department Imaging 2
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 173
- 试验地点
- 6
- 主要终点
- Accuracy of ED clinicians reporting CT head scans
研究概览
简要总结
Background and study aims:
Computerised Tomography (CT) head scans are frequently requested by Emergency Department (ED) clinicians as one of the investigations for their patients. This often causes a delay when waiting for specialist radiologists to report the findings of the scan. The purpose of this study is to see if online training can improve the ability of ED clinicians to interpret the scans themselves, to a level sufficient to make clinical decisions based on their findings and to explore what aspects of this process they find most challenging.
Participants:
Emergency Department clinicians who are working in the Emergency Departments of participating sites between April to September 2022 (inclusive), who request CT Head scans as part of their routine clinical practice.
What does the study involve?:
180 ED clinicians will be recruited across 6 hospital sites in the United Kingdom. All will undertake a baseline online assessment to measure their accuracy in interpreting CT head scans.
One group will then undertake an online training module, with a subsequent assessment immediately afterwards, then over the following 3 months will record interpretations for 30 CT head scans.
Head images encountered in participants' routine clinical practice, and their findings, will be compared with the radiology reports for each scan. Participants will then undertake further online assessments 3 and 6 months after the start of the study. Their overall results will be compared with a control group, who will undergo the same process, but undertake the online training after they have tried to interpret 30 scans in their clinical practice.
Participants will continue to base their clinical decisions on radiologist reports, not their own interpretations, so patient care will not be affected by this study.
详细描述
STUDY DESIGN
This is a randomised controlled trial (RCT) to assess the improvement in the image interpretation accuracy and confidence of reporters using online simulation training for CT head scan interpretation.
Using the RAIQC online platform (www.raiqc.com), the trial participants will be required to complete a baseline assessment where users will review and interpret a pre-existing set of CT scans, which have been curated and reported by senior radiologists. They will be asked to record their interpretation, which will be subsequently compared against that of the radiologists. The participants will be blinded to both original reports for the images, and their overall performance results. After completing the baseline assessment, participants will be given access to an online training package. After completing the training, the participants will complete a further assessment. The improvement in diagnostic accuracy pre- and post-training will be measured.
Once the participants have been trained, they will each be asked to evaluate a minimum total of 30 CT scans during clinical shifts spread over a 3-month period. For each CT scan included they will be asked to record their scan interpretation, the time the scan was performed, the time they reviewed the scan and the time the radiology report was issued. The radiology report will be considered the gold-standard diagnosis. Online assessments will be repeated at the end of the 3 month period and at 6months post training, to monitor changes in performance over time.
Subsequent comparison and analysis will aim to measure the real-world accuracy of ED staff at interpreting CT head scans. In addition, the investigators will also be able to measure potential time saving by ED staff interpreting the scans compared with the radiology report being issued.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Diagnostic
- 盲法
- Single (Participant)
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Emergency department clinicians who review CT head scans as part of their clinical practice.
- •Working in the relevant ED during the clinical phase of the project.
排除标准
- •Previous formal postgraduate CT reporting training.
- •Previous career to registrar level in radiology/neurosurgery.
- •Staff in Emergency Department post for less than 4 months.
研究组 & 干预措施
Intervention (training)
Users will access an online training module on the RAIQC simulation platform, featuring didactic tutorials and interactive case-based simulations on CT head pathologies such as haemorrhage, infarction, mass effect, and hydrocephalus. The training, designed to take 2-4 hours, is completed during protected non-clinical time. After training, users complete a post-training assessment with 50 different CT cases to evaluate immediate learning gain, followed by a second assessment. Over the next 3 months, users interpret at least 30 CT scans each during clinical shifts, recording their interpretations, the time scans were performed and reviewed, radiology report findings, and report issue times. At the end of 3 months, they repeat the assessment to measure performance, and again after a further 3 months to assess retention of any improvements.
干预措施: Online training (Other)
Control (no Training)
To serve as a control for comparing the benefits of the online training and clinical interpretation phases on reporting performance, 30 participants (6 clinicians per site) will be randomized to complete the clinical interpretation phase before the training module. These subjects will not undergo online CT head interpretation training initially.
结局指标
主要结局
Accuracy of ED clinicians reporting CT head scans
时间窗: 6 months
Accuracy of ED clinicians in reporting non-contrast CT head scans (sensitivity and specificity) measured using online assessment at pre/post-training, 3 months, 6 months post-training
次要结局
- Self-reported confidence scale at pre/post-training, 3 months, 6 months post-training. The self reported confidence scale has a minimum value of "not confident at all" and a maximum value of "really confident". A higher or lower score does(6 months)
- Potential clinical and health economic impact of introducing CT head reporting into ED clinical practice(6 months)
- Time difference between ED clinician interpretation and final radiology report measured using recorded report times at 3 months post-training(3 months)
- Factors that influence clinicians' reporting accuracy(6 months)
- Diagnostic accuracy of ED clinicians in reporting non-contrast CT head scans during clinical practice(3 months)
- Ability of clinicians to retain newly acquired CT reporting skills(6 months post-training)
- Factors affecting the uptake of new image reporting roles in the ED clinical population(6 months)
- Clinicians' interpretation accuracy with and without undergoing online training(6 months)
研究者
Alex Novak
Primary Investigator
Oxford University Hospitals NHS Trust