Critical Illness Clinical Trial
— BRiDgEOfficial title:
Targeting Bias to Reduce Disparities in End of Life Care
This study aims to determine the ways in which clinician implicit racial biases affect clinician communication with family members of patients near the end of life and to test a novel physician training intervention to reduce the effects of implicit racial bias on quality of communication. Phase 1: A sample of 50 physicians who care for seriously ill patients, including oncologists, critical care physicians and hospital-based internists will participated in a simulated clinical encounter with a Black standardized family member (actor) of a hypothetical case patient. Measures of implicit and explicit bias will be correlated with verbal and nonverbal communication behavior. Phase 2: This is a 2-arm randomized feasibility pilot of an intervention to mitigate the effects of clinician implicit bias on communication behavior. Physicians who treat patients with serious illness including oncologists, critical care physicians and hospital-based internists will be recruited to participate in a communication training session to reduce the effects of implicit bias or a control training session focusing only on communication skills. Their communication behavior will be videotaped during a simulated encounter with a Black standardized family member (actor) of a hypothetical patient with serious illness before and after the training sessions. The communication behavior before and after the training session will be compared between physicians that received the communication skills only intervention versus the physicians that received the communication skills and bias mitigation training. The primary hypothesis is that physicians who receive both the communication skills and the bias mitigation training will have greater improvements in communication skills with the Black standardized caregiver (actor) compared with those who receive only the communication skills training.
Status | Recruiting |
Enrollment | 50 |
Est. completion date | October 23, 2024 |
Est. primary completion date | October 23, 2024 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Practicing physicians - Specializes in oncology, critical care, hospitalist medicine, emergency medicine or geriatrics Exclusion Criteria: - Physicians who do not care for seriously ill patients in the hospital at least 10% of their working time. - Physicians trained in Hospice and Palliative Medicine. |
Country | Name | City | State |
---|---|---|---|
United States | Montefiore Medical Center | Bronx | New York |
Lead Sponsor | Collaborator |
---|---|
Montefiore Medical Center |
United States,
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* Note: There are 35 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | verbal dominance | ratio of clinician to patient speaking time during the encounter, ranging from a minimum of 0 to a maximum of approximately 3 with a ratio of >1 meaning that the clinician dominated the discussion | during the intervention | |
Secondary | encounter duration | how long the physician speaks to the caregiver, ranging from 5 to 20 minutes with higher scores indicating more engagement | during the intervention | |
Secondary | Verbal communication | Quality of verbal communication as rated by standardized (actor) caregiver and researcher using the three-item CollaboRATE tool which has a minimum score of 0 and maximum of 30 with higher scores indicating better communication | during the intervention | |
Secondary | Nonverbal communication | Quality of nonverbal communication as rated by researcher using the Nonverbal Accommodation Analysis System which measures presence or absence of nonverbal communication behaviors (min 0= not present, max 1=present) for 10 communication behaviors during 2-minute time slices of videotaped encounters. | during the intervention |
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