Simulation-based Research to Enhance Patient Safety in Radiation Oncology

描述(由申请人提供)：总体目标是开发和评估标准化和可推广的基于模拟的培训(具体目标1)，以及用户界面和认知工作流程增强(具体目标2)对放射治疗(RT)提供者的业绩和脑力劳动的影响。基本原理：据估计，在美国每年接受放射治疗的患者中，高达5%的患者会出现放射治疗(RT)错误；在1,000-10,000项专利中，会发生严重/致命的事件。RT中相对较高的错误率和灾难性事件的可能性非常令人担忧，并突出了需要解决的潜在的系统挑战和性能和脑力工作负荷。因此，这项研究的发现将对大量患者产生直接影响。方法： 受试者被随机分为接受(与不接受)基于模拟的培训以及“当前”与“增强”的用户界面和认知工作流程，他们将进行事前和事后评估，以量化这些干预措施对RT提供者的表现和脑力工作负荷的影响。采用2×2平衡随机设计，我们将使用方差分析(ANOVA)来评估四组(基于+/-模拟的培训、当前用户界面和增强的用户界面和认知工作流程)的主要和交互效果。研究领域：患者安全、脑力劳动、个体表现、模拟。科学学科：认知科学和行为科学；人的因素。

DESCRIPTION (provided by applicant): The overall goal is to develop and assess the impact of standardized and generalizable simulation-based training (specific aim #1), and user interface and cognitive workflows enhancements (specific aim #2) on radiation therapy (RT) providers' performance and mental workload. Rationale: Errors in Radiation Therapy (RT) are estimated to occur in up to H 5% of the > H600,000 patients receiving RT per year in the US; with serious/lethal events occurring H 1 of 1,000-10,000 patents. The relatively high error rates and the potential for catastrophic events in RT is very concerning, and highlights underlying systematic challenges with performance and mental workload that need to be addressed. Thus, the findings from this study will have direct implications for a large number of patients. Methods: Subjects, randomized to receive (vs. not receive) simulation-based training and to 'current' vs. 'enhanced' user interfaces and cognitive workflows, will have pre- and post- assessments to quantify the impact of these interventions on a RT providers' performance and mental workload. Using a 2 x 2 balanced randomization design, we will use analysis of variance (ANOVA) to evaluate main and interaction effects from the four groups (+/-simulation-based training, and 'current' vs. 'enhanced' user interface and cognitive workflow). Research areas: Patient safety, mental workload, individual performance, simulation. Scientific disciplines: Cognitive and Behavioral Sciences; Human Factors.