Clinical trial NCT02683447: Ageing and Acute Care Physicians' Performance
Official title: Impact of Acute Care Physician's Age on Crisis Management Performance and Learning After Simulation-based Education
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Ageing
Keywords: Continuing Medical Education
Simulation
Non-technical Skills
Crisis Resource Management
Lead sponsor: Sunnybrook Health Sciences Centre
Sponsor class: OTHER
Collaborators: name: University of Toronto
name: University of Ottawa
First posted: 2016-02-17
Enrollment: 48
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Practicing emergency, critical care and anesthesia staff with a minimum 5 years of practice post residency will be approached for participation.

Brief summary: The proportion of older acute care physicians (ACPs) has been increasing. Ageing is associated with physiological changes and research investigating how such age-related physiological changes affect clinical performance is lacking. Specifically, Crisis Resource Management (CRM) consists of essential clinical skills in acute care specialties which when absent, can significantly impact patient safety. As such, the goals of this study are to investigate whether ageing has a correlation with baseline CRM skills of ACPs and whether ageing influences learning from high fidelity simulation.

Detailed description: The proportion of older acute care physicians (ACP), emergency, critical care \& anesthesia, has been steadily increasing. Ageing is associated with physiological changes, which in turn can influence a physician's clinical abilities and decision-making. The litigation and physician disciplinary data suggests that incidents involving all physicians are likely to occur later in practice, with degree of injury identified in the claims being of greater severity. However research, investigating how age-related physiological changes affect clinical performance and patient safety, is lacking.

CRM skills are essential skills within acute care specialties, and are vital for patient safety. CRM encompasses technical skills, as well as a rapid and organized approach to non-technical, cognitive skills such as decision-making, task management, situational awareness and team management. High-fidelity full body mannequin simulation-based education is effective for learning CRM, including transfer of skills from the simulated setting to the clinical setting and improving patient outcome. However, there is a gap in the literature on whether physicians' age influences baseline CRM performance and also learning from simulation-based education.

Although the effectiveness of high-fidelity simulation-based education has been studied extensively in junior learner populations (students, residents, fellows), there are a limited number of studies investigating its effectiveness in teaching CRM in the ageing physician population. In fact, a recent systematic review looking at the role of simulation in continuing medical education (CME) in ACPs supported that there is limited evidence supporting improved learning. Despite not knowing whether simulation is the correct tool in an ageing population, it is being recommended as a training, regulation and assessment tool for practicing physicians.

Objectives:

The goals of this study are to:

1. Investigate whether ageing has a correlation with baseline CRM skills of ACPs using simulated crisis scenarios and
2. Assess whether ageing influences learning from high fidelity simulation.

Eligibility criteria: Inclusion Criteria:

* Emergency physicians
* Critical care physicians
* Anesthesiologists
* minimum 5 years of practice post-residency

Exclusion Criteria:

* Post-call day of participation

Primary outcomes:
measure: CRM Performance During First Sim Scenario Assessed by Ottawa Global Rating Scale (GRS)
timeFrame: After managing first simulation scenario - Day 1
measure: CRM Performance During First Sim Scenario Assessed by ACLS Checklist
timeFrame: After managing first simulation scenario - Day 1
Secondary outcomes:
measure: Learning From High-fidelity Simulation Education Assessed by Ottawa Global Rating Scale
timeFrame: After managing second simulation scenario - Day 1
measure: Learning From High-fidelity Simulation Education Assessed by ACLS Checklist
timeFrame: After managing second simulation scenario - Day 1
Other outcomes:
measure: Retention of Learning From Simulation as Assessed by Ottawa Global Rating Scale
timeFrame: 3 months after completing first two scenarios - Day 90
measure: Retention of Learning From Simulation as Assessed by ACLS Checklist
timeFrame: 3 months after completing first two scenarios - Day 90
Locations:
city: Ottawa
country: Canada
facility: University of Ottawa
state: Ontario
city: Toronto
country: Canada
facility: Sunnybrook Health Sciences Centre
state: Ontario
Study officials:
affiliation: Sunnybrook Health Sciences Centre
name: Fahad Alam, MD, FRCPC
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Ottawa
name: Sylvain Boet, MD, MEd, PhD
role: PRINCIPAL_INVESTIGATOR
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