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Analyzing Challenging Clinical Discussions in Orthopaedics

Effectiveness of Teach-back in Orthopedic Treatment Decision Discussions

Status
Terminated
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03058393
Enrollment
7
Registered
2017-02-20
Start date
2017-04-17
Completion date
2018-11-07
Last updated
2019-12-17

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Arthritis, Knee Arthropathy, Knee Osteoarthritis, Teach-Back Communication

Brief 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.

Interventions

OTHERTeach-Back Lesson

A teach-back lesson will be given to providers (teach-back group) who have challenging clinical discussions with patients

Sponsors

Duke University
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
Yes

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

Design outcomes

Primary

MeasureTime frameDescription
Provider's uninterrupted utterancesEnd of discussion with patient, 20 minutesWe 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
Patient/provider talking ratioEnd of discussion with patient, 20 minutesThis 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.

Secondary

MeasureTime frameDescription
Providers perceptions about teach-backEnd of semi-structured interview, one hourThis outcome will be assessed via semi-structured interviews.
Providers belief of future use of teach-backEnd of semi-structured interview, one hourThis outcome will be assessed via the semi-structured interview

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026