Increasing Reporting of Intimidation of Medical Students With Simulation

Increasing Reporting of Intimidation of Medical Students With Simulation: a Randomised Controlled Trial

Intimidation of medical students by health care professionals is a well-documented phenomenon. Raising awareness of what constitutes intimidation is a preferred method for preventing it through increased reporting. Simulation is a novel method of raising awareness of intimidation.

This is a randomised controlled trial comparing the effectiveness of simulation (involving actors), an educational video and no intervention, as adjuncts to group discussion, on students' ability to identify and report intimidation. Medical students from the University of Montreal in Montreal, Canada, will be recruited at the beginning of surgical clerkship. They will complete a standardized and validated pre-intervention questionnaire on their experience with intimidation consisting of multiple choice questions and short answers. They will be randomised to one of the three interventions lasting 70 minutes that will be followed by a 20-minute standardized discussion on intimidation with all students participating together. At the end of their surgical rotation, they will complete a similar post-intervention questionnaire with additional questions pertaining to the reporting of intimidation.

Differences in intimidation reporting after the intervention as well as a before and after comparison of the "Negative Acts Questionnaire" score will be studied.

Study Overview

• Status: Completed
• Conditions: Intimidation
• Intervention / Treatment: Behavioral: Simulation; Behavioral: Video; Behavioral: Control group

• Study Type: Interventional
• Enrollment (Actual): 129
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Quebec
    • Montréal, Quebec, Canada, H3T 1J4
      • Faculté de Médecine de l'Université de Montréal

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Medical students at the University of Montreal at the beginning of their surgical clerkship rotation.

Exclusion Criteria:

-

Study Plan

How is the study designed?

Design Details

• Primary Purpose: PREVENTION
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: DOUBLE

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Simulation; During a suturing class at the simulation center, the students enter a classroom. Although the students are not aware of this, among them is an actor playing the role of a student. One of the two professors is also an actor. As the activity progresses, the professor targets the student played by an actor. The intimidation intensifies until the end. At the end of the activity, there is a debriefing explaining to the students that the bullying professor and the victim were actors.	Behavioral: Simulation; Students witness the intimidation of one of their peers (who is an actor) by a professor (also an actor). (see arm description)
EXPERIMENTAL: Video; During a suturing class at the simulation center, after 55 minutes of suturing, the students will be exposed to a 15-minute video on workplace and hospital intimidation and how to manage it.	Behavioral: Video; Student watch a 15-minute intimidation video (see arm description).
PLACEBO_COMPARATOR: Control; During a suturing class at the simulation center, the students suture for the entire 70-minute duration of the activity. They are not exposed to intimidation (control group).	Behavioral: Control group; No intervention. The students suture for 70 minutes

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Comfort in reporting intimidation	Based on post-intervention questionnaire question.	6 weeks after enrollment
Perception of intimidation after intervention	Based on post-intervention Negative Acts Questionnaire (NAQ-R)	6 weeks after enrollment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Baseline prevalence of intimidation	Based on pre-intervention Negative Acts Questionnaire (NAQ-R)	at enrollment
Before and after comparison	Difference between pre and post-intervention Negative Acts Questionnaire (NAQ-R)	at enrollment vs 6 weeks post-intervention
Reasons for not reporting intimidation	Open-ended question asking why students don't report intimidation	at enrollment
Frequency of intimidation reporting	Did the students report intimidation during the 6 weeks of their surgical clerkship?	6 weeks post-intervention

Collaborators and Investigators

• Sponsor: Centre hospitalier de l'Université de Montréal (CHUM)

Publications and helpful links

General Publications

• Stone JP, Charette JH, McPhalen DF, Temple-Oberle C. Under the knife: medical student perceptions of intimidation and mistreatment. J Surg Educ. 2015 Jul-Aug;72(4):749-53. doi: 10.1016/j.jsurg.2015.02.003.
• Isaranuwatchai W, Brydges R, Carnahan H, Backstein D, Dubrowski A. Comparing the cost-effectiveness of simulation modalities: a case study of peripheral intravenous catheterization training. Adv Health Sci Educ Theory Pract. 2014 May;19(2):219-32. doi: 10.1007/s10459-013-9464-6. Epub 2013 Jun 1.
• Curtis MT, DiazGranados D, Feldman M. Judicious use of simulation technology in continuing medical education. J Contin Educ Health Prof. 2012 Fall;32(4):255-60. doi: 10.1002/chp.21153.
• Einarsen S, Helge H, Notelaers G. Measuring exposure to bullying and harassment at work: validity, factor structure & psychometric properties of the negative acts questionnaire-revised. Work Stress 23(1):24-44, 2009.

Study record dates

Study Major Dates

• Study Start (ACTUAL): June 15, 2017
• Primary Completion (ACTUAL): December 21, 2017
• Study Completion (ACTUAL): December 21, 2017

Study Registration Dates

• First Submitted: June 8, 2017
• First Submitted That Met QC Criteria: June 8, 2017
• First Posted (ACTUAL): June 12, 2017

Study Record Updates

• Last Update Posted (ACTUAL): May 9, 2018
• Last Update Submitted That Met QC Criteria: May 8, 2018
• Last Verified: May 1, 2018

More Information

Terms related to this study

• Keywords: Medical education; Surgical education; Simulation; Intimidation
• Other Study ID Numbers: 16.422

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No