The Study Guide Cluster Randomized Control Trial

Study Overview
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Brief Summary
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Spaced education is a promising theory-driven strategy to improve clinical competence. Our aim is to improve the clinical competence of Family Physicians, an outcome associated with the quality of care delivered to Canadians.

Detailed Description
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Research Question: Among family medicine residents, does enhanced feedback through an app providing alerts and test questions (spaced education), compared to the same app without alerts and enhanced feedback (no spaced education), improve competence as measured by the certification examination? In building this proposal for a definitive trial, the investigators have support from coast to coast. In addition to key clinician educators, the team includes knowledge users from the organization responsible for the certification examination in Family Medicine, methodologists and experienced researchers who study how mobile apps can promote engagement with clinical information. The team has the right blend of expertise in medical education and cluster randomized trials. Approach and Methods: The investigators will follow an organizational participatory research approach, and propose a cluster randomized controlled trial. Setting: All incoming family medicine residents in Canada will be eligible to participate. Intervention site residents will receive alerts through an app to adaptively reinforce the learning of clinical content based on cases and test questions (spaced education). Residents in the control group will receive the same app providing identical clinical cases and test questions-on-demand, but with alerts inactivated (no spaced education). The primary outcome will be scores on the certification examination. This routinely collected data will be provided to the team by the College of Family Physicians of Canada. Expected Results and Conclusion: Spaced education will improve examination scores. This will inform educational practice by providing evidence to optimize the training of residents.

Official Title
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Can an App Improve the Examination Scores of Family Medicine Residents? A Cluster Randomized Controlled Trial

Conditions
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Behavior

Intervention / Treatment
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* Behavioral: Spaced educational intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: incoming family medicine residents in Canada (July 2017) Exclusion Criteria: not a family medicine resident did not start residency on July 1, 2017
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Intervention site residents will receive alerts through an app to adaptively reinforce the learning of clinical content based on cases and test questions (spaced education). | Behavioral: Spaced educational intervention<br>* A spaced educational intervention will be provided to participants<br>|
| No Intervention: Control<br>Residents in the control group will receive the same app providing identical clinical cases and test questions-on-demand, but with alerts inactivated (no spaced education). | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Scores on the Certification Examination | This is the score on the written component of the examination of the College of Family Physicians of Canada. This refers to the grade/score given to participants on the Short Answer Management Problems (SAMP) section of the exam ranging from 0 to 100. Higher values represent a better outcome. The score minimum observed was 53.9 and max is 84.4 for this study. | 2 years |