• J Gen Intern Med · Jul 2024

    A Rapid Response Mobile Application Improves First-Year Resident Clinical Performance During Simulated Care Events: A Randomized Controlled Trial.

    • Alexandra C Collis, A Vincent Raikhel, Joseph R Bell, David Carlbom, Victoria Roach, and Elizabeth D Rosenman.
    • University of Washington, Seattle, WA, USA. acollis@uw.edu.
    • J Gen Intern Med. 2024 Jul 22.

    BackgroundRapid response teams (RRTs) are critical to the timely and appropriate management of acutely decompensating patients. In the academic setting, the vital role of RRT leader is often filled by a junior resident physician who may lack the necessary medical knowledge and experience. Cognitive aids help improve guideline adherence and may support resident performance as they transition into leadership roles.ObjectiveThis study evaluated the impact of a rapid response mobile application on intern performance during simulated rapid response events.DesignThis randomized controlled trial compared the performance of interns in two simulated rapid response scenarios with and without access to the rapid response mobile application. The scenarios included anaphylaxis and supraventricular tachycardia (SVT). Simulations were video recorded and coded by trained raters.ParticipantsInterns in all specialties at our institution.Main MeasuresOutcomes included (1) time to ordering critical medications (epinephrine and adenosine), (2) overall clinical performance using a checklist-based performance measure, and (3) usability of the mobile application. Enrollment and data collection occurred between November 2022 and February 2023.Key ResultsForty-four interns from 12 specialties were randomized to the intervention group (N = 22) and the control group (N = 22). Time to order critical medications was significantly reduced in the intervention group compared to control for anaphylaxis (P < 0.005) and SVT (P < 0.005). The intervention group had significantly higher performance scores compared to the control group for the anaphylaxis portion (P < 0.006). Usability scores for the rapid response toolkit were good.ConclusionsAccess to a rapid response mobile application improved the quality of care administered by interns during two simulated rapid response scenarios as determined by a decrease in time to ordering critical medications and improved performance scores. The intervention group found the mobile application to be usable. This work adds to existing literature supporting the use of technology-based cognitive aids to improve patient care.© 2024. The Author(s), under exclusive licence to Society of General Internal Medicine.

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