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Ageing and Acute Care Physicians' Performance

Sponsor
Sunnybrook Health Sciences Centre (Other)
Overall Status
Active, not recruiting
CT.gov ID
NCT02683447
Collaborator
University of Toronto (Other), University of Ottawa (Other)
70
Enrollment
2
Locations
71
Anticipated Duration (Months)
35
Patients Per Site
0.5
Patients Per Site Per Month

Study Details

Study Description

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.

Condition or Disease Intervention/Treatment Phase
  • Other: CRM 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.

Study Design

Study Type:
Observational
Anticipated Enrollment :
70 participants
Observational Model:
Cohort
Time Perspective:
Prospective
Official Title:
Impact of Acute Care Physician's Age on Crisis Management Performance and Learning After Simulation-based Education
Actual Study Start Date :
Jan 1, 2017
Anticipated Primary Completion Date :
Dec 1, 2022
Anticipated Study Completion Date :
Dec 1, 2022

Arms and Interventions

Arm Intervention/Treatment
CRM Simulation

Each participant will manage a PEA arrest scenario (pre-test) and then be debriefed on their CRM skills by a trained facilitator for 20 minutes. They will then manage another crisis scenario (PEA arrest with a different inciting event) as an immediate post-test. Three months afterwards participants will return to manage a third PEA arrest scenario, which will serve as a retention post-test.

Other: CRM Simulation
Each participant will manage a PEA arrest scenario (pre-test) and then be debriefed on their CRM skills by a trained facilitator for 20 minutes. They will then manage another crisis scenario (PEA arrest with a different inciting event) as an immediate post-test. Three months afterwards participants will return to manage a third PEA arrest scenario, which will serve as a retention post-test.

Outcome Measures

Primary Outcome Measures

  1. CRM Performance during first sim scenario assessed by Ottawa Global Rating Scale (GRS) [After managing first simulation scenario - Day 1]

    Ottawa GRS score will be correlated with age

  2. CRM Performance during first sim scenario assessed by ACLS checklist [After managing first simulation scenario - Day 1]

    ACLS score will be correlated with age

Secondary Outcome Measures

  1. Learning from high-fidelity simulation education assessed by Ottawa Global Rating Scale [After managing second simulation scenario - Day 1]

    Ottawa GRS score will be compared to score in first scenario to look for improvement

  2. Learning from high-fidelity simulation education assessed by ACLS checklist [After managing second simulation scenario - Day 1]

    ACLS score will be compared to score in first scenario to look for improvement

Other Outcome Measures

  1. Retention of learning from simulation as assessed by Ottawa Global Rating Scale [3 months after completing first two scenarios - Day 90]

    Ottawa GRS score will be compared to score in second scenario on Day 1 to look for improvement

  2. Retention of learning from simulation as assessed by ACLS checklist [3 months after completing first two scenarios - Day 90]

    ACLS score will be compared to score in second scenario on Day 1 to look for improvement

Eligibility Criteria

Criteria

Ages Eligible for Study:
N/A and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
Yes
Inclusion Criteria:

  • Emergency physicians

  • Critical care physicians

  • Anesthesiologists

  • minimum 5 years of practice post-residency

Exclusion Criteria:
  • Post-call day of participation

Contacts and Locations

Locations

Site City State Country Postal Code
1 University of Ottawa Ottawa Ontario Canada K1H 8L6
2 Sunnybrook Health Sciences Centre Toronto Ontario Canada M4N3M5

Sponsors and Collaborators

  • Sunnybrook Health Sciences Centre
  • University of Toronto
  • University of Ottawa

Investigators

  • Principal Investigator: Fahad Alam, MD, FRCPC, Sunnybrook Health Sciences Centre
  • Principal Investigator: Sylvain Boet, MD, MEd, PhD, University of Ottawa

Study Documents (Full-Text)

None provided.

More Information

Publications

Responsible Party:
Dr. Fahad Alam, Anesthesiologist, Sunnybrook Health Sciences Centre
ClinicalTrials.gov Identifier:
NCT02683447
Other Study ID Numbers:
  • 140-2015
First Posted:
Feb 17, 2016
Last Update Posted:
Feb 9, 2022
Last Verified:
Feb 1, 2022
Individual Participant Data (IPD) Sharing Statement:
No
Plan to Share IPD:
No
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
No
Keywords provided by Dr. Fahad Alam, Anesthesiologist, Sunnybrook Health Sciences Centre
Continuing Medical Education
Simulation
Non-technical Skills
Crisis Resource Management

Study Results

No Results Posted as of Feb 9, 2022