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Intimidation of medical students by health care professionals is a well-documented phenomenon. Raising awareness of what constitutes intimidation is a preferred method for preventing it through increased reporting. Simulation is a novel method of raising awareness of intimidation.
This is a randomised controlled trial comparing the effectiveness of simulation (involving actors), an educational video and no intervention, as adjuncts to group discussion, on students' ability to identify and report intimidation. Medical students from the University of Montreal in Montreal, Canada, will be recruited at the beginning of surgical clerkship. They will complete a standardized and validated pre-intervention questionnaire on their experience with intimidation consisting of multiple choice questions and short answers. They will be randomised to one of the three interventions lasting 70 minutes that will be followed by a 20-minute standardized discussion on intimidation with all students participating together. At the end of their surgical rotation, they will complete a similar post-intervention questionnaire with additional questions pertaining to the reporting of intimidation.
Differences in intimidation reporting after the intervention as well as a before and after comparison of the "Negative Acts Questionnaire" score will be studied.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Simulation | Experimental | During a suturing class at the simulation center, the students enter a classroom. Although the students are not aware of this, among them is an actor playing the role of a student. One of the two professors is also an actor. As the activity progresses, the professor targets the student played by an actor. The intimidation intensifies until the end. At the end of the activity, there is a debriefing explaining to the students that the bullying professor and the victim were actors. |
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| Video | Experimental | During a suturing class at the simulation center, after 55 minutes of suturing, the students will be exposed to a 15-minute video on workplace and hospital intimidation and how to manage it. |
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| Control | Placebo Comparator | During a suturing class at the simulation center, the students suture for the entire 70-minute duration of the activity. They are not exposed to intimidation (control group). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Simulation | Behavioral | Students witness the intimidation of one of their peers (who is an actor) by a professor (also an actor). (see arm description) |
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| Measure | Description | Time Frame |
|---|---|---|
| Comfort in reporting intimidation | Based on post-intervention questionnaire question. | 6 weeks after enrollment |
| Perception of intimidation after intervention | Based on post-intervention Negative Acts Questionnaire (NAQ-R) | 6 weeks after enrollment |
| Measure | Description | Time Frame |
|---|---|---|
| Baseline prevalence of intimidation | Based on pre-intervention Negative Acts Questionnaire (NAQ-R) | at enrollment |
| Before and after comparison | Difference between pre and post-intervention Negative Acts Questionnaire (NAQ-R) |
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Inclusion Criteria:
Exclusion Criteria:
-
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| Name | Affiliation | Role |
|---|---|---|
| Erica Patocskai, MD | Centre hospitalier de l'Université de Montréal (CHUM) | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculté de Médecine de l'Université de Montréal | Montreal | Quebec | H3T 1J4 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26073477 | Background | Stone JP, Charette JH, McPhalen DF, Temple-Oberle C. Under the knife: medical student perceptions of intimidation and mistreatment. J Surg Educ. 2015 Jul-Aug;72(4):749-53. doi: 10.1016/j.jsurg.2015.02.003. | |
| 23728476 | Background | Isaranuwatchai W, Brydges R, Carnahan H, Backstein D, Dubrowski A. Comparing the cost-effectiveness of simulation modalities: a case study of peripheral intravenous catheterization training. Adv Health Sci Educ Theory Pract. 2014 May;19(2):219-32. doi: 10.1007/s10459-013-9464-6. Epub 2013 Jun 1. |
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| ID | Term |
|---|---|
| D014743 | Videotape Recording |
| D035061 | Control Groups |
| ID | Term |
|---|---|
| D013637 | Tape Recording |
| D001296 | Audiovisual Aids |
| D018961 | Educational Technology |
| D013672 | Technology |
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Single-blind randomised controlled trial with two experimental arms and a control arm
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Students cannot be masked as an arm undergoes a simulation intervention. The researcher evaluating the outcomes through the questionnaires will be blinded.
| Video | Behavioral | Student watch a 15-minute intimidation video (see arm description). |
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| Control group | Behavioral | No intervention. The students suture for 70 minutes |
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| at enrollment vs 6 weeks post-intervention |
| Reasons for not reporting intimidation | Open-ended question asking why students don't report intimidation | at enrollment |
| Frequency of intimidation reporting | Did the students report intimidation during the 6 weeks of their surgical clerkship? | 6 weeks post-intervention |
| 23280528 | Background | Curtis MT, DiazGranados D, Feldman M. Judicious use of simulation technology in continuing medical education. J Contin Educ Health Prof. 2012 Fall;32(4):255-60. doi: 10.1002/chp.21153. |
| Background | Einarsen S, Helge H, Notelaers G. Measuring exposure to bullying and harassment at work: validity, factor structure & psychometric properties of the negative acts questionnaire-revised. Work Stress 23(1):24-44, 2009. |
| D013676 |
| Technology, Industry, and Agriculture |
| D013690 | Television |
| D015340 | Epidemiologic Research Design |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D012107 | Research Design |
| D008722 | Methods |