Connie C Schmitz1, Jonathan P Braman2, Norman Turner3, Stephanie Heller4, David M Radosevich5, Yelena Yan6, Jane Miller7, Jeffrey G Chipman5. 1. Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA. Electronic address: schmi002@umn.edu. 2. Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA. 3. Department of Orthopedic Surgery, Mayo School of Graduate Medical Education, Rochester, Minnesota, USA. 4. Department of General Surgery, Mayo School of Graduate Medical Education, Rochester, Minnesota, USA. 5. Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA. 6. University of Minnesota, OIT Academic Technology, Minneapolis, Minnesota, USA. 7. University of Minnesota Academic Health Center Simulation Center, Minneapolis, Minnesota, USA.
Abstract
BACKGROUND: Teaching residents to lead end of life (EOL) and error disclosure (ED) conferences is important. METHODS: We developed and tested an intervention using videotapes of EOL and error disclosure encounters from previous Objective Structured Clinical Exams. Residents (n = 72) from general and orthopedic surgery programs at 2 sites were enrolled. Using a prospective, pre-post, block group design with stratified randomization, we hypothesized the treatment group would outperform the control on EOL and ED cases. We also hypothesized that online course usage would correlate positively with post-test scores. RESULTS: All residents improved (pre-post). At the group level, treatment effects were insignificant, and post-test performance was unrelated to course usage. At the subgroup level for EOL, low performers assigned to treatment scored higher than controls at post-test; and within the treatment group, post graduate year 3 residents outperformed post graduate year 1 residents. CONCLUSIONS: To be effective, online curricula illustrating communication behaviors need face-to-face interaction, individual role play with feedback and discussion.
RCT Entities:
BACKGROUND: Teaching residents to lead end of life (EOL) and error disclosure (ED) conferences is important. METHODS: We developed and tested an intervention using videotapes of EOL and error disclosure encounters from previous Objective Structured Clinical Exams. Residents (n = 72) from general and orthopedic surgery programs at 2 sites were enrolled. Using a prospective, pre-post, block group design with stratified randomization, we hypothesized the treatment group would outperform the control on EOL and ED cases. We also hypothesized that online course usage would correlate positively with post-test scores. RESULTS: All residents improved (pre-post). At the group level, treatment effects were insignificant, and post-test performance was unrelated to course usage. At the subgroup level for EOL, low performers assigned to treatment scored higher than controls at post-test; and within the treatment group, post graduate year 3 residents outperformed post graduate year 1 residents. CONCLUSIONS: To be effective, online curricula illustrating communication behaviors need face-to-face interaction, individual role play with feedback and discussion.