Trial reportAcademic medicine : journal of the Association of American Medical Colleges2023
Communicating Diagnostic Uncertainty at Emergency Department Discharge: A Simulation-Based Mastery Learning Randomized Trial.
Trial report in Academic medicine : journal of the Association of American Medical Colleges, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 22 citations in OpenAlex.
- Inside the Black Box of Deliberate Practice: How do Coaches Coach to Improve Trauma Triage.The Journal of surgical research · 2024Trial
- Testing a Novel Deliberate Practice Intervention to Improve Diagnostic Reasoning in Trauma Triage: A Pilot Randomized Clinical Trial.JAMA network open · 2023Trial
- Clinical Reasoning Uncertainty in Veterinary Medical Encounters with a Clinical Example.Veterinary sciences · 2025Review
- Twelve Tips to Train Medical Students to Manage Their Uncertainty and to Provide Reassurance to Patients and Their Caregivers.Medical science educator · 2025Article
- Sustained Impact: Long-Term Application of Diagnostic Uncertainty Communication Training.AEM education and training · 2025Article
- Teaching the Communication of Diagnostic Uncertainty at Scale: Leveraging a Mobile App for Just-in-Time Instruction.Cureus · 2025Article
- Developing Simulation-Based Mastery Learning Curricula for Emergency Medicine Skills Training.AEM education and training · 2025Article
- Targeted EHR-based communication of diagnostic uncertainty (TECU) in the emergency department: Protocol for an effectiveness implementation trial.Contemporary clinical trials · 2025Article
- Unveiling the gaps: A comprehensive, equity-focused observational examination of Emergency Department discharge.PloS one · 2025Observational
- A Mixed-Methods Analysis of Negative Patient Experiences in Emergency Department Care: Identifying Challenges and Evidence-Informed Strategies Across the Care Continuum.Journal of patient experience · 2025Article
- Development and Initial Validity Evidence for a Pregnancy Disclosure and Options Counseling Checklist in Emergency Medicine.AEM education and training · 2024Article
- Identifying Facilitators and Inhibitors of Shared Understanding: An Ethnography of Diagnosis Communication in Acute Medical Settings.Health expectations : an international journal of public participation in health care and health policy · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 3 institutions in 2 countries.
Funding
Abstract
purposeThere are no standardized approaches for communicating with patients discharged from the emergency department with diagnostic uncertainty. This trial tested efficacy of the Uncertainty Communication Education Module, a simulation-based mastery learning curriculum designed to establish competency in communicating diagnostic uncertainty.
methodResident physicians at 2 sites participated in a 2-arm waitlist randomized controlled trial from September 2019 to June 2020. After baseline (T1) assessment of all participants via a standardized patient encounter using the Uncertainty Communication Checklist (UCC), immediate access physicians received training in the Uncertainty Communication Education Module, which included immediate feedback, online educational modules, a smartphone-based application, and telehealth deliberate practice with standardized patients. All physicians were retested 16-19 weeks later (T2) via in-person standardized patient encounters; delayed access physicians then received the intervention. A final test of all physicians occurred 11-15 weeks after T2 (T3). The primary outcome measured the percentage of physicians in the immediate versus delayed access groups meeting or exceeding the UCC minimum passing standard at T2.
resultsOverall, 109 physicians were randomized, with mean age 29 years (range 25-46). The majority were male (n = 69, 63%), non-Hispanic/Latino (n = 99, 91%), and White (n = 78, 72%). At T2, when only immediate access participants had received the curriculum, immediate access physicians demonstrated increased mastery (n = 29, 52.7%) compared with delayed access physicians (n = 2, 3.7%, P < .001; estimated adjusted odds ratio of mastery for the immediate access participants, 31.1 [95% CI, 6.8-143.1]). There were no significant differences when adjusting for training site or stage of training.
conclusionsThe Uncertainty Communication Education Module significantly increased mastery in communicating diagnostic uncertainty at the first postintervention test among emergency physicians in standardized patient encounters. Further work should assess the impact of clinical implementation of these communication skills.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.