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Completed

NCT Number: NCT05284838

Facilitating Adaptive Expertise in Learning Computed Tomography

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.

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Key information

Conditions

Adaptive Expertise Error Management Training Learning

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Stanford University

Stanford, California, 94305, United States

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

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

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

Treatment and study plan

Error Management Training (Difficult)

Other

Error Management Training is used to teach head computed tomography interpretation. Participants encounter difficult questions.

Error Management Training (Easy)

Other

Error Management Training is used to teach head computed tomography interpretation. Participants encounter easy questions.

Error Avoidance Training

Other

Error Avoidance Training used to teach head computed tomography interpretation.

Primary outcomes

  1. 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%.

Secondary outcomes

  1. 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%.

  2. 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%.

  3. 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.

Sponsors and collaborators

Lead sponsor

Stanford University

Other

Collaborators

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

Registry information

Official study title

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

Acronym: FAIL CT

Important dates

Study start
2022
Primary completion
2023
Study completion
2023
First posted
Mar 17, 2022
Registry last updated
Apr 2, 2024

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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