Learning Retention in Radiograph Interpretation

Fractures, Bone Clinical Trial

Official title:

Optimizing Skill Retention in Radiograph Interpretation: A Multicentre Randomized Control Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03370900
• Other study ID #: 1000028986
• Status: Completed
• Phase: N/A
• Start date: November 1, 2014
• Est. completion date: June 15, 2016

Study information

• Verified date: December 2017
• Source: The Hospital for Sick Children
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Learning retention after the deliberate practice of radiograph interpretation may be challenging for image types which are common enough to be clinically relevant but not so common that proficiency can be sustained through clinical practice. This is especially relevant for radiographs such as paediatric elbow films (EXR) that carry high risks for the patient if pathology is missed. Building on prior research in this area, this study will develop an innovative computer learning application for paediatric EXR interpretation. After an initial learning period, this study will quantitatively determine the rate of skill decay and the optimal timing for refresher-education.

Description:

Objectives Learning retention after the deliberate practice of radiograph interpretation may be challenging for image types which are common enough to be clinically relevant but not so common that proficiency can be sustained through clinical practice. This is especially relevant for radiographs such as paediatric elbow films (EXR) that carry high risks for the patient if pathology is missed. Building on our prior research in this area, this study will develop an innovative computer learning application for paediatric EXR interpretation. After an initial learning period, this study will quantitatively determine the rate of skill decay and the optimal timing for refresher-education.

Design A prospective cohort design with purposive sampling will be used to develop the EXR education intervention. A four arm randomized control trial will be used to test for the outcomes of skill decay and optimal timing of refresher education.

Setting The education intervention will be developed at two tertiary care children's hospitals. Study participants will include physicians from two large paediatric education networks in the United States (Paediatric Outcomes in Simulation Education) and Canada (Paediatric Emergency Research Canada).

Statistical analysis For the primary analysis, a four-group multi-level model with time-points nested within participants will be used. Secondary analyses will include a time series approach within each block of 20 test EXR to check for sequential effects, and between each block to determine whether we can efficiently model skill decay curves that can separate the underlying learning attrition curve from the effects of "boluses" of education.

Conclusion This study anticipates that learners will increase their learning of elbow radiographs by participating in the deliberate practice of radiographs, with skill decay over time that will be mitigated by refresher education. The results will allow evidence based recommendations regarding refresher education for learning from item banks of radiographs.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 233
• Est. completion date: June 15, 2016
• Est. primary completion date: June 15, 2016
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: N/A to 70 Minutes

Eligibility

Inclusion Criteria:

• Pediatric and emergency medicine residents enrolled in an accredited residency in Canada and the United States

Exclusion Criteria:

• None

Related Conditions & MeSH terms

• Fractures, Bone

Intervention

Other:
• Testing
Participants either received 20 case testing with or without feedback

Locations

Country	Name	City	State
n/a

Sponsors (3)

Lead Sponsor	Collaborator
The Hospital for Sick Children	New York University, St. Justine's Hospital

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Accuray	The percent of cases that were diagnosed correctly by the study participants	12 months after learning intervention
Secondary	Accuracy	The percent of cases that were diagnosed correctly by the study participants	2, 4, 6, 8, 10 months
Secondary	Experience Curve	Learning and forgetting curve for each group by linking learning curve parameters (y-intercept, slope) with the amount of forgetting (T12 score).	12 months