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Trial registered on ANZCTR
Registration number
ACTRN12616000882426
Ethics application status
Approved
Date submitted
29/06/2016
Date registered
5/07/2016
Date last updated
8/05/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Can we identify junior doctors with low visuospatial and psychomotor ability and provide extra skills training to allow them to perform fibreoptic bronchoscopy
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Scientific title
Targeting educational intervention in fibreoptic bronchoscopy skills training based on visuospatial and psychomotor testing of junior doctors
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Secondary ID [1]
289566
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none
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Universal Trial Number (UTN)
U1111-1184-7939
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Junior doctors with low visuospatial and low psychomotor ability
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Condition category
Condition code
Public Health
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0
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Health service research
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
In this non-drug trial, we will perform psychometric testing on junior doctors recruited into the study. The testing is paper based and is a battery of norm based, standardised neuro-cognitive tests of innate visuospatial and psychomotor ability and administered by a trained neuropsychologist. Tests include the Mental Rotations A, Block Design, Matrix Reasoning, Zig-Zag, and Trail Making Tests A and B. All tests will take 45-60minutes.
Participants will then be stratified into low ability cohorts (defined as > 1 standard deviation below population mean). The low ability cohort will receive mental imagery training, which is a textually and graphically rich written script with step by step descriptions of the fibreoptic bronchoscopy procedure. Participants will be asked to read through and mentally rehearse each of the steps for 1 week. Training is via a paper booklet sent to participants. Each participant will be asked to perform mental imagery training daily for the 1 week, and should take approximately 15 minutes per rehearsal. Compliance will be audited by researchers at the end of the training week. This week of training will occur 3 weeks after psychometric baseline assessment; ie. 1 week prior to bronchoscopy testing.
All participants will then be asked to perform a fibreoptic bronchoscopy procedure on an anatomically correct bench top manikin. This performance will be timed and a video recorded of the performance for scoring by blinded experts using a validated global rating scale
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Intervention code [1]
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Treatment: Other
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Intervention code [2]
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Behaviour
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Comparator / control treatment
The control group are junior doctors performing the same fibreoptic bronchoscopy task, but stratified as high ability on psychometric testing. The control group will not receive the additional mental imagery training
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Control group
Active
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Outcomes
Primary outcome [1]
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Time taken to complete the fibreoptic bronchoscopy task, recorded on stopwatch by a research assistant from picking up the bronchoscope to reaching the endpoint (successful intubation of the right and left main bronchus)
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Assessment method [1]
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Timepoint [1]
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immediately after psychometric testing (baseline), and at 1 month post baseline
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Secondary outcome [1]
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proficiency score of bronchoscopy performance, based on global rating scale
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Assessment method [1]
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Timepoint [1]
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at baseline, and at 1 month post baseline
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Eligibility
Key inclusion criteria
All junior doctors rotating into critical care terms at Liverpool Hospital, including rotations into anaesthesia, intensive care, and emergency medicine.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Has had previous training, workshops or actual performance of video fibreoptic bronchoscopy. Has had psychometric testing or neurocognitive testing in the past 12 months.
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Based on individual scores in the psychometric tests, participants will be stratified by population norms into ‘low’ and ‘high’ ability cohorts. Sample size is based on population norms of psychometric tests used, which are normally distributed. We expect 12-15 participants in each low and high ability cohorts. No formal power calculation has been performed.
The time taken to successfully complete the task, and Global rating scale numerical scores, will be analysed against cohort by t tests or the Mann-Whitney U tests. Dichotomous satisfactory and unsatisfactory performance item in the global rating scale will be analysed against cohort by Fisher's exact test. Rate of improvement from baseline to 1-month performance for each cohort will be analysed by repeated measures ANOVA. Correlation between psychometric scores, time taken to complete the task, and GRS scores, will be analysed by Pearson or Spearman rank correlation. A two tailed, P value < 0.05 will be deemed significant.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
30/09/2016
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Actual
1/02/2017
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Date of last participant enrolment
Anticipated
6/11/2017
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Actual
6/11/2017
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Date of last data collection
Anticipated
6/12/2017
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Actual
6/12/2017
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Sample size
Target
60
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Accrual to date
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Final
60
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Liverpool Hospital - Liverpool
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Recruitment postcode(s) [1]
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2170 - Liverpool
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Liverpool Hospital Department of Anaesthesia
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Address [1]
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Level 1, New Clinical Building,
Liverpool Hospital
Elizabeth Street
Liverpool
NSW 2170
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Liverpool Hospital
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Address
Elizabeth Street
Liverpool
NSW 2170
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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South West Sydney HREC
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Ethics committee address [1]
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‘Research and Ethics Office’ Locked Bag 7103 LIVERPOOL BC NSW 1871
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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24/06/2016
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Approval date [1]
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22/11/2016
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Ethics approval number [1]
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Summary
Brief summary
Flexible video fibreoptic bronchoscopy (FOB) is an important component of the airway skills required by doctors in the area of critical care, including anaesthetists, intensive care physicians, and in emergency medicine. Speed and accuracy of performance, as well as causing no trauma to the patient's airway, is essential to secure the airway for adequate oxygenation and ventilation. However, FOB skills are often learnt in an unstructured format by trainees, and clinical exposure is limited by their relative rarity, causing skills decay after initial training. In this study, we are examining if training in FOB skills can be improved based on the innate visuospatial and psychomotor abilities of doctors. Other procedural tasks in medicine, similar in complexity to FOB, have previously been shown to be associated with these cognitive abilities as they influence hand-eye dexterity and motor skills. An educational intervention will be provided to those novices identified with lower visuospatial and psychomotor abilities, to determine if these novices can be brought up to the same level of FOB performance as their higher ability colleagues. This training is based on mental rehearsal of the procedure, which has been used by professional athletes, musicians, and by surgeons where they "practice" the performance in their heads before they actually perform it in real life. This study will recruit doctors rotating into critical care areas where FOB skill is necessary (anaesthesia, intensive care, emergency medicine). Visuospatial and psychomotor ability will be assessed by a standardised test battery. For doctors stratified into the low ability cohort of visuospatial and psychomotor ability, mental imagery training will be provided. FOB performance is measured using an anatomically correct, benchtop manikin of the human airway. Primary endpoint of performance is time taken to successfully perform a FOB task, and secondary endpoint is proficiency as evaluated by blinded assessors using a validated global rating scale.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Alwin Chuan
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Address
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Department of Anaesthesia
Room 124, Level 1, New Clinical Building
Liverpool Hospital
Elizabeth Street
Liverpool
NSW 2170
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Country
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Australia
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Phone
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+61 407743668
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Alwin Chuan
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Address
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Department of Anaesthesia
Room 124, Level 1, New Clinical Building
Liverpool Hospital
Elizabeth Street
Liverpool
NSW 2170
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Country
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Australia
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Phone
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+61 2 9828 3173
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Alwin Chuan
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Address
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Department of Anaesthesia
Room 124, Level 1, New Clinical Building
Liverpool Hospital
Elizabeth Street
Liverpool
NSW 2170
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Country
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Australia
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Phone
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+61 407743668
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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