Resident Supervision Index: Assessing Feasibility and Validity

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Department of Veterans Affairs
ClinicalTrials.gov Identifier:
NCT00680368
First received: May 16, 2008
Last updated: August 26, 2014
Last verified: August 2014
  Purpose

OBJECTIVES: To develop, assess feasibility, and test the validity of the Resident Supervision Index (RSI), a survey tool for medical residents designed to measure quantitatively the level of supervision the resident received while caring for an outpatient during a patient care encounter.

RESEARCH DESIGN: This is a prospective trial assessing the Residency Supervision Index (Index) applied to outpatient care encounters for content validity, test-retest reliability, and construct validity.


Condition
Healthy

Study Type: Observational
Study Design: Time Perspective: Prospective
Official Title: Resident Supervision Index: Assessing Feasibility and Validity

Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:
  • The instrument is planned for future studies to assess the association between resident supervision and training outcomes, clinical workload, patient outcomes, quality of care, and care costs. [ Time Frame: 1 Year ] [ Designated as safety issue: No ]

Biospecimen Retention:   None Retained

The study did not involve a biospecimen. None was collected. None was retained.


Enrollment: 118
Study Start Date: March 2008
Study Completion Date: December 2008
Primary Completion Date: December 2008 (Final data collection date for primary outcome measure)

Detailed Description:

OBJECTIVES: To develop, assess feasibility, and test the validity of the Resident Supervision Index (RSI), a survey tool for medical residents designed to measure quantitatively the level of supervision the resident received while caring for an outpatient during a patient care encounter.

RESEARCH DESIGN: This is a prospective trial assessing the Residency Supervision Index (Index) applied to outpatient care encounters for content validity, test-retest reliability, and construct validity.

METHODOLOGY: Trained interviewers will administer the Index during face-to-face and in-clinic interviews, with consented residents (n=60) within 6 hours and again within 24 hours attending physicians (n=25) within 6 hours, and consented nurses (n=20) within 6 hours after the resident completes the care of a randomly selected outpatient care encounter (=250 clinic stops) during the data collection period (=4 months) at outpatient clinics of the Loma Linda VA Medical Center. Study encounters, or clinic stops, are selected at random during selected observation days for patients who have a primary or secondary diagnosis of major depression or diabetes.

For each encounter, data comes from administering the Resident Supervision Index to the resident, attending, and other health professional (nurse). Information about each patient encounter (procedures, diagnoses) comes from chart reviews. Procedures are coded into Current Physician Codes and weighted by VA Reasonable charges to estimate encounter costs as a proxy for case complexity. Baseline data comes from face-to-face interviews with consented resident, attending, and other professional, and includes administering the Office of Management and Budget-approved Learner's Perception Survey (residents only), and brief demographic and education survey (resident, attending, other professional) determining years experience, training background, and clinical discipline.

Test-retest reliability is assessed by re-administering the Index to residents for within 24 hours of the encounter. Content validity is assessed by convening a national expert panel (12 members) to review index elements and scoring algorithm. Feasibility is determined by measuring completion rates and total time necessary to complete the questionnaire and qualitative comments by residents. Concurrent validity is assessed by re-administering the Index to the attending and other professional (nurse) involved in the case encounter. Construct validity is assessed by examining if the supervision level is inversely related to resident experience (year of training), case complexity (presence of comorbid condition, costs of the encounter based on procedures done), and resident satisfaction. Resident satisfaction is determined by responses to the Office of Academic Affiliations Learner's Perception Survey (OMB-approved for VA residents). Analyses are designed to correct for attending-resident and resident-encounter nesting.

CLINICAL RELATIONSHIPS: The study will help our understanding of how residents at VA medical centers receive training and are supervised for the purpose of both education and patient outcomes.

IMPACT/SIGNIFICANCE: The instrument is planned for future studies to assess the association between resident supervision and training outcomes, clinical workload, patient outcomes, quality of care, and care costs.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population

Residents

Criteria

Inclusion Criteria:

  • Males and females
  • Ages 18 and older

Exclusion Criteria:

  • None
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00680368

Locations
United States, California
VA Medical Center, Loma Linda
Loma Linda, California, United States, 92357
Sponsors and Collaborators
Investigators
Principal Investigator: Terrell Michael Kashner, PhD JD MPH VA Loma Linda Healthcare System, Loma Linda, CA
Principal Investigator: Dale S. Cannon, PhD Salt Lake City
  More Information

Publications:
Responsible Party: Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT00680368     History of Changes
Other Study ID Numbers: SHP 08-164
Study First Received: May 16, 2008
Last Updated: August 26, 2014
Health Authority: United States: Federal Government

Keywords provided by Department of Veterans Affairs:
Feasibility
Supervision
Assessing

ClinicalTrials.gov processed this record on October 20, 2014