Crisis Resource Management Improvement Through Intellectual Questioning of Authority

Medical Education, Simulation, Crisis Resource Management Clinical Trial

— CRITIQue  

Official title:

Crisis Resource Management Improvement Through Intellectual Questioning of Authority

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03707964
• Other study ID #: CRITIQue
• Status: Completed
• Phase: N/A
• Start date: March 11, 2019
• Est. completion date: November 20, 2020

Study information

• Verified date: March 2021
• Source: National University Hospital, Singapore
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a randomized controlled trial examining the effectiveness of a teaching intervention on residents' and medical students' ability to challenge clearly wrong decisions by a superior during a simulated life-threatening crisis. Participants will be randomly allocated into the control or intervention arm. The intervention arm will receive education on crisis resource management (CRM) and teaching targeting the cognitive skills required to monitor and challenge a superior's decision, and conflict resolution tools. Participants will then take part in a simulation scenario 2 to 4 weeks later and will be assessed based on 6 challenge points, followed by a debrief session.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 25
• Est. completion date: November 20, 2020
• Est. primary completion date: September 20, 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 21 Years and older

Eligibility

Inclusion Criteria:

• Medical officers or Internal medicine, surgical and emergency medicine residents who are in their 2nd post-graduate year of training, or

• Phase V medical students from Yong Loo Lin School of Medicine, National University of Singapore

Exclusion Criteria:

• Refusal for informed consent, or

• Refusal for video recording during simulation sessions

Related Conditions & MeSH terms

• Medical Education, Simulation, Crisis Resource Management

Intervention

Other:
• Crisis Resource Management Skill Training
Focused crisis resource management training which targets at the cognitive skills needed to monitor and challenge a superior's decision.
• Standard ACLS Training
Standard didactic interactive session on Advanced Cardiac Life Support (ACLS) principles.

Locations

Country	Name	City	State
Singapore	National University Hospital, Singapore	Singapore

Sponsors (1)

Lead Sponsor	Collaborator
National University Hospital, Singapore

Country where clinical trial is conducted

Singapore, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Qualitative analysis of themes surrounding hierarchy and challenging authority	Themes elicited during open disclosure and discussion during debrief session with participants	10 minutes
Primary	Effect of a teaching intervention on participants' ability to challenge clearly wrong decisions by a superior during a simulated life-threatening crisis	Comparison of the best modified Advocacy-Inquiry Score (mAIS) responses of the 6 challenge opportunities between the intervention and control groups. The mAIS is a modification of the Advocacy-Inquiry method which includes five scoring levels with the addition of a sixth level when a trainee attempts to take over management of the case.	20 minutes
Secondary	Influence of the confederate's gender on participant's ability to challenge incorrect decisions	Comparison of the median modified Advocacy-Inquiry Score (mAIS) responses between the subjects exposed to male versus female confederate specialist. The mAIS is a modification of the Advocacy-Inquiry method which includes five scoring levels with the addition of a sixth level when a trainee attempts to take over management of the case.	20 minutes