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Online training improves medical students' ability to recognise when a person is dying: The ORaClES randomised controlled trial

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Title: Online training improves medical students' ability to recognise when a person is dying: The ORaClES randomised controlled trial
Authors: White, N
Oostendorp, LJM
Tomlinson, C
Yardley, S
Ricciardi, F
Gokalp, H
Minton, O
Boland, JW
Clark, B
Harries, P
Stone, P
Item Type: Journal Article
Abstract: Background: Recognising dying is a key clinical skill for doctors, yet there is little training. Aim: To assess the effectiveness of an online training resource designed to enhance medical students’ ability to recognise dying. Design: Online multicentre double-blind randomised controlled trial (NCT03360812). The training resource for the intervention group was developed from a group of expert palliative care doctors’ weightings of various signs/symptoms to recognise dying. The control group received no training. Setting/participants: Participants were senior UK medical students. They reviewed 92 patient summaries and provided a probability of death within 72 hours (0% certain survival – 100% certain death) pre, post, and 2 weeks after the training. Primary outcome: (1) Mean Absolute Difference (MAD) score between participants’ and the experts’ scores, immediately post intervention. Secondary outcomes: (2) weight attributed to each factor, (3) learning effect and (4) level of expertise (Cochran–Weiss–Shanteau (CWS)). Results: Out of 168 participants, 135 completed the trial (80%); 66 received the intervention (49%). After using the training resource, the intervention group had better agreement with the experts in their survival estimates (δMAD = −3.43, 95% CI −0.11 to −0.34, p = <0.001) and weighting of clinical factors. There was no learning effect of the MAD scores at the 2-week time point (δMAD = 1.50, 95% CI −0.87 to 3.86, p = 0.21). At the 2-week time point, the intervention group was statistically more expert in their decision-making versus controls (intervention CWS = 146.04 (SD 140.21), control CWS = 110.75 (SD 104.05); p = 0.01). Conclusion: The online training resource proved effective in altering the decision-making of medical students to agree more with expert decision-making.
Issue Date: 14-Nov-2019
Date of Acceptance: 1-Nov-2019
URI: http://hdl.handle.net/10044/1/75408
DOI: 10.1177/0269216319880767
ISSN: 0269-2163
Publisher: SAGE Publications
Start Page: 134
End Page: 144
Journal / Book Title: Palliative Medicine
Volume: 34
Issue: 1
Copyright Statement: © 2019 by SAGE Publications. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Keywords: Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Public, Environmental & Occupational Health
Medicine, General & Internal
General & Internal Medicine
Medical education
palliative care
dying
prognosis
decision-making
PALLIATIVE CARE EDUCATION
KNOWLEDGE
Medical education
decision-making
dying
palliative care
prognosis
Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Public, Environmental & Occupational Health
Medicine, General & Internal
General & Internal Medicine
Medical education
palliative care
dying
prognosis
decision-making
PALLIATIVE CARE EDUCATION
KNOWLEDGE
1117 Public Health and Health Services
1199 Other Medical and Health Sciences
Gerontology
Publication Status: Published
Open Access location: https://journals.sagepub.com/doi/10.1177/0269216319880767
Article Number: UNSP 0269216319880767
Online Publication Date: 2019-11-14
Appears in Collections:Department of Metabolism, Digestion and Reproduction
Faculty of Medicine
Faculty of Natural Sciences