Facilitating Adaptive Expertise in Learning Computed Tomography (FAIL CT)

March 31, 2024 updated by: Leonardo Aliaga, Stanford University

The FAIL CT Study: Facilitating Adaptive Expertise in Learning Computed Tomography, a Multi-center Randomized Controlled Trial

The main objective of this study is to demonstrate that Error Management Training improves adaptive expertise in head computed tomography interpretation. The investigators will conduct a randomized controlled trial comparing two learning strategies, Error Management Training vs Error Avoidance Training, in emergency medicine residents. The investigators hypothesize that Error Management Training, as compared to Error Avoidance Training, will improve adaptive expertise, as measured by skills transfer, when used to teach head computed tomography interpretation to emergency medicine residents.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Adaptive expertise is the ability to apply existing skills to novel situations. Adaptive expertise enables physicians to reduce preventable medical errors when managing clinical scenarios not encountered during training. However, residency curricula rarely address this learning outcome. Error Management Training improves transfer of skills to new contexts and develops adaptive expertise. Although this methodology has been shown to improve adaptive expertise in procedural skills, its impact on cognitive skills in medical training remains underexplored. Error Management Training promises to improve patient care by developing emergency physicians' adaptive expertise. However, the investigators need further evidence for its efficacy with cognitive skills in residency training. The investigators aim to demonstrate that Error Management Training improves adaptive expertise in a cognitive skill, using head computed tomography interpretation as a model.

Study Type

Interventional

Enrollment (Actual)

150

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • California
      • Stanford, California, United States, 94305
        • Stanford University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Study participation will be available to all current emergency medicine residents at Stanford and at thirteen external sites.

Exclusion Criteria:

  • Adults unable to consent
  • Pregnant women
  • Individuals who are not yet adults (infants, children, teenagers)
  • Prisoners
  • Medical students
  • Residents from specialties other than emergency medicine

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Error Management Training (Difficult)
Participants receive the learning strategy Error Management Training and encounter difficult questions.
Other: Error Management Training (Difficult)
Error Management Training is used to teach head computed tomography interpretation. Participants encounter difficult questions.
Experimental: Error Management Training (Easy)
Participants receive the learning strategy Error Management Training and encounter easy questions.
Other: Error Management Training (Easy)
Error Management Training is used to teach head computed tomography interpretation. Participants encounter easy questions.
Active Comparator: Error Avoidance Training
Participants receive the learning strategy Error Avoidance Training.
Other: Error Avoidance Training
Error Avoidance Training used to teach head computed tomography interpretation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percent correct on an assessment of transfer of skills (adaptive expertise)
Time Frame: Immediately after instructional session (up to 60 minutes to complete the assessment)
Participants will have to demonstrate transfer of head computed tomography interpretation skills by interpreting novel radiology cases different from those used in the instructional session. Performance will be assessed by percent score on a head computed tomography interpretation test using novel radiology content not addressed in the instructional session. Score range is 0-100%.
Immediately after instructional session (up to 60 minutes to complete the assessment)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percent correct on an assessment of post-session proficiency for learning objectives (routine expertise)
Time Frame: Immediately after instructional session (up to 60 minutes to complete the assessment)
Participants will have to demonstrate direct application of the intervention's learning objectives by interpreting radiology cases similar to those used in the instructional session. Performance will be assessed by percent score on a head computed tomography interpretation test using radiology content similar to that used in the instructional session. Score range is 0-100%.
Immediately after instructional session (up to 60 minutes to complete the assessment)
Effect of post-graduate year level on post-test performance
Time Frame: Immediately after instructional session (up to 60 minutes to complete the assessment)
Performance on a head computed tomography interpretation test (both adaptive expertise and routine expertise cases) will be assessed by percent score, stratified by post-graduate year level to show differences across residency training stage. Score range is 0-100%.
Immediately after instructional session (up to 60 minutes to complete the assessment)
Mediation effect of errors on performance on the adaptive expertise cases
Time Frame: Number of errors will be measured during the educational intervention
The number of errors made during the educational intervention will be measured for both the Error Management Training (Difficult) arm and the Error Management Training (Easy) arm. A mediation analysis will be conducted to assess the effect of committing errors during learning on subsequent performance in the cases measuring adaptive expertise.
Number of errors will be measured during the educational intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Stanford University

Collaborators

The University of Texas Health Science Center, Houston
University of California, Los Angeles
University of Chicago
Brown University
University of Wisconsin, Madison
Vanderbilt University
Alameda Health System

Investigators

  • Principal Investigator: Leonardo Aliaga, MD, Stanford University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 18, 2022

Primary Completion (Actual)

July 31, 2023

Study Completion (Actual)

September 30, 2023

Study Registration Dates

First Submitted

March 10, 2022

First Submitted That Met QC Criteria

March 10, 2022

First Posted (Actual)

March 17, 2022

Study Record Updates

Last Update Posted (Actual)

April 2, 2024

Last Update Submitted That Met QC Criteria

March 31, 2024

Last Verified

March 1, 2024

More Information

Terms related to this study

Other Study ID Numbers

  • 64099

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

No current plan to share data.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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