Fractures, BoneNCT03370900
Learning Retention in Radiograph Interpretation
A study testing Testing in people with Fractures, Bone, run by The Hospital for Sick Children.
Trial summary
Learning retention after the deliberate practice of radiograph interpretation may be challenging for image types which are common enough to be clinically relevant but not so common that proficiency can be sustained through clinical practice. Read more about this study
- Who is it for?
- Ages Up to 70 minutesHealthy volunteers can take part
- Conditions the study is for
- Fractures, Bone
- What is being tested?
- Testing
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 233 participants
- Where
- No sites listed yet
- Study dates
- 1 Nov 2014to 15 Jun 2016
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Up to 70 minutes
- All sexes
- Healthy volunteers accepted
- Child
Who may be able to join
- Pediatric and emergency medicine residents enrolled in an accredited residency in Canada and the United States
Who cannot join
- None
About this study
Official title: Optimizing Skill Retention in Radiograph Interpretation: A Multicentre Randomized Control Trial
Learning retention after the deliberate practice of radiograph interpretation may be challenging for image types which are common enough to be clinically relevant but not so common that proficiency can be sustained through clinical practice. This is especially relevant for radiographs such as paediatric elbow films (EXR) that carry high risks for the patient if pathology is missed. Building on prior research in this area, this study will develop an innovative computer learning application for paediatric EXR interpretation. After an initial learning period, this study will quantitatively determine the rate of skill decay and the optimal timing for refresher-education.
Read the detailed description
Objectives Learning retention after the deliberate practice of radiograph interpretation may be challenging for image types which are common enough to be clinically relevant but not so common that proficiency can be sustained through clinical practice. This is especially relevant for radiographs such as paediatric elbow films (EXR) that carry high risks for the patient if pathology is missed. Building on our prior research in this area, this study will develop an innovative computer learning application for paediatric EXR interpretation. After an initial learning period, this study will quantitatively determine the rate of skill decay and the optimal timing for refresher-education.
Design A prospective cohort design with purposive sampling will be used to develop the EXR education intervention. A four arm randomized control trial will be used to test for the outcomes of skill decay and optimal timing of refresher education.
Setting The education intervention will be developed at two tertiary care children's hospitals. Study participants will include physicians from two large paediatric education networks in the United States (Paediatric Outcomes in Simulation Education) and Canada (Paediatric Emergency Research Canada).
Statistical analysis For the primary analysis, a four-group multi-level model with time-points nested within participants will be used. Secondary analyses will include a time series approach within each block of 20 test EXR to check for sequential effects, and between each block to determine whether we can efficiently model skill decay curves that can separate the underlying learning attrition curve from the effects of "boluses" of education.
Conclusion This study anticipates that learners will increase their learning of elbow radiographs by participating in the deliberate practice of radiographs, with skill decay over time that will be mitigated by refresher education. The results will allow evidence based recommendations regarding refresher education for learning from item banks of radiographs.
- Conditions
- Fractures, Bone
- Being tested
- Testing
- Keywords
- Education (Medical); Retention;
- Medical subject headings
- Fractures, Bone
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TestingOther
Participants either received 20 case testing with or without feedback
| Study group | Role | What they receive |
|---|---|---|
| Learning and Assessment at 12 months | No intervention | Study participants will complete an 80 case learning set followed by a 20-case post test. The study intervention in this group is a 20-case test at 12 months. |
| Testing Every Two Months | Experimental | Study participants will complete an 80 case learning set followed by a 20-case post test. Study participants in this group will receive the following study interventions: 20-case post tests without any feedback at 2, 4, 6, 8, 10, 12 months. Receives: Other: Testing |
| Low Bolus Feedback | Experimental | Study participants will complete an 80 case learning set followed by a 20-case post test. Study participants in this group will receive the following study interventions: 20-case post tests at 2, 4, 6, 8, 10, 12 months. At 6 months, the 20-case post-test will be delivered with feedback. Receives: Other: Testing |
| High Bolus Feedback | Experimental | Study participants will complete an 80 case learning set followed by a 20-case post test. Study participants in this group will receive the following study interventions: 20-case post tests at 2, 4, 6, 8, 10, 12 months. At 4, 8, and 12 months, the 20-case post-test will be delivered with feedback. Receives: Other: Testing |
What is being measured
The primary outcome is the main question the study is designed to answer.
Accuray
The percent of cases that were diagnosed correctly by the study participants
Measured: 12 months after learning intervention
Secondary outcomes (2)
Accuracy
The percent of cases that were diagnosed correctly by the study participants
Measured: 2, 4, 6, 8, 10 months
Experience Curve
Learning and forgetting curve for each group by linking learning curve parameters (y-intercept, slope) with the amount of forgetting (T12 score).
Measured: 12 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Dec 2017
- Study start1 Nov 2014
- Primary completion15 Jun 2016
- Study completion15 Jun 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Fractures, BoneStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Diagnosis
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- This was a four arm randomized control trial. All participants completed an 80-case deliberately practiced learning set of pediatric elbow radiographs followed by an immediate 20-case post-test. Following this, Group 1 had no testing until 12 months; Groups 2, 3, and 4 had testing (20 cases without feedback) every 2 months until 12 months, but Group 3 also had refresher education (20 cases with feedback) at six months while Group 4 had refresher education at two, six, and ten months.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 233 participants (actual)
Sponsor and investigators
- Lead sponsor
- The Hospital for Sick Children
- Sponsor type
- University, hospital or other
- Collaborators
- New York University, St. Justine's Hospital
- Responsible party
- Principal investigator, Kathy Boutis, The Hospital for Sick Children
- Investigators
- Kathy Boutis, Principal investigator, The Hospital for Sick Children
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03370900
- Sponsor's protocol ID
- 1000028986
- Status last verified
- Dec 2017
- First submitted
- 2 Dec 2017
- Last updated
- 22 Nov 2023
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 22 Nov 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Optimizing Skill Retention in Radiograph Interpretation: A Multicentre Randomized Control Trial
- ClinicalTrials.gov ID
- NCT03370900
- Acronym / sponsor ID
- 1000028986
- Conditions
- Fractures, Bone
- Keywords
- Education (Medical); Retention;
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 233 participants (actual)
- Lead sponsor
- The Hospital for Sick ChildrenUniversity, hospital or other
- Collaborators
- New York University, St. Justine's Hospital
- Study start
- 1 Nov 2014 (actual)
- Primary completion
- 15 Jun 2016 (actual)
- Study completion
- 15 Jun 2016 (actual)
- First posted
- 13 Dec 2017 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Learning retention after the deliberate practice of radiograph interpretation may be challenging for image types which are common enough to be clinically relevant but not so common that proficiency can be sustained through clinical practice. This is especially relevant for radiographs such as paediatric elbow films (EXR) that carry high risks for the patient if pathology is missed. Building on prior research in this area, this study will develop an innovative computer learning application for paediatric EXR interpretation. After an initial learning period, this study will quantitatively determine the rate of skill decay and the optimal timing for refresher-education.
Detailed description
Objectives Learning retention after the deliberate practice of radiograph interpretation may be challenging for image types which are common enough to be clinically relevant but not so common that proficiency can be sustained through clinical practice. This is especially relevant for radiographs such as paediatric elbow films (EXR) that carry high risks for the patient if pathology is missed. Building on our prior research in this area, this study will develop an innovative computer learning application for paediatric EXR interpretation. After an initial learning period, this study will quantitatively determine the rate of skill decay and the optimal timing for refresher-education.
Design A prospective cohort design with purposive sampling will be used to develop the EXR education intervention. A four arm randomized control trial will be used to test for the outcomes of skill decay and optimal timing of refresher education.
Setting The education intervention will be developed at two tertiary care children's hospitals. Study participants will include physicians from two large paediatric education networks in the United States (Paediatric Outcomes in Simulation Education) and Canada (Paediatric Emergency Research Canada).
Statistical analysis For the primary analysis, a four-group multi-level model with time-points nested within participants will be used. Secondary analyses will include a time series approach within each block of 20 test EXR to check for sequential effects, and between each block to determine whether we can efficiently model skill decay curves that can separate the underlying learning attrition curve from the effects of "boluses" of education.
Conclusion This study anticipates that learners will increase their learning of elbow radiographs by participating in the deliberate practice of radiographs, with skill decay over time that will be mitigated by refresher education. The results will allow evidence based recommendations regarding refresher education for learning from item banks of radiographs.
Study design
- Primary purpose
- Diagnosis
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 4
- Model description
- This was a four arm randomized control trial. All participants completed an 80-case deliberately practiced learning set of pediatric elbow radiographs followed by an immediate 20-case post-test. Following this, Group 1 had no testing until 12 months; Groups 2, 3, and 4 had testing (20 cases without feedback) every 2 months until 12 months, but Group 3 also had refresher education (20 cases with feedback) at six months while Group 4 had refresher education at two, six, and ten months.
| Arm | Type | Receives |
|---|---|---|
| Learning and Assessment at 12 months | No intervention | –Study participants will complete an 80 case learning set followed by a 20-case post test. The study intervention in this group is a 20-case test at 12 months. |
| Testing Every Two Months | Experimental | Other: TestingStudy participants will complete an 80 case learning set followed by a 20-case post test. Study participants in this group will receive the following study interventions: 20-case post tests without any feedback at 2, 4, 6, 8, 10, 12 months. |
| Low Bolus Feedback | Experimental | Other: TestingStudy participants will complete an 80 case learning set followed by a 20-case post test. Study participants in this group will receive the following study interventions: 20-case post tests at 2, 4, 6, 8, 10, 12 months. At 6 months, the 20-case post-test will be delivered with feedback. |
| High Bolus Feedback | Experimental | Other: TestingStudy participants will complete an 80 case learning set followed by a 20-case post test. Study participants in this group will receive the following study interventions: 20-case post tests at 2, 4, 6, 8, 10, 12 months. At 4, 8, and 12 months, the 20-case post-test will be delivered with feedback. |
Who may qualify
- Ages
- Up to 70 minutes
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child
Key inclusion criteria (1 listed)
- Pediatric and emergency medicine residents enrolled in an accredited residency in Canada and the United States
Key exclusion criteria (1 listed)
- None
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| TestingParticipants either received 20 case testing with or without feedback | Other | High Bolus Feedback, Low Bolus Feedback, Testing Every Two Months |
Primary outcome
Accuray
Time frame: 12 months after learning intervention
The percent of cases that were diagnosed correctly by the study participants
2 secondary outcomes
Accuracy
Time frame: 2, 4, 6, 8, 10 months
Experience Curve
Time frame: 12 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Nov 2023.
- Individual participant dataSharing planned: No
Related trials for Fractures, Bone
Recruiting
Lateral Ankle Treatment
Avulsion Fracture
Not yet recruiting
Magnesium Alloy Scaffold With Controlled Degradation for Periarticular Bone Defects
Periarticular Bone Defect, Proximal Humerus Fracture
Recruiting
Trial of Social Work Services in Fracture Clinic Setting
Orthopaedic Fractures, Socioeconomic Factors
Enrolling by invitationObservational study
GRACE II (General Retrospective Analysis of Commercial Experience With AGN1 LOEP)
Osteoporosis
Not yet recruiting
Comparison of GMI, PNF, and Standard Care for Post-Traumatic Elbow Stiffness Rehabilitation in Adults
Elbow Stiffess, Rehabilitation Treatment
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Kathy Boutis principal investigator
The Hospital for Sick Children
Questions about this trial
What is this clinical trial studying?
A study testing Testing in people with Fractures, Bone, run by The Hospital for Sick Children.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 22 Nov 2023. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Accuray (time frame: 12 months after learning intervention). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Nov 2023.