Evidence map›Paper›PMID 39208492›Full record

Trial reportThe Journal of surgical research2024

Inside the Black Box of Deliberate Practice: How do Coaches Coach to Improve Trauma Triage.

Deepika Mohan, Robert M Arnold, Baruch Fischhoff, Jonathan Elmer, Raquel M Forsythe, Kimberly J Rak, Jacqueline L Barnes, Douglas B White

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in The Journal of surgical research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Deepika MohanDepartment of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Electronic address: mohand@upmc.edu.
Robert M ArnoldDepartment of Geriatrics and Palliative Care, Icahn School of Medicine at Mount Sinai, New York City, New York.
Baruch FischhoffDepartment of Engineering and Environmental Policy, Carnegie Mellon University, Pittsburgh, Pennsylvania.
Jonathan ElmerDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Raquel M ForsytheDepartment of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Kimberly J RakDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Jacqueline L BarnesDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Douglas B WhiteDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Funding

Quantitative electroencephalography after cardiac arrestK23NS097629 · NINDS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ELMER, JONATHAN · 2017 to 2021
$945k
Mentored Patient Oriented Research in Improving Surrogate Decision Making for Patients with Advanced Respiratory FailureK24HL148314 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Douglas B White · 2019 to 2026
$944k
Development and feasibility testing of a novel intervention to implement trauma triage guidelinesR21AG072072 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI MOHAN, DEEPIKA · 2021 to 2022
$385k
NHLBI NIH HHS K24 HL148314NIA NIH HHS R21 AG072072NINDS NIH HHS K23 NS097629
6 · The paper itself

Abstract

introductionDeliberate practice, goal-oriented training with feedback from a coach, is a common tool for improving physicians' performance. However, little is known about how coaches foster performance improvement.

methodsA content analysis of video-recorded training sessions was performed to analyze the coaches' behaviors during a pilot randomized trial of deliberate practice in trauma triage. The intervention consisted of three video-conference sessions during which trial physicians, under the supervision of a coach, played a customized video game designed to review trauma triage principles. A multidisciplinary team specified tasks (e.g., create collaborative learning environment) that coaches should complete, and suggested 19 coaching strategies (e.g., encourage culture of error) to allow execution of these tasks. Two independent raters translated those strategies into a coding framework and applied it deductively to the recorded sessions. The frequencies of the coaching strategies were summarized, and tested for variation across coaches and time.

resultsThirty physicians received the intervention across two 1-mo blocks. Most (28 [93%]) completed three sessions, each covering two (interquartile range 1-2) triage principles. Coaches used coaching strategies 18 (interquartile range 14.5-22) times per triage principle, using some often (2-3 times/principle) and others infrequently (<1 time/principle). The three coaches used similar numbers (20 versus 16 versus 18.5, P = 0.07) and types of strategies. However, use increased over time (16.8 [Block 1] versus 20 [Block 2] P = 0.018).

conclusionsCoaches used 19 coaching strategies to deliver this deliberate practice intervention, with behavior that evolved over time. Future trials should isolate the most potent strategies and should assess the best method of standardizing coaching.

Indexed as

MentoringTriageAdultClinical CompetenceFemaleHumansMalePatient Care TeamPilot ProjectsVideo GamesVideo RecordingWounds and InjuriesBehavioral intervention developmentDeliberate practiceHealthcare professional educationHeuristicsTrauma triage

Identifiers

PMID39208492
PMCPMC12243022

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Registered trials

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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.