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OpenTrials
Completed

NCT Number: NCT03707964

Crisis Resource Management Improvement Through Intellectual Questioning of Authority

This is a randomized controlled trial examining the effectiveness of a teaching intervention on residents' and medical students' ability to challenge clearly wrong decisions by a superior during a simulated life-threatening crisis. Participants will be randomly allocated into the control or intervention arm. The intervention arm will receive education on crisis resource management (CRM) and teaching targeting the cognitive skills required to monitor and challenge a superior's decision, and conflict resolution tools. Participants will then take part in a simulation scenario 2 to 4 weeks later and will be assessed based on 6 challenge points, followed by a debrief session.

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Key information

Conditions

Medical Education, Simulation, Crisis Resource Management

Age range

21 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

National University Hospital, Singapore

Singapore, 119085

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Medical officers or Internal medicine, surgical and emergency medicine residents who are in their 2nd post-graduate year of training, or
  • Phase V medical students from Yong Loo Lin School of Medicine, National University of Singapore

Exclusion criteria

  • Refusal for informed consent, or
  • Refusal for video recording during simulation sessions

Treatment and study plan

Crisis Resource Management Skill Training

Other

Focused crisis resource management training which targets at the cognitive skills needed to monitor and challenge a superior's decision.

Standard ACLS Training

Other

Standard didactic interactive session on Advanced Cardiac Life Support (ACLS) principles.

Primary outcomes

  1. Effect of a teaching intervention on participants' ability to challenge clearly wrong decisions by a superior during a simulated life-threatening crisis

    Time frame: 20 minutes

    Comparison of the best modified Advocacy-Inquiry Score (mAIS) responses of the 6 challenge opportunities between the intervention and control groups. The mAIS is a modification of the Advocacy-Inquiry method which includes five scoring levels with the addition of a sixth level when a trainee attempts to take over management of the case.

Secondary outcomes

  1. Influence of the confederate's gender on participant's ability to challenge incorrect decisions

    Time frame: 20 minutes

    Comparison of the median modified Advocacy-Inquiry Score (mAIS) responses between the subjects exposed to male versus female confederate specialist. The mAIS is a modification of the Advocacy-Inquiry method which includes five scoring levels with the addition of a sixth level when a trainee attempts to take over management of the case.

Other outcomes

  1. Qualitative analysis of themes surrounding hierarchy and challenging authority

    Time frame: 10 minutes

    Themes elicited during open disclosure and discussion during debrief session with participants

Sponsors and collaborators

Lead sponsor

National University Hospital, Singapore

Other

Registry information

Acronym: CRITIQue

Important dates

Study start
2019
Primary completion
2020
Study completion
2020
First posted
Oct 16, 2018
Registry last updated
Mar 3, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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