{"id":26579,"date":"2024-10-05T04:17:00","date_gmt":"2024-10-04T20:17:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=26579"},"modified":"2024-10-05T05:56:45","modified_gmt":"2024-10-04T21:56:45","slug":"jama-netw-open%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e9%80%9a%e8%bf%87%e4%bc%97%e5%8c%85%e5%8f%8d%e9%a6%88%e6%8f%90%e5%8d%87%e4%bd%8f%e9%99%a2%e5%8c%bb%e5%b8%88%e6%8a%ab%e9%9c%b2%e9%94%99","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=26579","title":{"rendered":"[JAMA Netw Open\u53d1\u8868\u8bba\u6587]\uff1a\u901a\u8fc7\u4f17\u5305\u53cd\u9988\u63d0\u5347\u4f4f\u9662\u533b\u5e08\u62ab\u9732\u9519\u8bef\u7684\u6280\u80fd"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Medical Education<\/p>\n\n\n\n

August 7, 2024<\/p>\n\n\n\n

Crowdsourced Feedback to Improve Resident Physician Error Disclosure Skills: A Randomized Clinical Trial<\/h1>\n\n\n\n

Andrew A.\u00a0White,\u00a0Ann M.\u00a0King,\u00a0Angelo E.\u00a0D\u2019Addario,\u00a0et al<\/h3>\n\n\n\n

JAMA Netw Open.\u00a0<\/em>2024;7(8):e2425923. doi:10.1001\/jamanetworkopen.2024.25923<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  Is crowdsourced feedback from laypeople an effective educational intervention to improve resident physicians\u2019 error disclosure communication skills?<\/p>\n\n\n\n

Findings<\/strong>  In this randomized clinical trial including 146 second-year internal medicine and family medicine residents, practice with simulation software followed by feedback from crowdsourced laypeople was associated with a modest increase in communication ratings on a 5-point scale among residents who reviewed their feedback.<\/p>\n\n\n\n

Meaning<\/strong>  The findings from this trial suggest that self-directed review of crowdsourced feedback is an effective way for residency programs to address their requirement to prepare trainees for communicating with patients after medical harm.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Residents must prepare for effective communication with patients after medical errors. The video-based communication assessment (VCA) is software that plays video of a patient scenario, asks the physician to record what they would say, engages crowdsourced laypeople to rate audio recordings of physician responses, and presents feedback to physicians.<\/p>\n\n\n\n

Objective<\/strong>  To evaluate the effectiveness of VCA feedback in resident error disclosure skill training.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This single-blinded, randomized clinical trial was conducted from July 2022 to May 2023 at 7 US internal medicine and family medicine residencies (10 total sites). Participants were second-year residents attending required teaching conferences. Data analysis was performed from July to December 2023.<\/p>\n\n\n\n

Intervention<\/strong>  Residents completed 2 VCA cases at time 1 and were randomized to the intervention, an individual feedback report provided in the VCA application after 2 weeks, or to control, in which feedback was not provided until after time 2. Residents completed 2 additional VCA cases after 4 weeks (time 2).<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  Panels of crowdsourced laypeople rated recordings of residents disclosing simulated medical errors to create scores on a 5-point scale. Reports included learning points derived from layperson comments. Mean time 2 ratings were compared to test the hypothesis that residents who had access to feedback on their time 1 performance would score higher at time 2 than those without feedback access. Residents were surveyed about demographic characteristics, disclosure experience, and feedback use. The intervention\u2019s effect was examined using analysis of covariance.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0A total of 146 residents (87 [60.0%] aged 25-29 years; 60 female [41.0%]) completed the time 1 VCA, and 103 (70.5%) completed the time 2 VCA (53 randomized to intervention and 50 randomized to control); of those, 28 (54.9%) reported reviewing their feedback. Analysis of covariance found a significant main effect of feedback between intervention and control groups at time 2 (mean [SD] score, 3.26 [0.45] vs 3.14 [0.39]; difference, 0.12; 95% CI, 0.08-0.48;\u00a0P<\/em>\u2009=\u2009.01). In post hoc comparisons restricted to residents without prior disclosure experience, intervention residents scored higher than those in the control group at time 2 (mean [SD] score, 3.33 [0.43] vs 3.09 [0.44]; difference, 0.24; 95% CI, 0.01-0.48;\u00a0P<\/em>\u2009=\u2009.007). Worse performance at time 1 was associated with increased likelihood of dropping out before time 2 (odds ratio, 2.89; 95% CI, 1.06-7.84;\u00a0P<\/em>\u2009=\u2009.04).<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  In this randomized clinical trial, self-directed review of crowdsourced feedback was associated with higher ratings of internal medicine and family medicine residents\u2019 error disclosure skill, particularly for those without real-life error disclosure experience, suggesting that such feedback may be an effective way for residency programs to address their requirement to prepare trainees for communicating with patients after medical harm.<\/p>\n\n\n\n

Trial Registration<\/strong>  ClinicalTrials.gov Identifier: NCT06234085<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Medical Education August&n […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26579"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=26579"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26579\/revisions"}],"predecessor-version":[{"id":26580,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26579\/revisions\/26580"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=26579"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=26579"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=26579"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}