Forethought, Performance, Self-regulation
Conditions
Keywords
Massive transfusion protocols, Self-regulatory learning, Forethought, Clinical expertise, Simulation, Education
Brief summary
The purpose of the project is to investigate the function of self-regulatory processes in anesthesiologists and how application of these processes influence performance in a crisis situation.The investigators intend to explore specifically the first phase of self-regulation, i.e. the forethought phase which describes processes related to strategic planning, goal setting, goal orientation, and outcome expectation. The investigators hypothesize that prompting forethought before engaging in a simulated massive transfusion crisis situation will result in better task performance in anesthesiologists.
Detailed description
The investigators will conduct 3 studies building on each other. * Pilot Study: the purpose of this study is to develop measurement tools for forethought, performance and a tool for prompting forethought. This study will include 2 attending anesthesiologists and 2 anesthesia residents (PGY2, 5). * Study I: the purpose of this study is to validate the measurement tools for forethought, performance and the tool for prompting forethought. This will include 6 attending anesthesiologists, 6 PGY5 and 6 PGY2 anesthesia residents. * Study II: the purpose of this study is to investigate if prompting forethought in anesthesia residents will result in better performance in a simulated massive transfusion than no prompting.
Interventions
OTHERPrompting forethought
Participants will be asked questions which elicit specific forethought elements related to the given clinical situation. These are elements that relate to strategic planning, goal setting, goal orientation, imagery, outcome expectation. These context specific questions will be determined in the Pilot study and validated in Study I.
Sponsors
University Health Network, Toronto
Unity Health Toronto
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Pilot study: attending anesthesiologists at St. Michael's Hospital , PGY5, PGY2 anesthesia residents at University of Toronto * Study I: attending anesthesiologists at St. Michael's Hospital, PGY5, PGY2 anesthesia residents at University of Toronto * Study II: PGY2, PGY3, PGY4 anesthesia residents at University of Toronto
Exclusion criteria
* Refusal to take part in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Performance in managing simulated massive transfusion scenario | Each individual's performance will be video recorded and subsequently evaluated within 8 weeks. | Task specific performance tool will be developed in the Pilot study and will be validated in Study I. Each performance will be video recorded and two independent, blinded rater will evaluate the videos and assess performance. Performance assessment tool will be numerical including a 1-5 point scale for each performance element and a Global Rating Scale. Difference between massive transfusion management performance will be compared in anesthesia residents whose forethought is prompted to residents who don't receive prompting. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Correlation between forethought scores and performance scores. | Forethought scores and performance scores will be determined within 8 weeks after individuals participated in the study. | The investigators will determine if quality of forethought relates to quality of performance in anesthesia residents managing the simulated massive transfusion scenario. The Pilot study and Study I will be used to develop and validate a scoring form for forethought. This will include scores (1-5) for each forethought elements (strategic planning, goal setting, goal orientation, imaginary, outcome expectation) and a GRS (1-5). |
Other
| Measure | Time frame | Description |
|---|---|---|
| Development and validation of measurement tools for forethought, performance and a tool for prompting forethought. | Within 4 weeks after completion of Pilot study and Study I. | In the Pilot study, think-aloud protocol will be used to identify forethought elements in experts (attending anesthesiologists) and non-expert (anesthesia residents). The real-time interviews will be used to design the measurement tool for forethought and also to develop a tool for prompting forethought. Equally, performance in a simulated massive transfusion scenario in experts and non-experts will be used to develop a scoring format for performance. The provisional scoring format then will be reviewed by experts and the research group. Study I will determine construct and predictive validity and reproducibility (inter-rater reliability) of these measurement scores. |
Countries
Canada
Contacts
Primary ContactJohn G Laffey, MD, FCARCSI
Backup ContactMaya J Contreras, PhD, FCARCSI
Outcome results
None listed