Medical Education Clinical Trial
Official title:
Breaking Bad News in Obstetrics: A Trial of Simulation-Debrief Based Education
The purpose of this study is to assess the utility of training in Breaking Bad News (BBN)
skills. We hypothesize that given little or no formal training in breaking bad news,
obstetric providers will benefit from a curriculum of teaching breaking bad news techniques,
but will benefit more from a simulation teaching technique than from a lecture in breaking
bad news techniques.
The investigators also hypothesize that providers who have undergone breaking bad news
simulation will receive improved scores after the simulation debriefing compared to their
pre-simulation scores, and their improvement with be greater than the control group.
The investigators' study is part of a planned educational initiative on breaking bad news
communication skills, planned for house staff in the department of Obstetrics and
Gynecology. All subjects will undergo both a baseline and post-education simulation. The
investigators' study intervention is a personalized review and debriefing of the simulation,
as compared with a conventional lecture in order to assess the best curriculum for teaching
this skill set.
The investigators' study design will be described, consent obtained and consenting house
staff will be randomized to participate in a simulation-based education session/debrief or
to attend lecture. Randomization will be achieved using sequential opaque envelopes
containing allocation cards, designating group assignment. A physician who is not involved
in the study will randomly insert allocation cards into the envelopes and group assignment
will be concealed until after enrollment is complete.
Subjects will be assigned a study number. The list of subject identifiers and study numbers
will be kept separate from other study data, and destroyed after all phases of the study are
complete. All other study data will have identifying information deleted, and will be stored
in a password protected database.
The investigators plan to have subjects assess baseline characteristics and breaking bad
news skills using a self-assessment tool. Subsequently all house staff will be evaluated on
their management of breaking bad news through a baseline SP scenario, with assessments by
physician-teachers as well as the SPs . These SPs are non-physicians, and do not have
supervisory control over the study subjects. The physician-teachers are the co-investigators
on this study: Drs. Chazotte, Dayal, Landsberger, Bernstein, Goffman, and Karkowsky.
After this baseline assessment, the intervention group will debrief their baseline
simulation with a physician educator. The control group will instead undergo a conventional
lecture about "Breaking Bad News" techniques. Finally, both groups will undergo a second
simulation, which will be assessed by SPs and physician-teachers
After this step, subjects will fill out self-assessment tools on BBN. House staff who did
not undergo the conventional curriculum will then attend the lecture; similarly, those
subjects who were not in the intervention group will then have the opportunity to review
their simulation in a personal debriefing session.
Six months after the study, we plan to have all subjects fill out a self-assessment form to
assess if any long-term change to their BBN skills has been sustained.
SPs will be formally trained in the scenario and in their responses, as well as in
standardized assessment of the subjects.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator)
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