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Search All Research Studies
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 25 Research Studies DisplayedCohen TN, Anger JT, Kanji FF
A novel approach for engagement in team training in high-technology surgery: the Robotic-Assisted Surgery Olympics.
The purpose of this study was to develop the “Robotic-Assisted Surgery (RAS) Olympics,” a “serious game”-based educational competition to improve the skills required to successfully perform RAS. The pilot study was conducted at an academic medical center in Southern California. Sixteen operating room members participated in the event, reporting that they preferred the RAS Olympics to traditional training, enjoyed the activity, would recommend all staff participate, felt that it was relevant to their work, and believed that they practiced and learned new techniques that would improve their practice. The participants’ confidence in their skills did not change. The researchers concluded that new information was gained about new possibilities for simultaneously engaging and training surgical staff while emphasizing RAS safety and efficiency.
AHRQ-funded; HS026491.
Citation: Cohen TN, Anger JT, Kanji FF .
A novel approach for engagement in team training in high-technology surgery: the Robotic-Assisted Surgery Olympics.
J Patient Saf 2022 Sep 1;18(6):570-77. doi: 10.1097/pts.0000000000001056..
Keywords: Surgery, Training, Education: Continuing Medical Education, Simulation, Teams
Heiderscheit EA, Schlick CJR, Ellis RJ
Experiences of LGBTQ+ residents in US general surgery training programs.
The purpose of this study was to determine the national prevalence of mistreatment and poor well-being for lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) surgery residents compared with their non-LGBTQ+ peers. A voluntary, anonymous survey was conducted for clinically active general surgery residents training in accredited general surgery programs following their American Board of Surgery In-Training Examination. Findings showed that mistreatment was a common experience for LGBTQ+ surgery residents, with attending surgeons being the most common overall source. Increased suicidality among LGBTQ+ surgery residents was associated with this mistreatment. Recommendations included multifaceted interventions to develop safer and more inclusive learning environments.
AHRQ-funded; HS000078.
Citation: Heiderscheit EA, Schlick CJR, Ellis RJ .
Experiences of LGBTQ+ residents in US general surgery training programs.
JAMA Surg 2022 Jan;157(1):23-32. doi: 10.1001/jamasurg.2021.5246..
Keywords: Provider: Physician, Surgery, Training, Education: Continuing Medical Education
Thomas GW, Long S, Tatum M
A vision for using simulation & virtual coaching to improve the community practice of orthopedic trauma surgery.
In this paper, a vision is presented to elevate community orthopedic practice and improve patient safety by advancing the use of simulators for training and assessing surgical skills. Key elements of this vision included 1) methods for the objective and rigorous assessment of the performance of practicing surgeons now exist, 2) simulators are sufficiently mature and sophisticated that practicing surgeons will use them, and 3) practicing surgeons can improve their performance with appropriate feedback and coaching.
AHRQ-funded; HS022077; HS025353.
Citation: Thomas GW, Long S, Tatum M .
A vision for using simulation & virtual coaching to improve the community practice of orthopedic trauma surgery.
Iowa Orthop J 2020;40(1):25-34..
Keywords: Orthopedics, Surgery, Simulation, Training, Provider: Physician, Provider
Anton NE, Bean EA, Myers E
Optimizing learner engagement during mental skills training: a pilot study of small group vs. individualized training.
This study compared small group versus individualized training results for a group of residents learning laparoscopic suturing. Residents at one institution completed small group training and the second institution completed individualized training. After mental skills training, the completed FLS training at which time they completed the Short State Stress Questionnaire detailing the training. Twenty-one residents completed the training. Individualized training showed greater engagement and mental skills than small group training.
AHRQ-funded; HS022080.
Citation: Anton NE, Bean EA, Myers E .
Optimizing learner engagement during mental skills training: a pilot study of small group vs. individualized training.
Am J Surg 2020 Feb;219(2):335-39. doi: 10.1016/j.amjsurg.2019.12.022..
Keywords: Training, Education: Continuing Medical Education, Simulation, Surgery, Education: Curriculum
Hu YY, Ellis RJ, Hewitt DB
Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training.
A cross-sectional national survey of general surgery residents, administered with the 2018 American Board of Surgery In-Training Examination, assessed mistreatment, burnout, and suicidal thoughts during the past year. The authors assessed the association of mistreatment with burnout and suicidal thoughts; they found that mistreatment occurs frequently among general surgery residents, especially women, and is associated with burnout and suicidal thoughts.
AHRQ-funded; HS000078.
Citation: Hu YY, Ellis RJ, Hewitt DB .
Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training.
N Engl J Med 2019 Oct 31;381(18):1741-52. doi: 10.1056/NEJMsa1903759..
Keywords: Education: Continuing Medical Education, Burnout, Stress, Surgery, Provider: Physician, Provider, Training
Long SA, Thomas G, Karam MD
Do skills acquired from training with a wire navigation simulator transfer to a mock operating room environment?
This study compared performance of residents getting traditional and simulation orthopedic surgery training at three medical centers: University of Iowa, University of Minnesota, and the Mayo Clinic. All residents first received traditional training in how to treat an intertrochanteric fracture. Then the groups were divided up with two groups getting additional simulated-based training and another group getting proficiency training for specific components of wire navigation. The two simulation-based training groups performed better in lower tip-apex distance than the traditional training group. Residents in the proficiency training group used more images than the other groups.
AHRQ-funded; HS022077; HS025353.
Citation: Long SA, Thomas G, Karam MD .
Do skills acquired from training with a wire navigation simulator transfer to a mock operating room environment?
Clin Orthop Relat Res 2019 Oct;477(10):2189-98. doi: 10.1097/corr.0000000000000799..
Keywords: Simulation, Training, Education: Continuing Medical Education, Surgery, Orthopedics
Long S, Thomas GW, Anderson DD
An extensible orthopaedic wire navigation simulation platform.
The demand for simulation-based skills training in orthopaedics is steadily growing. Wire navigation, or the ability to use 2D images to place an implant through a specified path in bone, is an area of training that has been difficult to simulate given its reliance on radiation based fluoroscopy. The investigators group previously presented on the development of a wire navigation simulator for a hip fracture module. In this paper, they present a new methodology for extending the simulator to other surgical applications of wire navigation.
AHRQ-funded; HS022077; HS025353.
Citation: Long S, Thomas GW, Anderson DD .
An extensible orthopaedic wire navigation simulation platform.
J Med Device 2019 Sep;13(3):031001-310017. doi: 10.1115/1.4043461..
Keywords: Orthopedics, Simulation, Training, Surgery, Education: Continuing Medical Education
Anton NE, Mizota T, Whiteside JA
Mental skills training limits the decay in operative technical skill under stressful conditions: results of a multisite, randomized controlled study.
The authors hypothesize that surgery residents trained on mental skills would outperform controls under increased stress conditions in the simulated operating room. They find that their comprehensive mental skills curriculum implemented with surgery residents at two institutions was effective at minimizing the deterioration of resident technical performance under stressful conditions compared with controls. They conclude that their results provide further evidence for the effectiveness of mental skills training to optimize surgery trainees' technical performance during challenging clinical situations.
AHRQ-funded; R18 HS022080.
Citation: Anton NE, Mizota T, Whiteside JA .
Mental skills training limits the decay in operative technical skill under stressful conditions: results of a multisite, randomized controlled study.
Surgery 2019 Jun;165(6):1059-64. doi: 10.1016/j.surg.2019.01.011..
Keywords: Surgery, Education: Continuing Medical Education, Stress, Provider Performance, Training, Provider: Physician, Provider
Martin JR, Anton N, Timsina L
Performance variability during training on simulators is associated with skill transfer.
Researchers looked at performance variability during training on simulators for performing laparoscopic surgery. Their hypothesis was that participants (surgery residents and medical students) who had consistent scores were most likely to have the most expertise and be capable of training others. The trainees first used the Fundamentals of Laparoscopic Surgery (FLS) simulator to learn laparoscopic suturing and then were transfer tested on a live, anesthetized porcine model. Their hypothesis was proven true and those with decreased practice variability was associated with greater scores in posttests and transfer tests.
AHRQ-funded; R18 HS022080.
Citation: Martin JR, Anton N, Timsina L .
Performance variability during training on simulators is associated with skill transfer.
Surgery 2019 Jun;165(6):1065-68. doi: 10.1016/j.surg.2019.01.013..
Keywords: Simulation, Training, Surgery, Education: Continuing Medical Education, Provider Performance, Provider: Physician, Provider
Anton NE, Mizota T, Timsina LR
Attentional selectivity, automaticity, and self-efficacy predict simulator-acquired skill transfer to the clinical environment.
The objective of this study was to identify trainee characteristics that predict the transfer of simulator-acquired skill to the operating room. The investigators concluded that promoting automaticity, self-efficacy, and attention selectivity may help improve the transfer of simulator-acquired skill. They indicated that mental skills training and training to automaticity may therefore be valuable interventions to achieve this goal.
AHRQ-funded; HS022080.
Citation: Anton NE, Mizota T, Timsina LR .
Attentional selectivity, automaticity, and self-efficacy predict simulator-acquired skill transfer to the clinical environment.
Am J Surg 2019 Feb;217(2):266-71. doi: 10.1016/j.amjsurg.2018.11.028..
Keywords: Education: Continuing Medical Education, Patient Safety, Provider, Provider: Physician, Simulation, Surgery, Training
Bateni SB, Canter RJ, Meyers FJ
Palliative care training and decision-making for patients with advanced cancer: a comparison of surgeons and medical physicians.
Surgical decision-making in patients with advanced cancer requires careful thought and deliberation to balance the high risks with the potential palliative benefits. In this study, the investigators sought to compare surgical decision-making and palliative care training among surgeons and medical physicians who commonly treat advanced cancer patients. The investigators concluded that substantial deficiencies in palliative care training persised among surgeons and were associated with more aggressive recommendations for treatment for the selected scenarios presented in patients with advanced cancer.
AHRQ-funded; HS022236.
Citation: Bateni SB, Canter RJ, Meyers FJ .
Palliative care training and decision-making for patients with advanced cancer: a comparison of surgeons and medical physicians.
Surgery 2018 Jul;164(1):77-85. doi: 10.1016/j.surg.2018.01.021..
Keywords: Shared Decision Making, Palliative Care, Cancer, Surgery, Education: Continuing Medical Education, Training
Taylor LK, Thomas GW, Karam MD
Developing an objective assessment of surgical performance from operating room video and surgical imagery.
IISE Trans Healthc Syst Eng 2018;88(2):110-16. doi: 10.1080/24725579.2017.1418767.
An unbiased, repeatable process for assessing operating room performance is an important step toward quantifying the relationship between surgical training and performance. This study analyzed the following performance measures: duration of wire navigation, number of fluoroscopic images collected, degree of intervention by the surgeon's supervisor, and the tip-apex distance (TAD). The study results indicated that two metrics of hip fracture wire navigation performance, duration and TAD, significantly differentiated surgical experience.
An unbiased, repeatable process for assessing operating room performance is an important step toward quantifying the relationship between surgical training and performance. This study analyzed the following performance measures: duration of wire navigation, number of fluoroscopic images collected, degree of intervention by the surgeon's supervisor, and the tip-apex distance (TAD). The study results indicated that two metrics of hip fracture wire navigation performance, duration and TAD, significantly differentiated surgical experience.
AHRQ-funded; HS022077.
Citation: Taylor LK, Thomas GW, Karam MD .
Developing an objective assessment of surgical performance from operating room video and surgical imagery.
IISE Trans Healthc Syst Eng 2018;88(2):110-16. doi: 10.1080/24725579.2017.1418767..
Keywords: Provider Performance, Surgery, Training, Education: Continuing Medical Education
Myers CG, Kudsi OY, Ghaferi AA
Social media as a platform for surgical learning: use and engagement patterns among robotic surgeons.
This study analyzed data from a closed-membership Facebook group for robotic surgeons to better understand surgeons' engagement with social media platforms. This analysis observed that surgeons responded to text posts with more comments, but "liked" posts containing links, photos, or video images in greater numbers.
AHRQ-funded; HS023621.
Citation: Myers CG, Kudsi OY, Ghaferi AA .
Social media as a platform for surgical learning: use and engagement patterns among robotic surgeons.
Ann Surg 2018 Feb;267(2):233-35. doi: 10.1097/sla.0000000000002479..
Keywords: Education: Continuing Medical Education, Provider, Practice Patterns, Social Media, Surgery, Training
Branzetti JB, Adedipe AA, Gittinger MJ
Randomised controlled trial to assess the effect of a Just-in-Time training on procedural performance: a proof-of-concept study to address procedural skill decay.
The purpose of this study was to evaluate the impact of a novel Just-in-Time (JIT) intervention on transvenous pacemaker (TVP) placement during a simulated patient event. The authors concluded that a JIT intervention improved procedure performance, suggesting a role for JIT interventions in rarely performed procedures.
AHRQ-funded; HS020295
Citation: Branzetti JB, Adedipe AA, Gittinger MJ .
Randomised controlled trial to assess the effect of a Just-in-Time training on procedural performance: a proof-of-concept study to address procedural skill decay.
BMJ Qual Saf 2017 Nov;26(11):881-91. doi: 10.1136/bmjqs-2017-006656..
Keywords: Medical Devices, Patient Safety, Surgery, Training, Emergency Medical Services (EMS)
Scerbo MW, Britt RC, Montano M
Effects of a retention interval and refresher session on intracorporeal suturing and knot tying skill and mental workload.
The effects of refraining from practice for different intervals on laparoscopic suturing and mental workload were assessed with a secondary task developed by the authors. When participants who reached proficiency in suturing and knot tying were reassessed after either 1 or 5 months without practice, their performance times increased by 35 percent and secondary task scores decreased by 30 percent. These deficits, however, were nearly reversed after a single refresher session.
AHRQ-funded; HS020386.
Citation: Scerbo MW, Britt RC, Montano M .
Effects of a retention interval and refresher session on intracorporeal suturing and knot tying skill and mental workload.
Surgery 2017 May;161(5):1209-14. doi: 10.1016/j.surg.2016.11.011.
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Keywords: Surgery, Education: Continuing Medical Education, Training, Provider: Health Personnel
Kruser JM, Taylor LJ, Campbell TC
"Best case/worst case": training surgeons to use a novel communication tool for high-risk acute surgical problems.
"Best Case/Worst Case" (BC/WC) is a communication tool designed to promote goal-concordant care during discussions about high-risk surgery. The objective of this study was to evaluate a structured training program designed to teach surgeons how to use BC/WC. It concluded that : surgeons can learn to use BC/WC with older patients considering acute high-risk surgical interventions..
AHRQ-funded; HS000078.
Citation: Kruser JM, Taylor LJ, Campbell TC .
"Best case/worst case": training surgeons to use a novel communication tool for high-risk acute surgical problems.
J Pain Symptom Manage 2017 Apr;53(4):711-19.e5. doi: 10.1016/j.jpainsymman.2016.11.014.
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Keywords: Communication, Shared Decision Making, Provider: Health Personnel, Surgery, Training
Blay E, Jr., Hewitt DB, Chung JW
Association between flexible duty hour policies and general surgery resident examination performance: a Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial analysis.
This study investigated whether a flexible, less-restrictive duty hour policy (Flexible Policy) was associated with differential general surgery examination performance compared with current ACGME duty hour policy (Standard Policy). It found that flexible, less-restrictive duty hour policies were not associated with differences in general surgery resident performance on examinations during the FIRST Trial.
AHRQ-funded; HS000078.
Citation: Blay E, Jr., Hewitt DB, Chung JW .
Association between flexible duty hour policies and general surgery resident examination performance: a Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial analysis.
J Am Coll Surg 2017 Feb;224(2):137-42. doi: 10.1016/j.jamcollsurg.2016.10.042.
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Keywords: Education: Continuing Medical Education, Patient Safety, Provider, Surgery, Training
Scerbo MW, Britt RC, Stefanidis D
Differences in mental workload between traditional and single-incision laparoscopic procedures measured with a secondary task.
The purpose of this study was to use a secondary task to measure the incremental workload demands of single-incision laparoscopic surgery (SILS) procedures versus traditional laparoscopic procedures. It concluded that SILS procedures were significantly more mentally demanding than traditional laparoscopic procedures, as corroborated by primary and secondary tasks scores and subjective ratings.
AHRQ-funded; HS020386.
Citation: Scerbo MW, Britt RC, Stefanidis D .
Differences in mental workload between traditional and single-incision laparoscopic procedures measured with a secondary task.
Am J Surg 2017 Feb;213(2):244-48. doi: 10.1016/j.amjsurg.2016.09.056.
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Keywords: Surgery, Training, Simulation
Stefanidis D, Anton NE, Howley LD
Effectiveness of a comprehensive mental skills curriculum in enhancing surgical performance: results of a randomized controlled trial.
The researchers hypothesized that the implementation of a novel mental skills curriculum (MSC) during laparoscopic simulator training would improve mental skills and performance, and decrease stress. They found that, compared to controls, the intervention group significantly improved their mental skill use, demonstrated higher laparoscopic skill improvement during retention, and reported less stress during the transfer test.
AHRQ-funded; HS022080.
Citation: Stefanidis D, Anton NE, Howley LD .
Effectiveness of a comprehensive mental skills curriculum in enhancing surgical performance: results of a randomized controlled trial.
Am J Surg 2017 Feb;213(2):318-24. doi: 10.1016/j.amjsurg.2016.10.016.
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Keywords: Surgery, Training, Stress, Patient Safety
Long S, Thomas GW, Anderson DD
Designing an affordable wire navigation surgical simulator.
This project was focused on developing a more affordable surgical simulator that could provide high-fidelity training for the task of wire navigation. The goal of the simulator, was to provide simulated X-ray images of a real K-wire as it is placed into an artificial bone. In testing the performance of the simulator, only of the 491 reconstructions were deemed as failed reconstructions, a success rate of roughly 98 percent.
AHRQ-funded; HS022077.
Citation: Long S, Thomas GW, Anderson DD .
Designing an affordable wire navigation surgical simulator.
J Med Device 2016 Sep;10(3). doi: 10.1115/1.4033799.
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Keywords: Surgery, Simulation, Patient Safety, Training
Grenda TR, Pradarelli JC, Dimick JB
Using surgical video to improve technique and skill.
The authors argue that video analysis affords the opportunity to study both surgical technique (i.e. the details of how an operation is conducted) and surgical skill (i.e. how well a surgeon performs a procedure). This strategy may be particularly applicable for technically complex procedures that already have the capability to capture video (e.g. advanced laparoscopy, robotic surgery, video-assisted thoracoscopic surgery). Furthermore, this work could also be extended to open procedures using other video-recording modalities.
AHRQ-funded; HS000053.
Citation: Grenda TR, Pradarelli JC, Dimick JB .
Using surgical video to improve technique and skill.
Ann Surg 2016 Jul;264(1):32-3. doi: 10.1097/sla.0000000000001592.
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Keywords: Patient Safety, Surgery, Training
Gurm HS, Sanz-Guerrero J, Johnson DD
Using simulation for teaching femoral arterial access: a multicentric collaboration.
The purpose of this paper was to assess the impact of simulation training on complications associated with femoral arterial access obtained by first year cardiology fellows. The authors found that incorporation of simulation in the training of first year fellows was associated with an improvement in proficiency and a clinically meaningful reduction in vascular complications.
AHRQ-funded; HS020447.
Citation: Gurm HS, Sanz-Guerrero J, Johnson DD .
Using simulation for teaching femoral arterial access: a multicentric collaboration.
Catheter Cardiovasc Interv 2016 Feb 15;87(3):376-80. doi: 10.1002/ccd.26256.
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Keywords: Adverse Events, Education: Continuing Medical Education, Patient Safety, Surgery, Training
Britt RC, Scerbo MW, Montano M
Intracorporeal suturing: transfer from fundamentals of laparoscopic surgery to cadavers results in substantial increase in mental workload.
The researchers hypothesized that laparoscopic suturing on genuine bowel would be more challenging than on the Fundamentals of Laparoscopic Surgery (FLS)-simulated bowel as reflected in differences on both suturing and secondary task scores. They found that the increase in mental workload is indexed by both an increase in suturing times and a decrease in the ability to attend to the secondary task.
AHRQ-funded; HS020386.
Citation: Britt RC, Scerbo MW, Montano M .
Intracorporeal suturing: transfer from fundamentals of laparoscopic surgery to cadavers results in substantial increase in mental workload.
Surgery 2015 Nov;158(5):1428-33. doi: 10.1016/j.surg.2015.03.032..
Keywords: Surgery, Patient Safety, Simulation, Training
Kho JY, Johns BD, Thomas GW
A hybrid reality radiation-free simulator for teaching wire navigation skills.
The objective of this study was to assess the construct validity for a novel radiation-free simulator designed to teach wire navigation skills in hip fracture fixation. It found that the magnitude of improvement on successive simulator attempts was dependent on the level of expertise; tip-apex distance improved significantly in the novice group, whereas it was unchanged in the experienced group.
AHRQ-funded; HS022077.
Citation: Kho JY, Johns BD, Thomas GW .
A hybrid reality radiation-free simulator for teaching wire navigation skills.
J Orthop Trauma 2015 Oct;29(10):e385-90. doi: 10.1097/bot.0000000000000372..
Keywords: Surgery, Training, Health Information Technology (HIT), Injuries and Wounds, Patient Safety
Rajaram R, Chung JW, Cohen ME
Association of the 2011 ACGME resident duty hour reform with postoperative patient outcomes in surgical specialties.
The 2011 ACGME resident duty hour reform implemented additional restrictions to existing duty hour policies. The study’s objective was to determine the association between this reform and patient outcomes among several surgical specialties. It found that implementation of the 2011 ACGME resident duty hour reform was not associated with a significant change in patient outcomes for several surgical specialties in the 2 years after reform.
AHRQ-funded; HS000078.
Citation: Rajaram R, Chung JW, Cohen ME .
Association of the 2011 ACGME resident duty hour reform with postoperative patient outcomes in surgical specialties.
J Am Coll Surg 2015 Sep;221(3):748-57. doi: 10.1016/j.jamcollsurg.2015.06.010..
Keywords: Education: Continuing Medical Education, Outcomes, Surgery, Training