Clinical trial NCT02199210: Exploring Self-regulatory Processes in Anesthesiologists During Massive Transfusion
Official title: Optimizing Intra-Operative Massive Transfusion: Probing for Forethought
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Self-regulation
Forethought
Performance
Keywords: Massive transfusion protocols
Self-regulatory learning
Forethought
Clinical expertise
Simulation
Education
Lead sponsor: Unity Health Toronto
Sponsor class: OTHER
Collaborators: name: University Health Network, Toronto
First posted: 2014-07-24
Enrollment: 40
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL

Brief summary: The purpose of the project is to investigate the function of self-regulatory processes in anesthesiologists and how application of these processes influence performance in a crisis situation.The investigators intend to explore specifically the first phase of self-regulation, i.e. the forethought phase which describes processes related to strategic planning, goal setting, goal orientation, and outcome expectation. The investigators hypothesize that prompting forethought before engaging in a simulated massive transfusion crisis situation will result in better task performance in anesthesiologists.

Detailed description: The investigators will conduct 3 studies building on each other.

* Pilot Study: the purpose of this study is to develop measurement tools for forethought, performance and a tool for prompting forethought. This study will include 2 attending anesthesiologists and 2 anesthesia residents (PGY2, 5).
* Study I: the purpose of this study is to validate the measurement tools for forethought, performance and the tool for prompting forethought. This will include 6 attending anesthesiologists, 6 PGY5 and 6 PGY2 anesthesia residents.
* Study II: the purpose of this study is to investigate if prompting forethought in anesthesia residents will result in better performance in a simulated massive transfusion than no prompting.

Eligibility criteria: Inclusion Criteria:

* Pilot study: attending anesthesiologists at St. Michael's Hospital , PGY5, PGY2 anesthesia residents at University of Toronto
* Study I: attending anesthesiologists at St. Michael's Hospital, PGY5, PGY2 anesthesia residents at University of Toronto
* Study II: PGY2, PGY3, PGY4 anesthesia residents at University of Toronto

Exclusion Criteria:

* Refusal to take part in the study

Primary outcomes:
measure: Performance in managing simulated massive transfusion scenario
timeFrame: Each individual's performance will be video recorded and subsequently evaluated within 8 weeks.
Secondary outcomes:
measure: Correlation between forethought scores and performance scores.
timeFrame: Forethought scores and performance scores will be determined within 8 weeks after individuals participated in the study.
Other outcomes:
measure: Development and validation of measurement tools for forethought, performance and a tool for prompting forethought.
timeFrame: Within 4 weeks after completion of Pilot study and Study I.
Locations:
city: Toronto
country: Canada
facility: St. Michael's Hospital
state: Ontario
Study officials:
affiliation: St. Michael's Hospital, University of Toronto
name: John G Laffey, MD, FCARCSI
role: PRINCIPAL_INVESTIGATOR
affiliation: The Wilson Center, University Health Network, University of Toronto
name: Charlotte Ringsted, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Zimmermann BJ. Development of adaptation of expertise: The role of self-regulatory processes and beliefs. In: Ericsson KA, ed. The Cambridge Handbook of Expertise and Expert Performance: Cambridge Unicersity Press 2006:705-22.
citation: Ericsson KA. Protocol analysis and expert thought: concurrent verbalisations of thinking during experts' performance on representative tasks. In: Ericsson KA, ed. The Cambridge Handbook of Expertise and Expert Performance: Cambridge University Press 2006:223-41.
citation: Artino AR Jr, Cleary TJ, Dong T, Hemmer PA, Durning SJ. Exploring clinical reasoning in novices: a self-regulated learning microanalytic assessment approach. Med Educ. 2014 Mar;48(3):280-91. doi: 10.1111/medu.12303.
citation: Cleary TJ, Sandars J. Assessing self-regulatory processes during clinical skill performance: a pilot study. Med Teach. 2011;33(7):e368-74. doi: 10.3109/0142159X.2011.577464.
citation: Brydges R, Nair P, Ma I, Shanks D, Hatala R. Directed self-regulated learning versus instructor-regulated learning in simulation training. Med Educ. 2012 Jul;46(7):648-56. doi: 10.1111/j.1365-2923.2012.04268.x.
citation: Dzik WH, Blajchman MA, Fergusson D, Hameed M, Henry B, Kirkpatrick AW, Korogyi T, Logsetty S, Skeate RC, Stanworth S, MacAdams C, Muirhead B. Clinical review: Canadian National Advisory Committee on Blood and Blood Products--Massive transfusion consensus conference 2011: report of the panel. Crit Care. 2011;15(6):242. doi: 10.1186/cc10498. Epub 2011 Dec 8.
citation: Cotton BA, Dossett LA, Au BK, Nunez TC, Robertson AM, Young PP. Room for (performance) improvement: provider-related factors associated with poor outcomes in massive transfusion. J Trauma. 2009 Nov;67(5):1004-12. doi: 10.1097/TA.0b013e3181bcb2a8.