Teaching safety skills to mental health service providers: a comparison of two training methods
| ISRCTN | ISRCTN18133140 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN18133140 |
| Secondary identifying numbers | 101/2020 |
- Submission date
- 05/09/2023
- Registration date
- 06/09/2023
- Last edited
- 20/05/2024
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English summary of protocol
Background and study aims
Violence in the workplace is a concern in healthcare and particularly in mental healthcare. Consequently, mental healthcare staff are often required to take safety skills training. However, little is known about what training methods work best. Our study aimed at comparing two training methods for staff in a large Canadian psychiatric hospital to see if one was better than the other in teaching staff safety skills and in improving staff confidence in using those skills. The two methods we compared were behavioral skills training, a method that measured performance and competence, and the hospital's usual training method which demonstrated the skills and allowed staff to practice but which did not measure performance and competence.
Who can participate?
All newly hired hospital staff were required to register for a mandatory safety skills training session. All those who registered and agree to participate in study were included.
What does the study involve?
All registrants went through the mandatory training and had their safety skill and their confidence in using those skills assessed before training started and just after training ended. The skills assessments for those registrants who had agreed to be in the study were videotaped (with their consent) while their confidence levels were assessed using a written questionnaire. Study participants were then asked to come in one month later to have their skills and confidence assessed again.
What are the possible benefits and risks of participating?
None directly to the study participants. The benefits are expected to be for the institution to help it decide how to deliver the training.
Where is the study run from?
The location of the study was the Centre for Addiction and Mental Health, a psychiatric hospital in Toronto, Canada.
When is the study starting and how long is it expected to run for?
January 2020 to October 2021
Who is funding the study?
The study was funded by the Centre for Addiction and Mental Health (Canada)
Who is the main contact?
Dr Elizabeth Lin, elizabethbetty.lin@camh.ca
Contact information
Principal Investigator
1025 Queen Street West
Toronto
M6J 1H1
Canada
 ORCID ID |
0000-0002-9653-0764 |
|---|---|
| Phone | +1 4165358501 |
| elizabethbetty.lin@camh.ca |
Study information
| Study design | Single center interventional pragmatic randomized controlled trial |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Randomised controlled trial |
| Study setting(s) | Hospital |
| Study type | Other |
| Participant information sheet | No participant information sheet available |
| Scientific title | Behavioral skills training for teaching safety skills to mental health service providers compared to training-as-usual: a pragmatic randomized control trial |
| Study acronym | BSTTAU |
| Study objectives | Behavioral skills training will be no different than training-as-usual for teaching mental health professionals safety skills or for changing their confidence in using those skills (null hypothesis). |
| Ethics approval(s) |
Approved 07/12/2020, Centre for Addiction and Mental Health Research Ethics Board (33 Ursula Franklin Street, Toronto, M5S 2S1, Canada; +1 4165358501; research.ethics@camh.ca), ref: 101/2020 |
| Health condition(s) or problem(s) studied | Mandatory safety skills training for all newly hired hospital staff |
| Intervention | Behavioral skills training (intervention) versus training-as-usual. Behavioral skills training is a performance and competency-based training method that uses a modeling, practice, and feedback loop as assessed by structured checklists to evaluate skill performance and mastery. Training-as-usual involved trainers describing and demonstrating safety skills with time for trainees to practice. However, it does not involve structured and objective performance measurement. Prior to the scheduled mandatory training sessions, registrants were randomly assigned to sessions and sessions randomly assigned to the intervention or control conditions using GraphPad software. All registrants attended a 30-minute information presentation about the study (immediately preceding their mandatory orientation session) during which they asked questions and were then met, privately and individually, with a research team member to indicate their consent to either participate or not participate. Those consenting were assessed, along with all other registrants, for their safety skills just prior to training and immediately after the 3-hour training session by a skills trainer. Additionally, study participants assessments were, with their consent, videotaped, and they were asked to come back one month later for a follow-up skills assessment. Study participants also completed a self-report survey on their confidence in using these skill at baseline, post-training, and one-month follow-up. For the intervention arm (behavioral skills training), trainers led the registrants through a feedback loop, guided by a skills checklist, in which each step of the skill was explained and demonstrated; the registrants were then asked to practice and repeatedly demonstrate the skill until a predetermined success level as defined by the checklist was achieved before moving on to the next skill. For the control arm (training-as-usual), the same sequence was followed except there was no checklist and no requirement that any particular level of successful performance was achieved before the trainer moved to the next skill. |
| Intervention type | Behavioural |
| Primary outcome measure | All videotaped assessments for both arms were scored using the skills checklists by raters blind to which condition the participant was assigned to as well as which timepoint (baseline, post-training, and one-month follow-up.) 1. Competence in self-protection and team-control safety skills was measured as the percentage of correct executions observed by the videoraters 2. Mastery calculated using a pre-set threshold -- specifically 80 percent or higher competence scores. |
| Secondary outcome measures | Staff confidence in using skills measured based on a self-reported survey at baseline, post-training, and one-month follow-up |
| Overall study start date | 07/12/2020 |
| Completion date | 30/09/2021 |
Eligibility
| Participant type(s) | Employee |
|---|---|
| Age group | Adult |
| Lower age limit | 18 Years |
| Upper age limit | 100 Years |
| Sex | Both |
| Target number of participants | 2 clusters with 40 participants each who completed all three assessments (baseline, post-training, follow-up) |
| Total final enrolment | 199 |
| Key inclusion criteria | 1. All newly hired hospital staff 2. Registering for mandatory safety skills training 3. Agreeing to participate in the study 4. Signing informed consent |
| Key exclusion criteria | Does not meet inclusion criteria |
| Date of first enrolment | 01/01/2020 |
| Date of final enrolment | 31/10/2021 |
Locations
Countries of recruitment
- Canada
Study participating centre
Toronto
M6J1H1
Canada
Sponsor information
Hospital/treatment centre
1025 Queen Street West
Toronto
M6J1H1
Canada
| Phone | +1 4165358501 |
|---|---|
| research.ethics@camh.ca | |
| Website | http://www.camh.ca/en/hospital/Pages/home.aspx |
"ROR" |
https://ror.org/03e71c577 |
Funders
Funder type
Hospital/treatment centre
Government organisation / Research institutes and centers
- Alternative name(s)
- Centre for Addiction & Mental Health, Centre de Toxicomanie et de Santé Mentale, CAMH
- Location
- Canada
Results and Publications
| Intention to publish date | 01/12/2023 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Available on request |
| Publication and dissemination plan | Planned publication in a high-impact peer-reviewed journal |
| IPD sharing plan | The datasets generated during and analyzed during the current study will be available upon request from Elizabeth Lin (elizabeth.lin@camh.ca). Data available will be in de-identified and aggregated form. All participants signed informed consents. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Protocol article | 14/12/2022 | 06/09/2023 | Yes | No | |
| Results article | 17/05/2024 | 20/05/2024 | Yes | No |
Editorial Notes
20/05/2024: Publication reference added.
06/09/2023: Trial's existence confirmed by Centre for Addiction and Mental Health Research Ethics Board.
