Increasing Reporting of Intimidation of Medical Students With Simulation

Study Overview
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Brief Summary
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Intimidation of medical students by health care professionals is a well-documented phenomenon. Raising awareness of what constitutes intimidation is a preferred method for preventing it through increased reporting. Simulation is a novel method of raising awareness of intimidation. This is a randomised controlled trial comparing the effectiveness of simulation (involving actors), an educational video and no intervention, as adjuncts to group discussion, on students' ability to identify and report intimidation. Medical students from the University of Montreal in Montreal, Canada, will be recruited at the beginning of surgical clerkship. They will complete a standardized and validated pre-intervention questionnaire on their experience with intimidation consisting of multiple choice questions and short answers. They will be randomised to one of the three interventions lasting 70 minutes that will be followed by a 20-minute standardized discussion on intimidation with all students participating together. At the end of their surgical rotation, they will complete a similar post-intervention questionnaire with additional questions pertaining to the reporting of intimidation. Differences in intimidation reporting after the intervention as well as a before and after comparison of the Negative Acts Questionnaire score will be studied.

Official Title
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Increasing Reporting of Intimidation of Medical Students With Simulation: a Randomised Controlled Trial

Conditions
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Intimidation

Intervention / Treatment
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* Behavioral: Simulation
* Behavioral: Video
* Behavioral: Control group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Medical students at the University of Montreal at the beginning of their surgical clerkship rotation. Exclusion Criteria: -

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Single-blind randomised controlled trial with two experimental arms and a control arm
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Simulation<br>During a suturing class at the simulation center, the students enter a classroom. Although the students are not aware of this, among them is an actor playing the role of a student. One of the two professors is also an actor. As the activity progresses, the professor targets the student played by an actor. The intimidation intensifies until the end. At the end of the activity, there is a debriefing explaining to the students that the bullying professor and the victim were actors. | Behavioral: Simulation<br>* Students witness the intimidation of one of their peers (who is an actor) by a professor (also an actor). (see arm description)<br>|
| Experimental: Video<br>During a suturing class at the simulation center, after 55 minutes of suturing, the students will be exposed to a 15-minute video on workplace and hospital intimidation and how to manage it. | Behavioral: Video<br>* Student watch a 15-minute intimidation video (see arm description).<br>|
| Placebo Comparator: Control<br>During a suturing class at the simulation center, the students suture for the entire 70-minute duration of the activity. They are not exposed to intimidation (control group). | Behavioral: Control group<br>* No intervention. The students suture for 70 minutes<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comfort in reporting intimidation | Based on post-intervention questionnaire question. | 6 weeks after enrollment | 
| Perception of intimidation after intervention | Based on post-intervention Negative Acts Questionnaire (NAQ-R) | 6 weeks after enrollment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Baseline prevalence of intimidation | Based on pre-intervention Negative Acts Questionnaire (NAQ-R) | at enrollment | 
| Before and after comparison | Difference between pre and post-intervention Negative Acts Questionnaire (NAQ-R) | at enrollment vs 6 weeks post-intervention | 
| Reasons for not reporting intimidation | Open-ended question asking why students don't report intimidation | at enrollment | 
| Frequency of intimidation reporting | Did the students report intimidation during the 6 weeks of their surgical clerkship? | 6 weeks post-intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Intimidation, Simulation, Medical education, Surgical education