Trial Outcomes & Findings for Targeting Bias to Reduce Disparities in End of Life Care (NCT NCT05165888)
NCT ID: NCT05165888
Last Updated: 2026-02-09
Results Overview
Verbal dominance was determined by the ratio of clinician to caregiver speaking time during the encounter, ranging from a minimum of 0 to a maximum of approximately 3. A ratio of \>1 indicates that the clinician dominated the discussion. Ratio of clinician to caregiver speaking times are expressed as decimals and summarized both prior to and following the intervention by study arm.
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
22 participants
Primary outcome timeframe
During the intervention, up to 5 hours
Results posted on
2026-02-09
Participant Flow
Participant milestones
| Measure |
Communication and Bias Mitigation Training
This is a communication training session based on a culturally-based program developed with rural, southern Black patients and families and modified for an urban, northern population. A strategy of bias mitigation successfully used with medical students will be adapted for practicing clinicians using results of phase 1. This strategy is based on transformational learning theory and incorporates critical reflection, guided dialogue, perspective taking exercises, role plays and strategy development. If specific communication behaviors are found related to bias and stereotyping in phase 1, these will be discussed and targeted using these techniques. Otherwise, these techniques will be used to address racial bias generally. The intervention will be incorporated within the communication training session.
Communication and Bias Mitigation Training: Training to improve communication skills and reduce the effect of racial bias on clinician communication behavior
|
Communication Training Only
This is a communication training session based on standard palliative care techniques to listen empathically, share prognostic information and treatment options, elicit patient and family goals and values related to their treatment, and facilitate shared decision-making regarding end-of-life treatment.
Communication skills training: Training to improve communication skills between physicians and caregivers.
|
|---|---|---|
|
Overall Study
STARTED
|
11
|
11
|
|
Overall Study
COMPLETED
|
11
|
10
|
|
Overall Study
NOT COMPLETED
|
0
|
1
|
Reasons for withdrawal
| Measure |
Communication and Bias Mitigation Training
This is a communication training session based on a culturally-based program developed with rural, southern Black patients and families and modified for an urban, northern population. A strategy of bias mitigation successfully used with medical students will be adapted for practicing clinicians using results of phase 1. This strategy is based on transformational learning theory and incorporates critical reflection, guided dialogue, perspective taking exercises, role plays and strategy development. If specific communication behaviors are found related to bias and stereotyping in phase 1, these will be discussed and targeted using these techniques. Otherwise, these techniques will be used to address racial bias generally. The intervention will be incorporated within the communication training session.
Communication and Bias Mitigation Training: Training to improve communication skills and reduce the effect of racial bias on clinician communication behavior
|
Communication Training Only
This is a communication training session based on standard palliative care techniques to listen empathically, share prognostic information and treatment options, elicit patient and family goals and values related to their treatment, and facilitate shared decision-making regarding end-of-life treatment.
Communication skills training: Training to improve communication skills between physicians and caregivers.
|
|---|---|---|
|
Overall Study
Withdrawal by Subject
|
0
|
1
|
Baseline Characteristics
Targeting Bias to Reduce Disparities in End of Life Care
Baseline characteristics by cohort
| Measure |
Communication and Bias Mitigation Training
n=11 Participants
This is a communication training session based on a culturally-based program developed with rural, southern Black patients and families and modified for an urban, northern population. A strategy of bias mitigation successfully used with medical students will be adapted for practicing clinicians using results of phase 1. This strategy is based on transformational learning theory and incorporates critical reflection, guided dialogue, perspective taking exercises, role plays and strategy development. If specific communication behaviors are found related to bias and stereotyping in phase 1, these will be discussed and targeted using these techniques. Otherwise, these techniques will be used to address racial bias generally. The intervention will be incorporated within the communication training session.
Communication and Bias Mitigation Training: Training to improve communication skills and reduce the effect of racial bias on clinician communication behavior
|
Communication Training Only
n=11 Participants
This is a communication training session based on standard palliative care techniques to listen empathically, share prognostic information and treatment options, elicit patient and family goals and values related to their treatment, and facilitate shared decision-making regarding end-of-life treatment.
Communication skills training: Training to improve communication skills between physicians and caregivers.
|
Total
n=22 Participants
Total of all reporting groups
|
|---|---|---|---|
|
Age, Customized
>18 years of age
|
11 Participants
n=41 Participants
|
11 Participants
n=1581 Participants
|
22 Participants
n=4626 Participants
|
|
Sex: Female, Male
Female
|
3 Participants
n=41 Participants
|
4 Participants
n=1581 Participants
|
7 Participants
n=4626 Participants
|
|
Sex: Female, Male
Male
|
8 Participants
n=41 Participants
|
7 Participants
n=1581 Participants
|
15 Participants
n=4626 Participants
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
1 Participants
n=41 Participants
|
1 Participants
n=1581 Participants
|
2 Participants
n=4626 Participants
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
8 Participants
n=41 Participants
|
7 Participants
n=1581 Participants
|
15 Participants
n=4626 Participants
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
2 Participants
n=41 Participants
|
3 Participants
n=1581 Participants
|
5 Participants
n=4626 Participants
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
0 Participants
n=41 Participants
|
0 Participants
n=1581 Participants
|
0 Participants
n=4626 Participants
|
|
Race (NIH/OMB)
Asian
|
5 Participants
n=41 Participants
|
5 Participants
n=1581 Participants
|
10 Participants
n=4626 Participants
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
0 Participants
n=41 Participants
|
0 Participants
n=1581 Participants
|
0 Participants
n=4626 Participants
|
|
Race (NIH/OMB)
Black or African American
|
1 Participants
n=41 Participants
|
0 Participants
n=1581 Participants
|
1 Participants
n=4626 Participants
|
|
Race (NIH/OMB)
White
|
3 Participants
n=41 Participants
|
4 Participants
n=1581 Participants
|
7 Participants
n=4626 Participants
|
|
Race (NIH/OMB)
More than one race
|
0 Participants
n=41 Participants
|
0 Participants
n=1581 Participants
|
0 Participants
n=4626 Participants
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
2 Participants
n=41 Participants
|
2 Participants
n=1581 Participants
|
4 Participants
n=4626 Participants
|
|
Region of Enrollment
United States
|
11 participants
n=41 Participants
|
11 participants
n=1581 Participants
|
22 participants
n=4626 Participants
|
|
Years in Practice
Less than 5 years
|
11 Participants
n=41 Participants
|
8 Participants
n=1581 Participants
|
19 Participants
n=4626 Participants
|
|
Years in Practice
5-10 years
|
0 Participants
n=41 Participants
|
2 Participants
n=1581 Participants
|
2 Participants
n=4626 Participants
|
|
Years in Practice
Greater than 10 years
|
0 Participants
n=41 Participants
|
1 Participants
n=1581 Participants
|
1 Participants
n=4626 Participants
|
|
Provider Specialty
Internist
|
0 Participants
n=41 Participants
|
3 Participants
n=1581 Participants
|
3 Participants
n=4626 Participants
|
|
Provider Specialty
Oncologist
|
1 Participants
n=41 Participants
|
0 Participants
n=1581 Participants
|
1 Participants
n=4626 Participants
|
|
Provider Specialty
Intensivist
|
10 Participants
n=41 Participants
|
6 Participants
n=1581 Participants
|
16 Participants
n=4626 Participants
|
|
Provider Specialty
Other
|
0 Participants
n=41 Participants
|
2 Participants
n=1581 Participants
|
2 Participants
n=4626 Participants
|
PRIMARY outcome
Timeframe: During the intervention, up to 5 hoursPopulation: One participant in the intervention arm withdrew due to time constraints.
Verbal dominance was determined by the ratio of clinician to caregiver speaking time during the encounter, ranging from a minimum of 0 to a maximum of approximately 3. A ratio of \>1 indicates that the clinician dominated the discussion. Ratio of clinician to caregiver speaking times are expressed as decimals and summarized both prior to and following the intervention by study arm.
Outcome measures
| Measure |
Communication and Bias Mitigation Training
n=11 Participants
This is a communication training session based on a culturally-based program developed with rural, southern Black patients and families and modified for an urban, northern population. A strategy of bias mitigation successfully used with medical students will be adapted for practicing clinicians using results of phase 1. This strategy is based on transformational learning theory and incorporates critical reflection, guided dialogue, perspective taking exercises, role plays and strategy development. If specific communication behaviors are found related to bias and stereotyping in phase 1, these will be discussed and targeted using these techniques. Otherwise, these techniques will be used to address racial bias generally. The intervention will be incorporated within the communication training session.
Communication and Bias Mitigation Training: Training to improve communication skills and reduce the effect of racial bias on clinician communication behavior
|
Communication Training Only
n=11 Participants
This is a communication training session based on standard palliative care techniques to listen empathically, share prognostic information and treatment options, elicit patient and family goals and values related to their treatment, and facilitate shared decision-making regarding end-of-life treatment.
Communication skills training: Training to improve communication skills between physicians and caregivers.
|
|---|---|---|
|
Verbal Dominance
Pre-Intervention
|
2.65 ratio
Standard Deviation 0.95
|
2.57 ratio
Standard Deviation 0.81
|
|
Verbal Dominance
Post-Intervention
|
2.10 ratio
Standard Deviation 0.88
|
1.74 ratio
Standard Deviation 0.62
|
SECONDARY outcome
Timeframe: During the intervention, up to 5 hoursPopulation: One participant in the intervention arm withdrew due to time constraints.
Encounter duration is an estimate of the time the physician speaks to the caregiver, ranging from 5 to 20 minutes, with higher scores indicating more engagement. Speaking time in minutes both prior to and following the intervention is summarized by study arm using basic descriptive statistics.
Outcome measures
| Measure |
Communication and Bias Mitigation Training
n=11 Participants
This is a communication training session based on a culturally-based program developed with rural, southern Black patients and families and modified for an urban, northern population. A strategy of bias mitigation successfully used with medical students will be adapted for practicing clinicians using results of phase 1. This strategy is based on transformational learning theory and incorporates critical reflection, guided dialogue, perspective taking exercises, role plays and strategy development. If specific communication behaviors are found related to bias and stereotyping in phase 1, these will be discussed and targeted using these techniques. Otherwise, these techniques will be used to address racial bias generally. The intervention will be incorporated within the communication training session.
Communication and Bias Mitigation Training: Training to improve communication skills and reduce the effect of racial bias on clinician communication behavior
|
Communication Training Only
n=11 Participants
This is a communication training session based on standard palliative care techniques to listen empathically, share prognostic information and treatment options, elicit patient and family goals and values related to their treatment, and facilitate shared decision-making regarding end-of-life treatment.
Communication skills training: Training to improve communication skills between physicians and caregivers.
|
|---|---|---|
|
Encounter Duration
Post-Intervention
|
13.64 minutes
Standard Deviation 3.73
|
16.00 minutes
Standard Deviation 1.83
|
|
Encounter Duration
Pre-Intervention
|
16.13 minutes
Standard Deviation 2.55
|
17.55 minutes
Standard Deviation 2.76
|
SECONDARY outcome
Timeframe: During the intervention, up to 5 hoursPopulation: One participant in the control arm withdrew due to time constraints.
Quality of verbal communication as rated by standardized (actor) caregiver using the three-item CollaboRATE tool which has a minimum score of 0 and maximum of 30 with higher scores indicating better communication. Scores prior to and following the intervention are summarized by study arm using basic descriptive statistics.
Outcome measures
| Measure |
Communication and Bias Mitigation Training
n=11 Participants
This is a communication training session based on a culturally-based program developed with rural, southern Black patients and families and modified for an urban, northern population. A strategy of bias mitigation successfully used with medical students will be adapted for practicing clinicians using results of phase 1. This strategy is based on transformational learning theory and incorporates critical reflection, guided dialogue, perspective taking exercises, role plays and strategy development. If specific communication behaviors are found related to bias and stereotyping in phase 1, these will be discussed and targeted using these techniques. Otherwise, these techniques will be used to address racial bias generally. The intervention will be incorporated within the communication training session.
Communication and Bias Mitigation Training: Training to improve communication skills and reduce the effect of racial bias on clinician communication behavior
|
Communication Training Only
n=11 Participants
This is a communication training session based on standard palliative care techniques to listen empathically, share prognostic information and treatment options, elicit patient and family goals and values related to their treatment, and facilitate shared decision-making regarding end-of-life treatment.
Communication skills training: Training to improve communication skills between physicians and caregivers.
|
|---|---|---|
|
Verbal Communication
Pre-Intervention
|
7.5 score on a scale
Standard Deviation 0.4
|
7.9 score on a scale
Standard Deviation 0.7
|
|
Verbal Communication
Post-Intervention
|
6.0 score on a scale
Standard Deviation 1.1
|
7.0 score on a scale
Standard Deviation 0.7
|
SECONDARY outcome
Timeframe: Duration of intervention, up to 5 hoursPopulation: Modified NAAS scores were not calculated instead individual components of the NAAS have been reported as separate outcome measures. This was done because the Nonverbal Accommodation Analysis System is not a score, but rather a system of coding nonverbal communication behaviors, consisting of 10 behaviors, the results for nine of which are individually reported below. There is no composite NAAS score in existence to calculate or report. The current protocol reflecting this has been uploaded.
The Nonverbal Accommodation Analysis System is not a score, but rather a system of coding nonverbal communication behaviors, consisting of 10 behaviors, the results of which are individually reported below. We modified the system as planned in the proposed research by removing behaviors not found to be related to bias or to standardized caregiver outcomes. This resulted in removing the speech rate variable, but retaining the remaining 9 variables. We also modified the system to count all instances of each behavior during the entire encounter, rather than in 2-minute slices of time.
Outcome measures
Outcome data not reported
SECONDARY outcome
Timeframe: During the intervention, up to 5 hoursPopulation: One participant in the intervention arm withdrew due to time constraints.
Physician talk time during the intervention was monitored and recorded. The mean duration of time the physician was speaking, both prior to and following the intervention, is summarized by study arm, adjusted by total duration of the encounter. The physician talk time is therefore given as a proportion of the total encounter duration and is expressed as a decimal unit.
Outcome measures
| Measure |
Communication and Bias Mitigation Training
n=11 Participants
This is a communication training session based on a culturally-based program developed with rural, southern Black patients and families and modified for an urban, northern population. A strategy of bias mitigation successfully used with medical students will be adapted for practicing clinicians using results of phase 1. This strategy is based on transformational learning theory and incorporates critical reflection, guided dialogue, perspective taking exercises, role plays and strategy development. If specific communication behaviors are found related to bias and stereotyping in phase 1, these will be discussed and targeted using these techniques. Otherwise, these techniques will be used to address racial bias generally. The intervention will be incorporated within the communication training session.
Communication and Bias Mitigation Training: Training to improve communication skills and reduce the effect of racial bias on clinician communication behavior
|
Communication Training Only
n=11 Participants
This is a communication training session based on standard palliative care techniques to listen empathically, share prognostic information and treatment options, elicit patient and family goals and values related to their treatment, and facilitate shared decision-making regarding end-of-life treatment.
Communication skills training: Training to improve communication skills between physicians and caregivers.
|
|---|---|---|
|
Physician Talk Time
Pre-Intervention
|
0.65 ratio
Standard Deviation 0.08
|
0.66 ratio
Standard Deviation 0.06
|
|
Physician Talk Time
Post-Intervention
|
0.55 ratio
Standard Deviation 0.10
|
0.55 ratio
Standard Deviation 0.08
|
SECONDARY outcome
Timeframe: During the intervention, up to 5 hoursPopulation: One participant in the intervention arm withdrew due to time constraints.
Number of times per minute the participant paused their speech during the encounter, both prior to the and following the intervention, is summarized by study arm using basic descriptive statistics.
Outcome measures
| Measure |
Communication and Bias Mitigation Training
n=11 Participants
This is a communication training session based on a culturally-based program developed with rural, southern Black patients and families and modified for an urban, northern population. A strategy of bias mitigation successfully used with medical students will be adapted for practicing clinicians using results of phase 1. This strategy is based on transformational learning theory and incorporates critical reflection, guided dialogue, perspective taking exercises, role plays and strategy development. If specific communication behaviors are found related to bias and stereotyping in phase 1, these will be discussed and targeted using these techniques. Otherwise, these techniques will be used to address racial bias generally. The intervention will be incorporated within the communication training session.
Communication and Bias Mitigation Training: Training to improve communication skills and reduce the effect of racial bias on clinician communication behavior
|
Communication Training Only
n=11 Participants
This is a communication training session based on standard palliative care techniques to listen empathically, share prognostic information and treatment options, elicit patient and family goals and values related to their treatment, and facilitate shared decision-making regarding end-of-life treatment.
Communication skills training: Training to improve communication skills between physicians and caregivers.
|
|---|---|---|
|
Pauses
Pre-Intervention
|
0.21 pauses per minute
Standard Deviation 0.18
|
0.25 pauses per minute
Standard Deviation 0.19
|
|
Pauses
Post-Intervention
|
0.53 pauses per minute
Standard Deviation 0.30
|
0.38 pauses per minute
Standard Deviation 0.20
|
SECONDARY outcome
Timeframe: During the intervention, up to 5 hoursPopulation: One participant in the intervention arm withdrew due to time constraints.
Number of times per minute that the subjects' speech overlapped with the standardized caregiver's speech, both prior to and following the intervention, is summarized by study arm using basic descriptive statistics.
Outcome measures
| Measure |
Communication and Bias Mitigation Training
n=11 Participants
This is a communication training session based on a culturally-based program developed with rural, southern Black patients and families and modified for an urban, northern population. A strategy of bias mitigation successfully used with medical students will be adapted for practicing clinicians using results of phase 1. This strategy is based on transformational learning theory and incorporates critical reflection, guided dialogue, perspective taking exercises, role plays and strategy development. If specific communication behaviors are found related to bias and stereotyping in phase 1, these will be discussed and targeted using these techniques. Otherwise, these techniques will be used to address racial bias generally. The intervention will be incorporated within the communication training session.
Communication and Bias Mitigation Training: Training to improve communication skills and reduce the effect of racial bias on clinician communication behavior
|
Communication Training Only
n=11 Participants
This is a communication training session based on standard palliative care techniques to listen empathically, share prognostic information and treatment options, elicit patient and family goals and values related to their treatment, and facilitate shared decision-making regarding end-of-life treatment.
Communication skills training: Training to improve communication skills between physicians and caregivers.
|
|---|---|---|
|
Simultaneous Speech
Pre-Intervention
|
0.21 instances of overlap per minute
Standard Deviation 0.18
|
0.25 instances of overlap per minute
Standard Deviation 0.19
|
|
Simultaneous Speech
Post-Intervention
|
0.53 instances of overlap per minute
Standard Deviation 0.30
|
0.38 instances of overlap per minute
Standard Deviation 0.20
|
SECONDARY outcome
Timeframe: During the intervention, up to 5 hoursPopulation: One participant in the intervention arm withdrew due to time constraints.
Number of times per minute the participant interrupted the standardized caregiver causing the standardized caregiver to stop speaking, both prior to and following the intervention, is summarized by study arm using basic descriptive statistics.
Outcome measures
| Measure |
Communication and Bias Mitigation Training
n=11 Participants
This is a communication training session based on a culturally-based program developed with rural, southern Black patients and families and modified for an urban, northern population. A strategy of bias mitigation successfully used with medical students will be adapted for practicing clinicians using results of phase 1. This strategy is based on transformational learning theory and incorporates critical reflection, guided dialogue, perspective taking exercises, role plays and strategy development. If specific communication behaviors are found related to bias and stereotyping in phase 1, these will be discussed and targeted using these techniques. Otherwise, these techniques will be used to address racial bias generally. The intervention will be incorporated within the communication training session.
Communication and Bias Mitigation Training: Training to improve communication skills and reduce the effect of racial bias on clinician communication behavior
|
Communication Training Only
n=11 Participants
This is a communication training session based on standard palliative care techniques to listen empathically, share prognostic information and treatment options, elicit patient and family goals and values related to their treatment, and facilitate shared decision-making regarding end-of-life treatment.
Communication skills training: Training to improve communication skills between physicians and caregivers.
|
|---|---|---|
|
Number of Interruptions
Post-Intervention
|
0.02 interruptions per minute
Standard Deviation 0.04
|
0.04 interruptions per minute
Standard Deviation 0.09
|
|
Number of Interruptions
Pre-Intervention
|
0.04 interruptions per minute
Standard Deviation 0.08
|
0 interruptions per minute
Standard Deviation 0
|
SECONDARY outcome
Timeframe: During the intervention, up to 5 hoursPopulation: One participant in the intervention group left early due to time constraints and did not complete post-intervention measures.
Number of times per minute the participant smiled during the encounter, both prior to and following the intervention, is summarized by study arm using basic descriptive statistics.
Outcome measures
| Measure |
Communication and Bias Mitigation Training
n=11 Participants
This is a communication training session based on a culturally-based program developed with rural, southern Black patients and families and modified for an urban, northern population. A strategy of bias mitigation successfully used with medical students will be adapted for practicing clinicians using results of phase 1. This strategy is based on transformational learning theory and incorporates critical reflection, guided dialogue, perspective taking exercises, role plays and strategy development. If specific communication behaviors are found related to bias and stereotyping in phase 1, these will be discussed and targeted using these techniques. Otherwise, these techniques will be used to address racial bias generally. The intervention will be incorporated within the communication training session.
Communication and Bias Mitigation Training: Training to improve communication skills and reduce the effect of racial bias on clinician communication behavior
|
Communication Training Only
n=11 Participants
This is a communication training session based on standard palliative care techniques to listen empathically, share prognostic information and treatment options, elicit patient and family goals and values related to their treatment, and facilitate shared decision-making regarding end-of-life treatment.
Communication skills training: Training to improve communication skills between physicians and caregivers.
|
|---|---|---|
|
Smiling
Pre-Intervention
|
0.01 smiles per minute
Standard Deviation 0.02
|
0.15 smiles per minute
Standard Deviation 0.26
|
|
Smiling
Post-Intervention
|
0.01 smiles per minute
Standard Deviation 0.02
|
0.09 smiles per minute
Standard Deviation 0.12
|
SECONDARY outcome
Timeframe: During the intervention, up to 5 hoursPopulation: One participant in the intervention group left early due to time constraints and did not complete post-intervention measures.
Number of times per minute the participant laughed during the encounter, both prior to and following the intervention, is summarized by study arm using basic descriptive statistics.
Outcome measures
| Measure |
Communication and Bias Mitigation Training
n=11 Participants
This is a communication training session based on a culturally-based program developed with rural, southern Black patients and families and modified for an urban, northern population. A strategy of bias mitigation successfully used with medical students will be adapted for practicing clinicians using results of phase 1. This strategy is based on transformational learning theory and incorporates critical reflection, guided dialogue, perspective taking exercises, role plays and strategy development. If specific communication behaviors are found related to bias and stereotyping in phase 1, these will be discussed and targeted using these techniques. Otherwise, these techniques will be used to address racial bias generally. The intervention will be incorporated within the communication training session.
Communication and Bias Mitigation Training: Training to improve communication skills and reduce the effect of racial bias on clinician communication behavior
|
Communication Training Only
n=11 Participants
This is a communication training session based on standard palliative care techniques to listen empathically, share prognostic information and treatment options, elicit patient and family goals and values related to their treatment, and facilitate shared decision-making regarding end-of-life treatment.
Communication skills training: Training to improve communication skills between physicians and caregivers.
|
|---|---|---|
|
Laughing
Pre-Intervention
|
0 laughs per minute
Standard Deviation 0
|
0.02 laughs per minute
Standard Deviation 0.03
|
|
Laughing
Post-Intervention
|
0.04 laughs per minute
Standard Deviation 0.08
|
0.04 laughs per minute
Standard Deviation 0.06
|
SECONDARY outcome
Timeframe: During the intervention, up to 5 hoursPopulation: One participant in the intervention group left early due to time constraints and did not complete post-intervention measures.
Number of times per minute the participant gestured with their hands during the encounter, both prior to and following the intervention, is summarized by study arm using basic descriptive statistics.
Outcome measures
| Measure |
Communication and Bias Mitigation Training
n=11 Participants
This is a communication training session based on a culturally-based program developed with rural, southern Black patients and families and modified for an urban, northern population. A strategy of bias mitigation successfully used with medical students will be adapted for practicing clinicians using results of phase 1. This strategy is based on transformational learning theory and incorporates critical reflection, guided dialogue, perspective taking exercises, role plays and strategy development. If specific communication behaviors are found related to bias and stereotyping in phase 1, these will be discussed and targeted using these techniques. Otherwise, these techniques will be used to address racial bias generally. The intervention will be incorporated within the communication training session.
Communication and Bias Mitigation Training: Training to improve communication skills and reduce the effect of racial bias on clinician communication behavior
|
Communication Training Only
n=11 Participants
This is a communication training session based on standard palliative care techniques to listen empathically, share prognostic information and treatment options, elicit patient and family goals and values related to their treatment, and facilitate shared decision-making regarding end-of-life treatment.
Communication skills training: Training to improve communication skills between physicians and caregivers.
|
|---|---|---|
|
Gesturing
Pre-Intervention
|
3.87 gestures per minute
Standard Deviation 1.52
|
3.93 gestures per minute
Standard Deviation 1.85
|
|
Gesturing
Post-Intervention
|
2.84 gestures per minute
Standard Deviation 1.54
|
2.22 gestures per minute
Standard Deviation 1.41
|
SECONDARY outcome
Timeframe: During the intervention, up to 5 hoursPopulation: One participant in the intervention group left early due to time constraints and did not complete post-intervention measures.
Number of times per minute the participant nodded during the encounter, both prior to and following the intervention, is summarized by study arm using basic descriptive statistics.
Outcome measures
| Measure |
Communication and Bias Mitigation Training
n=11 Participants
This is a communication training session based on a culturally-based program developed with rural, southern Black patients and families and modified for an urban, northern population. A strategy of bias mitigation successfully used with medical students will be adapted for practicing clinicians using results of phase 1. This strategy is based on transformational learning theory and incorporates critical reflection, guided dialogue, perspective taking exercises, role plays and strategy development. If specific communication behaviors are found related to bias and stereotyping in phase 1, these will be discussed and targeted using these techniques. Otherwise, these techniques will be used to address racial bias generally. The intervention will be incorporated within the communication training session.
Communication and Bias Mitigation Training: Training to improve communication skills and reduce the effect of racial bias on clinician communication behavior
|
Communication Training Only
n=11 Participants
This is a communication training session based on standard palliative care techniques to listen empathically, share prognostic information and treatment options, elicit patient and family goals and values related to their treatment, and facilitate shared decision-making regarding end-of-life treatment.
Communication skills training: Training to improve communication skills between physicians and caregivers.
|
|---|---|---|
|
Nodding
Pre-Intervention
|
2.68 nods per minute
Standard Deviation 0.67
|
2.15 nods per minute
Standard Deviation 0.78
|
|
Nodding
Post-Intervention
|
2.53 nods per minute
Standard Deviation 1.17
|
2.36 nods per minute
Standard Deviation 1.36
|
SECONDARY outcome
Timeframe: During the intervention, up to 5 hoursPopulation: One participant in the intervention group left early due to time constraints and did not complete post-intervention measures.
This is a REVERSE CODED variable. It measures the proportion of time during the encounter that the participant was looking away from the standardized caregiver in seconds divided by total encounter time in seconds. Eye contact time, both prior to and following the intervention, is summarized by study arm using basic descriptive statistics.
Outcome measures
| Measure |
Communication and Bias Mitigation Training
n=11 Participants
This is a communication training session based on a culturally-based program developed with rural, southern Black patients and families and modified for an urban, northern population. A strategy of bias mitigation successfully used with medical students will be adapted for practicing clinicians using results of phase 1. This strategy is based on transformational learning theory and incorporates critical reflection, guided dialogue, perspective taking exercises, role plays and strategy development. If specific communication behaviors are found related to bias and stereotyping in phase 1, these will be discussed and targeted using these techniques. Otherwise, these techniques will be used to address racial bias generally. The intervention will be incorporated within the communication training session.
Communication and Bias Mitigation Training: Training to improve communication skills and reduce the effect of racial bias on clinician communication behavior
|
Communication Training Only
n=11 Participants
This is a communication training session based on standard palliative care techniques to listen empathically, share prognostic information and treatment options, elicit patient and family goals and values related to their treatment, and facilitate shared decision-making regarding end-of-life treatment.
Communication skills training: Training to improve communication skills between physicians and caregivers.
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|---|---|---|
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Eye Contact
Pre-Intervention
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0.005 proportion of time in seconds
Standard Deviation 0.012
|
0.007 proportion of time in seconds
Standard Deviation 0.012
|
|
Eye Contact
Post-Intervention
|
0.014 proportion of time in seconds
Standard Deviation 0.023
|
0.010 proportion of time in seconds
Standard Deviation 0.024
|
Adverse Events
Communication and Bias Mitigation Training
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Communication Training Only
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place