- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT07615582
Clinical Performance and Multitasking in Anesthesia : a Simulation-based Study (FOCUS)
Cognitive failure under multitasking conditions has been demonstrated in various settings, including healthcare. However, in anesthesiology, the impact of multitasking on clinical performance in a simulated environment has not yet been fully characterized.
The objective of our study is to evaluate the impact of multitasking on anesthesiologists' clinical performance in a simulated setting.
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
This study is a prospective, single-center, non-interventional, randomized crossover study, within-control subject.
The study was classified as non-interventional by the institutional research committee, as the intervention consists of simulation training and the study population is healthcare practitioners.
The study participants are anesthesiologists: attending physicians and residents. Each participant will serve as their own control. The study will comprise two visits: one intervention visit consisting of a multitasking simulation session, and one control visit involving clinical questions administered under quiet conditions. The order of the visits will be randomized between participants using a crossover design in order to minimize potential learning bias.
The multitasking condition will consist of manual mask ventilation performed on a manikin while participants are simultaneously exposed to oral clinical questions administered in the form of Script Concordance Tests (SCTs). Participants will be instructed to ventilate the manikin at a tidal volume of 500 ml and a respiratory rate of 16 cycles/minute.
Clinical reasoning under quiet conditions will also consist of answering oral clinical questions in the SCT format.
The study will use a 44-item Script Concordance Test (SCT) distributed across 20 anesthesiology clinical vignettes. Vignettes are distributed as follows: 8 vignettes with 3 items, 8 vignettes with 2 items, and 4 vignettes with 1 item. The vignettes were adapted, without modification of their content, to be compatible with oral administration and the simulation scenario.
In addition, for each participant, the SCT clinical vignettes will be randomized between the "simulation vignettes" and the "control vignettes," with stratification according to the number of items per vignette. 5 vignettes will be allocated to intervention, and 15 to control. This approach will help limit the effect of differences in vignette difficulty that could otherwise bias the results. At the group level, all clinical vignettes will ultimately be assessed both in the simulation and in the control conditions.
Detailed information is available in the study protocol.
Tipo di studio
Iscrizione (Stimato)
Contatti e Sedi
Contatto studio
- Nome: Jean-Noël Evain, MD, PhD
- Numero di telefono: +33476766829
- Email: jnevain@chu-grenoble.fr
Backup dei contatti dello studio
- Nome: Caroline Sanchez, PhD
- Numero di telefono: 0476766829
- Email: csanchez5@chu-grenoble.fr
Luoghi di studio
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Grenoble, Francia, 38700
- Centre d'Évaluation et de Simulation Alpes Recherche (CESAR)
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Contatto:
- Jean-Noël Evain, MD, PhD
- Numero di telefono: 0476766829
- Email: jnevain@chu-grenoble.fr
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Contatto:
- Alexis Lesage, MD
- Numero di telefono: 0476766829
- Email: ALesage@chu-grenoble.fr
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Metodo di campionamento
Popolazione di studio
Descrizione
Inclusion Criteria:
- Anesthesiology and intensive care resident or attending physician
- Written informed consent
Exclusion Criteria:
- None
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Concordance score with the expert panel on a Script Concordance Test (SCT)
Lasso di tempo: At two time points: - During simulation session under multitasking conditions - During control visit under quiet conditions
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Each item of the SCT is scored out of 1 point, and the sum of the points, converted to a 100-point scale, defines the percentage of concordance with the expert panel.
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At two time points: - During simulation session under multitasking conditions - During control visit under quiet conditions
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Manual ventilation performance assessed by deviation from the instructed tidal volume per cycle (milliliters).
Lasso di tempo: During simulation, comparison between manual ventilation interrupted by clinical questions versus manual ventilation alone
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│Instructed tidal volume- Observed tidal volume│/ cycle (milliliters)
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During simulation, comparison between manual ventilation interrupted by clinical questions versus manual ventilation alone
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Manual ventilation performance assessed by deviation from the instructed respiratory rate (cycles/minutes).
Lasso di tempo: During simulation, comparison between manual ventilation interrupted by clinical questions versus manual ventilation alone
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│Instructed respiratory rate- Observed respiratory rate│
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During simulation, comparison between manual ventilation interrupted by clinical questions versus manual ventilation alone
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Cognitive load assessed by the NASA-TLX index (score out of 100)
Lasso di tempo: A two time points: - Evaluating cognitive load of manual ventilation alone, at the begginning of the simulation session - Evaluation cognitive load of multitasking, at the end of the simulation session
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The Official NASA Task Load Index (TLX) is a subjective workload assessment tool.
By incorporating a multi-dimensional rating procedure, NASA TLX derives an overall workload score based on a weighted average of ratings on six subscales: mental demand, physical demand, temporal demand, performance, effort, frustration.
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A two time points: - Evaluating cognitive load of manual ventilation alone, at the begginning of the simulation session - Evaluation cognitive load of multitasking, at the end of the simulation session
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Time to answer items of the script concordance test (seconds)
Lasso di tempo: Two time points: intervention and control.
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Time between end of question and beggining of answer for each item of the script concordance test. Evaluates the interruption lag. |
Two time points: intervention and control.
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Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Sub-group analysis of the primary outcome measure
Lasso di tempo: Two time points: intervention and control.
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Subgroups:
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Two time points: intervention and control.
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Collaboratori e investigatori
Sponsor
Pubblicazioni e link utili
Pubblicazioni generali
- Westbrook JI, Woods A, Rob MI, Dunsmuir WT, Day RO. Association of interruptions with an increased risk and severity of medication administration errors. Arch Intern Med. 2010 Apr 26;170(8):683-90. doi: 10.1001/archinternmed.2010.65.
- Sujka JA, Safcsak K, Bhullar IS, Havron WS 3rd. Simulation-Based Testing of Pager Interruptions During Laparoscopic Cholecystectomy. J Surg Educ. 2018 Sep-Oct;75(5):1351-1356. doi: 10.1016/j.jsurg.2018.01.012. Epub 2018 Feb 1.
- Murji A, Luketic L, Sobel ML, Kulasegaram KM, Leyland N, Posner G. Evaluating the effect of distractions in the operating room on clinical decision-making and patient safety. Surg Endosc. 2016 Oct;30(10):4499-504. doi: 10.1007/s00464-016-4782-4. Epub 2016 Feb 19.
- McCurdie T, Sanderson P, Aitken LM. Traditions of research into interruptions in healthcare: A conceptual review. Int J Nurs Stud. 2017 Jan;66:23-36. doi: 10.1016/j.ijnurstu.2016.11.005. Epub 2016 Nov 10.
- Adams TN, Rho JC. Multitasking simulation: Present application and future directions. Med Teach. 2017 Feb;39(2):120-122. doi: 10.1080/0142159X.2016.1230666. Epub 2016 Sep 15.
- Jackson KM, Shaw TH, Helton WS. Evaluating the dual-task decrement within a simulated environment: Word recall and visual search. Appl Ergon. 2023 Jan;106:103861. doi: 10.1016/j.apergo.2022.103861. Epub 2022 Aug 20.
- Gui JL, Nemergut EC, Forkin KT. Distraction in the operating room: A narrative review of environmental and self-initiated distractions and their effect on anesthesia providers. J Clin Anesth. 2021 Feb;68:110110. doi: 10.1016/j.jclinane.2020.110110. Epub 2020 Oct 16.
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- RNIPH-2026-CESAR-FOCUS
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Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .
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