Analyzing Challenging Clinical Discussions in Orthopaedics

Knee Osteoarthritis Clinical Trial

Official title:

Effectiveness of Teach-back in Orthopedic Treatment Decision Discussions

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT03058393
• Other study ID #: Pro00079809
• Status: Terminated
• Phase: N/A
• Start date: April 17, 2017
• Est. completion date: November 7, 2018

Study information

• Verified date: June 2018
• Source: Duke University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The goal of this study is to analyze patient:provider communication surrounding the discussion of difficult clinical conversations such as knee replacement options. This study will also examine how using the teach-back communication technique can improve communication between patients and providers. Orthopedic residents, fellows, physician assistants, and attendings that agree to participate will be consented. Patients, who are likely to engage in a difficult clinical conversation, such as those who have a clinical indication for a Total Knee Replacement or a Partial Knee Replacement, will be recruited from participating providers clinical schedules. Patient:provider interactions will be recorded and then the providers will attend a 1 hour education lecture about how to use teach-back. After attending the lecture, additional patient:provider interactions will be recorded and analyzed via a qualitative approach. Additionally, providers will participate in a semi-structured interview to capture their perceptions of teach-back and what challenges and benefits they may derive from using it.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 7
• Est. completion date: November 7, 2018
• Est. primary completion date: November 7, 2018
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 80 Years

Eligibility

Inclusion Criteria (Patient Participants):

• Age 18 years and older

• Clinical indication for multiple treatment options

Exclusion Criteria (Patient Participants):

• Non-English speaking

• Minors or non-consenting other individuals (spouses, friends, family members, children) in the patient room during the clinical visit

Inclusion Criteria (Provider Participants)

• Age 18 years and older

• A resident, fellow, physician assistant, or attending in the Duke Department of Orthopaedic Surgery

Exclusion criterion (Provider Participants):

• Non-English speaking

Related Conditions & MeSH terms

• Arthritis
• Joint Diseases
• Knee Arthropathy
• Knee Osteoarthritis
• Osteoarthritis, Knee
• Teach-Back Communication

Intervention

Other:
• Teach-Back Lesson
A teach-back lesson will be given to providers (teach-back group) who have challenging clinical discussions with patients

Locations

Country	Name	City	State
United States	Duke University Health System	Durham	North Carolina

Sponsors (1)

Lead Sponsor	Collaborator
Duke University

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Provider's uninterrupted utterances	We will assess this outcome directly from audio-recorded conversations. A coding scheme will then be developed that captures the average length of provider utterance without asking a question or an interruption from a patient	End of discussion with patient, 20 minutes
Primary	Patient/provider talking ratio	This outcome will also be assessed from audio-recorded conversations. The transcript will be coded and the coding scheme will compare how often and how long patients talk compared to provider talking.	End of discussion with patient, 20 minutes
Secondary	Providers perceptions about teach-back	This outcome will be assessed via semi-structured interviews.	End of semi-structured interview, one hour
Secondary	Providers belief of future use of teach-back	This outcome will be assessed via the semi-structured interview	End of semi-structured interview, one hour