Trial reportPloS one2025
Coaching doctors to improve ethical decision-making in adult hospitalized patients potentially receiving excessive treatment: Process evaluation study of the CODE intervention in doctors and nurses working in ten acute hospital wards.
Trial report in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05167019 (Coaching Doctors to Improve Ethical Decision-making in Adult Hospitalized Patients Potentially Receiving Excessive Treatment), which is not on this map. Cited by 2 papers.
What it found
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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.
Coaching Doctors to Improve Ethical Decision-making in Adult Hospitalized Patients Potentially Receiving Excessive Treatment: a Step Wedge Cluster Randomized Trial in 10 Departments of the Ghent University Hospital (CODE)
Who cites it
2 citing papers in PubMed.
- Knowledge, attitudes, and applied practices regarding "Do Not Attempt Resuscitation" among healthcare workers in Aljouf, Saudi Arabia: a multicenter cross-sectional questionnaire-based survey.Resuscitation plus · 2026Article
- A Cross-Sectional Study on Healthcare Providers' Perceived Compassion and Emotional Exhaustion Across Five Acute Geriatric Units: The Importance of Mutual Respect and Open Reflection.Healthcare (Basel, Switzerland) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
27 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHigh quality hospital care for serious ill persons requires exemplary team-based communication and decision-making. However, there is a need for evidence-based interventions in this area. This study's aim is to gain insight in the adoption and implementation of the COaching Doctors to improve Ethical decision-making (CODE) intervention, composed of one-on-one professional coaching in doctors and an alert to identify patients potentially receiving excessive treatment.
methodsMixed-method process evaluation study using focus group interviews, sub-analysis of the ethical decision-making climate questionnaire (EDMCQ) in nurses and doctors and a satisfaction survey in doctors.
resultsOf the 423 clinicians, 198 (60.2%) nurses and 63 (67.0%) doctors filled-out the EDMCQ and 20 nurses and 12 doctors participated to the focus-group interviews respectively. Thirty-five (70%) of the 50 coached doctors filled-out the satisfaction survey. Doctors estimated their leadership skills higher than the nurses prior to the study period (P = 0.006) but no longer after the study period (P = 0.366). Nurses estimated ethical awareness and reflection higher (respectively, P = 0.002 and P = 0.049) and non-avoiding end-of-life decisions and active involvement of nurses lower than the doctors (respectively P < 0.001 and P = 0.023) after the study period but not before the study period (all P-values >0.05). Doctors testified of increased awareness in ethical decision-making, more open interactions with patients and nurses, and more courage to intervene instead of doing nothing. Nurses spoke of an increased awareness to act as patient advocate, increased deliberation among peer nurses and frustration when they felt no effect of activating the CODE alert. Both doctors and nurses advised for more active involvement of nurses. The mean overall satisfaction score in doctors was 8.69 on 10.
conclusionThe CODE study intervention was effective in raising awareness and self-reflection, yet did not succeed to close the (communication) gap between doctors and nurses in team-based ethical decision-making.
trial registrationClinicalTrials.gov identifier: NCT05167019.
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