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Education, MedicalCLIEnTNCT05674500

Coaching Language to Improve Endoscopy Training Quality

A study testing Educational Training on standardized coaching language and Educational Training on goal setting in people with Education, Medical and Colonoscopy, run by University of Texas Southwestern Medical Center at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of this randomized control study is to determine if the use of standardized coaching language by faculty trainers for teaching colonoscopy is associated with improved colonoscopy performance. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Education, Medical, Colonoscopy
What is being tested?
Educational Training on standardized coaching language and Educational Training on goal setting
Could I receive a placebo?
No, everyone receives an active treatment
How many people
25 participants
Where
1 siteUnited States
Study dates
23 Mar 2022to 30 Jun 2023
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 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Faculty members who are endoscopy trainers in either pediatric or adult gastroenterology division at University of Texas Southwestern Medical Center or Children's Medical Center, Dallas
  • Fellow trainees in pediatric or adult gastroenterology division at University of Texas Southwestern Medical Center or Children's Medical Center, Dallas

Who cannot join

  • Advanced endoscopy fellows
  • Fellows beyond Post-Graduate Year-6 (PGY-6)

Trial locations and contacts

1 site in 1 country.

United States1 site
  • UTSW

    Dallas, Texas, 75390

Other trials in United States

About this study

Official title: A Prospective Study of Standardized Coaching Language to Improve Endoscopy Training Quality

The goal of this randomized control study is to determine if the use of standardized coaching language by faculty trainers for teaching colonoscopy is associated with improved colonoscopy performance. The main questions it aims to answer are:

  • If the use of standardized coaching language is effective in improving colonoscopy training?
  • If the use of standardized coaching language influences the clarity of instructions by the faculty trainers during colonoscopy teaching Participants will take part in simulated colonoscopy teaching encounter using a virtual reality simulator for 1 hour in 2 different sessions 2 weeks apart.

Researchers will compare 2 groups of faculty trainers to to see if the standardized coaching language effects the colonoscopy training quality.

Being tested
Educational Training on standardized coaching language, Educational Training on goal setting
Keywords
Faculty, Fellows, Simulation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Educational Training on standardized coaching languageOther

    The faculty trainer participants in training groups will watch a 15-min long video between the two simulated endoscopy teaching encounters. The video link will be emailed to them 1 week before the second simulated encounter, and they can watch it in their own time. The training video will demonstrate the use of recommended coaching language for endoscopy instruction (e.g., recommended 14 standard terms, need to refer to the screen when directing a trainee as opposed to their hands, use of a clockface analogy) and communication best practices (e.g., checking to ensure understanding, avoidance of cognitive overload, task deconstruction).

  • Educational Training on goal settingOther

    The faculty trainer participants in the control groups will watch a 15-min long video between the two simulated endoscopy teaching encounters. The video link will be emailed to them 1 week before the second simulated encounter, and they can watch it in their own time. The video will be a 'dummy' colonoscopy training video which outlines how to set goals ahead of an endoscopy training session. The video will not discuss standardized coaching language and/or communication best practices.

Study groups in NCT05674500
Study groupRoleWhat they receive
Training GroupExperimentalFaculty participants will participate in educational training designed to teach them standardized coaching language for endoscopy instruction and strategies to promote effective communication during an endoscopy teaching. It will be comprised of: 1. A 15-minute-long training video demonstrating the use of recommended coaching language for endoscopy instruction (e.g., recommended 14 standard terms, need to refer to the screen when directing a trainee as opposed to their hands, use of a clockface analogy) and communication best practices (e.g., checking to ensure understanding, avoidance of cognitive overload, task deconstruction) 2. The faculty will be given a small (10x10 cm) flash card with the recommended 14 standard terms which they can access during the second simulated encounter. To control for any potential effect of the presence of the card on the trainee during teaching, each faculty be given an identical card with 14 random words on it to hold during the first encounter
Receives: Other: Educational Training on standardized coaching language
Control GroupActive comparatorFaculty participants will take part in 'dummy' educational training comprised of: 1. A 15-minute-long 'dummy' colonoscopy training video which outlines how to set goals ahead of an endoscopy training session. The video will not discuss standardized coaching language and/or communication best practices 2. This group will also be provided a small (10x10cm) flash card but with random words on it (identical to the first simulated colonoscopy teaching encounter).
Receives: Other: Educational Training on goal setting

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in colonoscopy performance

    The de-identified video-recording of the simulated colonoscopy will be assessed by blinded external rater.

    This will be done using the Gastrointestinal Endoscopy Competency Assessment Tool (GiECAT) which is a colonoscopy assessment tool with strong validity evidence. For the GiECAT, 6 global rating items on supervision scale (measuring from 1 to 5) and 5 checklist items which are applicable to simulated procedures (i.e., no patients involved) will be used. Since it is a competency based tool with a checklist, there is no maximum score, but instead is a rating scale.

    To ensure blinding, only the trainee's gloved hands will be seen, and the videos used for assessment of colonoscopy performance will not have sound to control for any effects the faculty instruction may have on the ratings of performance.

    Measured: Change from Baseline colonoscopy performance at 2 weeks

  2. Change in colonoscopy performance

    The de-identified video-recording of the simulated colonoscopy will be assessed by blinded external rater.

    This will be done using another colonoscopy assessment form with strong validity evidence - 8 'Procedure' items from the Joint Advisory Group on GI Endoscopy (JAG) Colonoscopy Direct Observation of Procedural Skills (DOPS) form. This is a supervision-based scale (measuring from 1 to 4). Since this is also a competency based tool with a checklist, it has a rating scale with no maximum score.

    To ensure blinding, only the trainee's gloved hands will be seen, and the videos used for assessment of colonoscopy performance will not have sound to control for any effects the faculty instruction may have on the ratings of performance.

    Measured: Change from Baseline colonoscopy performance at 2 weeks

Secondary outcomes (9)
  1. Change in 'Red-out' time

    The percentage of procedure time during which the endoscope tip (camera) was against the mucosa of the virtual bowel (i.e., there was no proper visualization of the bowel mucosa - appears as 'reddened out screen', aka 'red-out'), as auto-generated automatically by the colonoscopy simulator. The percentage ranges from 0 to 100.

    Measured: Change from baseline time in red-out at 2 weeks

  2. Change in time to cecum

    The time it took the trainee to reach the cecum, as auto-generated automatically by the colonoscopy simulator. This is reported in minutes and seconds (min:sec). The range from 0 to 20 minutes

    Measured: Change from baseline time to cecum at 2 weeks

  3. Change in Cognitive load

    Printed forms will be given to all participants immediately after the pre-and post-sessions to measure the cognitive load. It will be measured by 3 measurement tools (Outcome 5-7) Overall cognitive load: A single item rating tool asking participants to rate the amount of mental effort they required to complete the simulated endoscopy on a 9-point scale (1 = very, very small effort and 9 = very, very high effort).

    Measured: Change from Baseline cognitive load at 2 weeks

  4. Change in Cognitive load

    Printed forms will be given to all participants immediately after the pre-and post-sessions to measure the cognitive load.

    NASA Task Load Index (NASA-TLX): A 6-item rating scale with strong validity evidence that assesses perceived demand, effort and frustration in performing the task, with higher scores indicating an increased cognitive load (Ranges from 0 to 20).

    Measured: Change from Baseline cognitive load at 2 weeks

  5. Change in Cognitive load

    Printed forms will be given to all participants immediately after the pre-and post-sessions to measure the cognitive load.

    Cognitive Load Index for Colonoscopy (for trainees ONLY): A measure of intrinsic, extraneous, and germane cognitive load related to performing colonoscopy. Fifteen items that are applicable to the simulation will be rated. Given the nature of this scale, it will be administered to trainees only. Scale ranges from 1 (strongly disagree) to 10 (strongly agree).

    Measured: Change from Baseline cognitive load at 2 weeks

  6. Change in the Clarity of instruction (trainee's perception)

    The clarity of instruction will be rated by the trainee on a Likert scale, using linguistics specific metrics developed an expert in linguistics. Description-based scale with following categories- Excellent, Satisfactory, Needs Improvement and Not Acceptable.

    This form will be provided to the trainees only to assess their perception of the instructions provided by the faculty instructor.

    Measured: Change from Baseline trainer's language assessment at 2 weeks

  7. Change in the trainer's language (assessed by linguistics expert)

    Based on the de-identified video recordings, the trainer's clarity of instructions and use of recommended language will be rated using specialized linguistic-designed assessment rubric by a blinded external linguistics expert.

    Name of Measurement- Clarity of language and use of standardized terminology Measurement Tool- Linguistics rubric (descriptive rating scale, with following categories- Excellent, Satisfactory, Needs Improvement and Not Acceptable)

    Measured: Change from Baseline trainer's language assessment at 2 weeks

  8. Semi-structured interview of the trainees

    In order to complement and enhance the data from above mentioned assessment tools (i.e., clarity of instruction, cognitive load), trainees will be asked to participate in a short 10-15 minute interview with the PI and/or Co-PI after the they have completed all 4 simulated cases, to explore their perceptions of instruction provided. The interview guide has been adapted from a study examining gastroenterology trainees' perception of endoscopy training activities. Interviews will be transcribed (removing any identifiers) and coded qualitatively using a constant comparison approach to compare differences in trainee's perceptions between groups

    Measured: At 2 weeks

  9. Semi-structured interview of the faculty instructor

    In order to explore faculty's perceptions of the training modality being tested, faculty participants will also be asked to participate in a separate 10-15 minute long semi-structured interview with the PI and/or co-PI, after completing the 2 simulation sessions with a trainee fellow. The interview guide has been adapted from a study exploring endoscopy trainers' experience in teaching endoscopy. Interview will be transcribed and coded qualitatively using a constant comparison approach to explore the faculty's perception of the instructional strategies.

    Measured: At 2 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Jan 2023
  2. Study start23 Mar 2022
  3. Primary completion30 May 2023
  4. Study completion30 Jun 2023

Resources

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
Other
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
25 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05674500
Sponsor's protocol ID
STU-2021-0829
Acronym
CLIEnT
Status last verified
Aug 2023
First submitted
9 Dec 2022
Last updated
29 Aug 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual Participant Data (IPD) will not be shared because this was not included in the consent form at the time of study design. Most of the participants have already been consented and recruited to participate and IPD was not included in that discussion.

Publications

  • Walsh CM. In-training gastrointestinal endoscopy competency assessment tools: Types of tools, validation and impact. Best Pract Res Clin Gastroenterol. 2016 Jun;30(3):357-74. doi: 10.1016/j.bpg.2016.04.001. Epub 2016 Apr 16.

    PubMed 27345645
  • Waschke KA, Anderson J, Macintosh D, Valori RM. Training the gastrointestinal endoscopy trainer. Best Pract Res Clin Gastroenterol. 2016 Jun;30(3):409-19. doi: 10.1016/j.bpg.2016.05.001. Epub 2016 May 14.

    PubMed 27345649
  • Siau K, Green JT, Hawkes ND, Broughton R, Feeney M, Dunckley P, Barton JR, Stebbing J, Thomas-Gibson S. Impact of the Joint Advisory Group on Gastrointestinal Endoscopy (JAG) on endoscopy services in the UK and beyond. Frontline Gastroenterol. 2019 Apr;10(2):93-106. doi: 10.1136/flgastro-2018-100969. Epub 2018 Nov 13.

    PubMed 31210174
  • Coderre S, Anderson J, Rostom A, McLaughlin K. Training the endoscopy trainer: from general principles to specific concepts. Can J Gastroenterol. 2010 Dec;24(12):700-4. doi: 10.1155/2010/493578.

    PubMed 21165376
  • Walsh CM, Anderson JT, Fishman DS. Evidence-based Approach to Training Pediatric Gastrointestinal Endoscopy Trainers. J Pediatr Gastroenterol Nutr. 2017 Apr;64(4):501-504. doi: 10.1097/MPG.0000000000001473.

    PubMed 27846065
  • Gavin DR, Valori RM, Anderson JT, Donnelly MT, Williams JG, Swarbrick ET. The national colonoscopy audit: a nationwide assessment of the quality and safety of colonoscopy in the UK. Gut. 2013 Feb;62(2):242-9. doi: 10.1136/gutjnl-2011-301848. Epub 2012 Jun 1.

    PubMed 22661458
  • Broekaert I, Tzivinikos C, Narula P, Antunes H, Dias JA, van der Doef H, Isoldi S, Norsa L, Romano C, Scheers I, Silbermintz A, Tavares M, Torroni F, Urs A, Thomson M. European Society for Paediatric Gastroenterology, Hepatology and Nutrition Position Paper on Training in Paediatric Endoscopy. J Pediatr Gastroenterol Nutr. 2020 Jan;70(1):127-140. doi: 10.1097/MPG.0000000000002496. No abstract available.

    PubMed 31799965
  • Dilly CK, Sewell JL. How to Give Feedback During Endoscopy Training. Gastroenterology. 2017 Sep;153(3):632-636. doi: 10.1053/j.gastro.2017.07.023. Epub 2017 Jul 27. No abstract available.

    PubMed 28757268
  • Zawadzki M, Gomez Ruiz M, Tou S, Jeffels A, Matzel KE. A proposed system for standardized terminology in minimally invasive surgery - a video vignette. Colorectal Dis. 2020 Dec;22(12):2346-2347. doi: 10.1111/codi.15309. Epub 2020 Sep 16. No abstract available.

    PubMed 32790087
  • Lauridsen KG, Watanabe I, Lofgren B, Cheng A, Duval-Arnould J, Hunt EA, Good GL, Niles D, Berg RA, Nishisaki A, Nadkarni VM. Standardising communication to improve in-hospital cardiopulmonary resuscitation. Resuscitation. 2020 Feb 1;147:73-80. doi: 10.1016/j.resuscitation.2019.12.013. Epub 2019 Dec 28.

    PubMed 31891790
  • Khan R, Zheng E, Wani SB, Scaffidi MA, Jeyalingam T, Gimpaya N, Anderson JT, Grover SC, McCreath G, Walsh CM. Colonoscopy competence assessment tools: a systematic review of validity evidence. Endoscopy. 2021 Dec;53(12):1235-1245. doi: 10.1055/a-1352-7293. Epub 2021 Mar 16.

    PubMed 33440438
  • Barton JR, Corbett S, van der Vleuten CP; English Bowel Cancer Screening Programme; UK Joint Advisory Group for Gastrointestinal Endoscopy. The validity and reliability of a Direct Observation of Procedural Skills assessment tool: assessing colonoscopic skills of senior endoscopists. Gastrointest Endosc. 2012 Mar;75(3):591-7. doi: 10.1016/j.gie.2011.09.053. Epub 2012 Jan 9.

    PubMed 22227035
  • Siau K, Dunckley P, Valori R, Feeney M, Hawkes ND, Anderson JT, Beales ILP, Wells C, Thomas-Gibson S, Johnson G; Joint Advisory Group on Gastrointestinal Endoscopy (JAG). Changes in scoring of Direct Observation of Procedural Skills (DOPS) forms and the impact on competence assessment. Endoscopy. 2018 Aug;50(8):770-778. doi: 10.1055/a-0576-6667. Epub 2018 Apr 3.

    PubMed 29614526
  • Siau K, Crossley J, Dunckley P, Johnson G, Feeney M, Iacucci M, Anderson JT; Joint Advisory Group on Gastrointestinal Endoscopy (JAG). Colonoscopy Direct Observation of Procedural Skills Assessment Tool for Evaluating Competency Development During Training. Am J Gastroenterol. 2020 Feb;115(2):234-243. doi: 10.14309/ajg.0000000000000426.

    PubMed 31738285
  • Walsh CM, Ling SC, Khanna N, Grover SC, Yu JJ, Cooper MA, Yong E, Nguyen GC, May G, Walters TD, Reznick R, Rabeneck L, Carnahan H. Gastrointestinal Endoscopy Competency Assessment Tool: reliability and validity evidence. Gastrointest Endosc. 2015;81(6):1417-1424.e2. doi: 10.1016/j.gie.2014.11.030. Epub 2015 Mar 7.

    PubMed 25753836

Questions about this trial

What is this clinical trial studying?

A study testing Educational Training on standardized coaching language and Educational Training on goal setting in people with Education, Medical and Colonoscopy, run by University of Texas Southwestern Medical Center at 1 site in United States.

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 2 inclusion and 2 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 29 Aug 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

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?

Change in colonoscopy performance (time frame: Change from Baseline colonoscopy performance at 2 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05674500, which also lists 20 linked publications.

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 29 Aug 2023.

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