Clincosm LogoSign in Get a demo

Analyzing Challenging Clinical Discussions in Orthopaedics

Sponsor
Duke University (Other)
Overall Status
Terminated
CT.gov ID
NCT03058393
Collaborator
(none)
7
Enrollment
1
Location
1
Arm
18.7
Actual Duration (Months)
0.4
Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The goal of this study is to analyze patient:provider communication surrounding the discussion of difficult clinical conversations such as knee replacement options. This study will also examine how using the teach-back communication technique can improve communication between patients and providers. Orthopedic residents, fellows, physician assistants, and attendings that agree to participate will be consented. Patients, who are likely to engage in a difficult clinical conversation, such as those who have a clinical indication for a Total Knee Replacement or a Partial Knee Replacement, will be recruited from participating providers clinical schedules. Patient:provider interactions will be recorded and then the providers will attend a 1 hour education lecture about how to use teach-back. After attending the lecture, additional patient:provider interactions will be recorded and analyzed via a qualitative approach. Additionally, providers will participate in a semi-structured interview to capture their perceptions of teach-back and what challenges and benefits they may derive from using it.

Condition or Disease Intervention/Treatment Phase
  • Other: Teach-Back Lesson
 N/A

Study Design

Study Type:
Interventional
Actual Enrollment :
7 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Health Services Research
Official Title:
Effectiveness of Teach-back in Orthopedic Treatment Decision Discussions
Actual Study Start Date :
Apr 17, 2017
Actual Primary Completion Date :
Nov 7, 2018
Actual Study Completion Date :
Nov 7, 2018

Arms and Interventions

Arm Intervention/Treatment
Experimental: Teach-Back Group

A teach-back lesson will be provided to physician participants (Teach-Back Group), who are participating in challenging clinical discussions with patients

Other: Teach-Back Lesson
A teach-back lesson will be given to providers (teach-back group) who have challenging clinical discussions with patients

Outcome Measures

Primary Outcome Measures

  1. Provider's uninterrupted utterances [End of discussion with patient, 20 minutes]

    We will assess this outcome directly from audio-recorded conversations. A coding scheme will then be developed that captures the average length of provider utterance without asking a question or an interruption from a patient

  2. Patient/provider talking ratio [End of discussion with patient, 20 minutes]

    This outcome will also be assessed from audio-recorded conversations. The transcript will be coded and the coding scheme will compare how often and how long patients talk compared to provider talking.

Secondary Outcome Measures

  1. Providers perceptions about teach-back [End of semi-structured interview, one hour]

    This outcome will be assessed via semi-structured interviews.

  2. Providers belief of future use of teach-back [End of semi-structured interview, one hour]

    This outcome will be assessed via the semi-structured interview

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years to 80 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
Yes
Inclusion Criteria (Patient Participants):

  • Age 18 years and older

  • Clinical indication for multiple treatment options

Exclusion Criteria (Patient Participants):

  • Non-English speaking

  • Minors or non-consenting other individuals (spouses, friends, family members, children) in the patient room during the clinical visit

Inclusion Criteria (Provider Participants)

  • Age 18 years and older

  • A resident, fellow, physician assistant, or attending in the Duke Department of Orthopaedic Surgery

Exclusion criterion (Provider Participants):

• Non-English speaking

Contacts and Locations

Locations

Site City State Country Postal Code
1 Duke University Health System Durham North Carolina United States 27710

Sponsors and Collaborators

  • Duke University

Investigators

  • Principal Investigator: Richard C Mather III, MD, MBA, Duke University

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Duke University
ClinicalTrials.gov Identifier:
NCT03058393
Other Study ID Numbers:
  • Pro00079809
First Posted:
Feb 20, 2017
Last Update Posted:
Dec 17, 2019
Last Verified:
Jun 1, 2018
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
Additional relevant MeSH terms:
Osteoarthritis
Osteoarthritis, Knee
Joint Diseases

Study Results

No Results Posted as of Dec 17, 2019