Clinical trial NCT05284838: Facilitating Adaptive Expertise in Learning Computed Tomography
Official title: The FAIL CT Study: Facilitating Adaptive Expertise in Learning Computed Tomography, a Multi-center Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Adaptive Expertise
Error Management Training
Learning
Lead sponsor: Stanford University
Sponsor class: OTHER
Collaborators: name: Brown University
name: Alameda Health System
name: University of California, Los Angeles
name: University of Chicago
name: The University of Texas Health Science Center, Houston
name: University of Wisconsin, Madison
name: Vanderbilt University
First posted: 2022-03-17
Enrollment: 150
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The main objective of this study is to demonstrate that Error Management Training improves adaptive expertise in head computed tomography interpretation. The investigators will conduct a randomized controlled trial comparing two learning strategies, Error Management Training vs Error Avoidance Training, in emergency medicine residents. The investigators hypothesize that Error Management Training, as compared to Error Avoidance Training, will improve adaptive expertise, as measured by skills transfer, when used to teach head computed tomography interpretation to emergency medicine residents.

Detailed description: Adaptive expertise is the ability to apply existing skills to novel situations. Adaptive expertise enables physicians to reduce preventable medical errors when managing clinical scenarios not encountered during training. However, residency curricula rarely address this learning outcome. Error Management Training improves transfer of skills to new contexts and develops adaptive expertise. Although this methodology has been shown to improve adaptive expertise in procedural skills, its impact on cognitive skills in medical training remains underexplored. Error Management Training promises to improve patient care by developing emergency physicians' adaptive expertise. However, the investigators need further evidence for its efficacy with cognitive skills in residency training. The investigators aim to demonstrate that Error Management Training improves adaptive expertise in a cognitive skill, using head computed tomography interpretation as a model.

Eligibility criteria: Inclusion Criteria:

* Study participation will be available to all current emergency medicine residents at Stanford and at thirteen external sites.

Exclusion Criteria:

* Adults unable to consent
* Pregnant women
* Individuals who are not yet adults (infants, children, teenagers)
* Prisoners
* Medical students
* Residents from specialties other than emergency medicine

Primary outcomes:
measure: Percent correct on an assessment of transfer of skills (adaptive expertise)
timeFrame: Immediately after instructional session (up to 60 minutes to complete the assessment)
Secondary outcomes:
measure: Percent correct on an assessment of post-session proficiency for learning objectives (routine expertise)
timeFrame: Immediately after instructional session (up to 60 minutes to complete the assessment)
measure: Effect of post-graduate year level on post-test performance
timeFrame: Immediately after instructional session (up to 60 minutes to complete the assessment)
measure: Mediation effect of errors on performance on the adaptive expertise cases
timeFrame: Number of errors will be measured during the educational intervention
Other outcomes:
Locations:
city: Stanford
country: United States
facility: Stanford University
state: California
Study officials:
affiliation: Stanford University
name: Leonardo Aliaga, MD
role: PRINCIPAL_INVESTIGATOR
References:
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