Bias Mitigation Training for End-of-Life Care
(BRiDgE-Sim Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial explores how doctors communicate with families of seriously ill patients, with a focus on reducing racial bias. Researchers are testing two types of training: one combines communication skills with bias reduction (Communication and Bias Mitigation Training), and the other focuses solely on communication skills. The goal is to determine if adding bias reduction helps doctors communicate better with Black family members. This trial suits physicians who work with seriously ill patients in hospitals and specialize in areas like oncology or critical care. As an unphased study, it offers a unique opportunity to improve communication and reduce bias in healthcare settings.
Will I have to stop taking my current medications?
The trial information does not specify whether participants need to stop taking their current medications.
What prior data suggests that this training intervention is safe for improving communication in end-of-life care?
Research has shown that training can help doctors communicate better with patients and their families at the end of life. This training teaches doctors to listen carefully and share important information clearly. It also helps them understand and respect the wishes of patients and families.
Studies have found that this training makes discussions about end-of-life care easier and more effective, reducing stress for both patients and doctors. Regarding safety, these training sessions have not shown any negative effects. They primarily involve role-playing and discussions, which are generally safe.
Bias mitigation training helps doctors recognize and reduce hidden biases. This training has been successfully adapted from programs used with medical students. Although specific safety data for this training is lacking, the methods used—such as discussions and exercises—are similar to other safe training programs.
Overall, both types of training aim to improve communication and understanding, and they appear safe based on past research.12345Why are researchers excited about this trial?
Researchers are excited about this trial because it aims to enhance end-of-life care by addressing biases that may affect patient interactions. Unlike standard communication training, which focuses on general palliative care techniques, the experimental training incorporates bias mitigation strategies adapted for clinicians. This includes transformational learning methods like critical reflection and perspective-taking exercises, which are designed to tackle racial bias and improve communication with diverse patient groups. By potentially improving clinician-patient interactions, this approach could lead to more personalized and equitable care in end-of-life situations.
What evidence suggests that this trial's training interventions could be effective for improving communication in end-of-life care?
Research has shown that training programs for end-of-life care, including activities like role-playing and reflection, can enhance healthcare professionals' communication skills. For example, one study found that oncologists who received communication training were more effective at discussing end-of-life issues with patients. Another study demonstrated that such training improved doctors' ability to deliver bad news to patients and their families. In this trial, participants will join one of two groups: one group will receive Communication and Bias Mitigation Training, which includes strategies to reduce bias and improve communication with Black patients and their families, while the other group will receive Communication Training Only, focusing on standard palliative care techniques. Although direct evidence of the combined training's effectiveness is limited, the individual components have shown positive results in similar situations.16789
Who Is on the Research Team?
Elizabeth Chuang, MD
Principal Investigator
Montefiore Medical Center/Albert Einstein College of Medicine
Are You a Good Fit for This Trial?
This trial is for physicians specializing in oncology, critical care, hospitalist medicine, emergency medicine or geriatrics who frequently care for seriously ill patients. It's not open to those trained in Hospice and Palliative Medicine or doctors who spend less than 10% of their time with critically ill hospitalized patients.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Phase 1: Simulated Clinical Encounter
Physicians participate in a simulated clinical encounter with a standardized caregiver to assess communication behaviors and implicit bias.
Phase 2: Communication Training
Randomized training session to mitigate implicit bias and improve communication skills, including a VR experience and role-play exercises.
Follow-up
Participants are monitored for changes in communication behavior and bias mitigation effectiveness post-training.
What Are the Treatments Tested in This Trial?
Interventions
- Communication and Bias Mitigation Training
- Communication skills training
Find a Clinic Near You
Who Is Running the Clinical Trial?
Montefiore Medical Center
Lead Sponsor
University of Nebraska Lincoln
Collaborator
Tulane University School of Medicine
Collaborator
Dartmouth College
Collaborator
National Institute on Minority Health and Health Disparities (NIMHD)
Collaborator