National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Cardiovascular Conditions (2)
- Care Management (1)
- Children/Adolescents (3)
- Clinician-Patient Communication (1)
- Communication (2)
- COVID-19 (1)
- Critical Care (1)
- Education: Continuing Medical Education (3)
- Education: Curriculum (2)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Emergency Medical Services (EMS) (2)
- Emergency Preparedness (1)
- Health Information Technology (HIT) (3)
- Heart Disease and Health (1)
- Hospitals (1)
- Intensive Care Unit (ICU) (2)
- Maternal Care (1)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (1)
- Orthopedics (1)
- Patient Safety (2)
- Provider (3)
- Provider: Physician (2)
- Provider Performance (1)
- Quality Improvement (1)
- Quality of Care (2)
- Research Methodologies (1)
- Respiratory Conditions (1)
- (-) Simulation (17)
- Surgery (3)
- Teams (2)
- Training (7)
- Trauma (1)
- Women (1)
- Workflow (1)
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 17 of 17 Research Studies DisplayedAnton NE, Cha JS, Hernandez E
Utilizing eye tracking to assess medical student non-technical performance during scenario-based simulation: results of a pilot study.
The purpose of this study was to determine if eye tracking (ET) metrics are associated with non-technical skills (NTS) performance. Participants wore a mobile ET system and participated in two patient care simulations in which they managed a deteriorating patient. Preliminary data suggests that visual attention on the patient was negatively associated with NTS and may indicate poor comprehension of the patient's status due to heightened cognitive load. The authors concluded that researchers and educators should consider using ET in future work to evaluate and provide feedback on their NTS.
AHRQ-funded; HS028026.
Citation: Anton NE, Cha JS, Hernandez E .
Utilizing eye tracking to assess medical student non-technical performance during scenario-based simulation: results of a pilot study.
Global Surg Educ 2023 Dec; 2(1). doi: 10.1007/s44186-023-00127-3.
Keywords: Simulation
Shields AD, Vidosh J, Thomson BA
Validation of a simulation-based resuscitation curriculum for maternal cardiac arrest.
The purpose of this study was to evaluate the knowledge, skills, and self-efficacy of health care participants completing a simulation-based blended learning training curriculum on managing maternal medical emergencies and maternal cardiac arrest. The study included a formative assessment of the Obstetric Life Support curriculum. The training consisted of self-guided pre-course work and an instructor-led simulation course using a customized low-fidelity simulator. Eighty-five participants consented to participation in the training (out of 88 invited); 77 participants completed the training over eight sessions. The study found that at baseline, less than 50% of participants were able to achieve a passing score on the cognitive assessment. After the course, mean cognitive assessment scores improved by 13 points, from 69.4% at baseline to 82.4% after the course. The researchers observed significant improvements in participant self-efficacy, and 92.6% of participants agreed or strongly agreed that the course met its educational objectives.
AHRQ-funded; HS026169.
Citation: Shields AD, Vidosh J, Thomson BA .
Validation of a simulation-based resuscitation curriculum for maternal cardiac arrest.
Obstet Gynecol 2023 Nov 1; 142(5):1189-98. doi: 10.1097/aog.0000000000005349..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Maternal Care, Simulation, Training, Education: Continuing Medical Education, Women
Taaffe K, Ferrand YB, Khoshkenar A
Operating room design using agent-based simulation to reduce room obstructions.
The purpose of this study was to improve the safety of clinical care provided in operating rooms (ORs) by examining wats in which characteristics of both the procedure and the physical environment affect surgical team movement and contacts. Researchers video recorded staff movements during surgical procedures, then divided the OR into multiple zones and analyzed the frequency and duration of movement from origin to destination. Results showed that OR size, the circulating nurse workstation location, and team size significantly affected surgical team contacts; two- and three-way interactions between staff, procedure type, table orientation, and workstation location also significantly affected contacts. Implications of these findings for OR managers and for future research about designing future ORs are discussed.
AHRQ-funded; HS0024380.
Citation: Taaffe K, Ferrand YB, Khoshkenar A .
Operating room design using agent-based simulation to reduce room obstructions.
Health Care Manag Sci 2023 Jun; 26(2):261-78. doi: 10.1007/s10729-022-09622-3..
Keywords: Surgery, Simulation
Straccia A, Chassagne F, Bass DI
A novel patient-specific computational fluid dynamics study of the activation of primary collateral pathways in the Circle of Willis during vasospasm.
This study presented a novel technique to create patient-specific computational fluid dynamics simulations of the Circle of Willis (a redundant network of blood vessels that perfuses the brain) before and during vasospasm. Computed tomographic angiography scans are segmented to model the vasculature, and transcranial Doppler ultrasound measurements of blood flow velocity are applied as boundary conditions. The authors stated that this analysis can be applied in future to a cohort of patients to investigate the relationship between the locations and severities of vasospasm, anatomical variability in individuals’ Circle of Willis, and the activation of collateral pathways.
AHRQ-funded; HS026690.
Citation: Straccia A, Chassagne F, Bass DI .
A novel patient-specific computational fluid dynamics study of the activation of primary collateral pathways in the Circle of Willis during vasospasm.
J Biomech Eng 2023 Apr;145(4):041008. doi: 10.1115/1.4055813.
Keywords: Cardiovascular Conditions, Simulation
Kman NE, Price A, Berezina-Blackburn V
First Responder Virtual Reality Simulator to train and assess emergency personnel for mass casualty response.
This paper describes the First Responder Virtual Reality Simulator, a high-fidelity, fully immersive, automated, programmable virtual reality (VR) simulation designed to train frontline responders to treat and triage victims of mass casualty incidents. First responder trainees wear a wireless VR head-mounted display linked to a compatible desktop computer. Autonomous, interactive victims who are programmed to simulate individuals with injuries consistent with an explosion in an underground space are used. The trainees are armed with a virtual medical kit, who are then tasked with triaging and treating the victims on the scene. Increased challenges can be added such as increasing the environmental chaos, adding patients, or increasing the acuity of patient injuries.
AHRQ-funded; HS025915.
Citation: Kman NE, Price A, Berezina-Blackburn V .
First Responder Virtual Reality Simulator to train and assess emergency personnel for mass casualty response.
J Am Coll Emerg Physicians Open 2023 Feb;4(1):e12903. doi: 10.1002/emp2.12903.
Keywords: Emergency Medical Services (EMS), Simulation, Health Information Technology (HIT), Training, Emergency Preparedness
Ellis AG, Iskandar R, Schmid CH
Active learning for efficiently training emulators of computationally expensive mathematical models.
The authors described a self-terminating active learning algorithm to efficiently develop emulators tailored to a specific emulation task and compared it with algorithms that optimize geometric criteria and other active learning algorithms. They found that the proposed algorithm attained satisfactory performance in all analyses, had smaller variability than the treed Gaussian Processes, and, on average, had similar or better performance as the treed Gaussian Processes in six out of seven benchmark functions and in the prostate cancer model.
AHRQ-funded; HS024653.
Citation: Ellis AG, Iskandar R, Schmid CH .
Active learning for efficiently training emulators of computationally expensive mathematical models.
Stat Med 2020 Nov 10;39(25):3521-48. doi: 10.1002/sim.8679..
Keywords: Simulation
Luo B, McLoone M, Rasooly IR
Analysis: protocol for a new method to measure physiologic monitor alarm responsiveness.
A team of researchers including biomedical engineers, human factors engineers, information technology specialists, nurses, physicians, facilitators from a hospital’s simulation center, clinical informaticians, and hospital administrative leadership worked with three units at a pediatric hospital to design and conduct simulations on newly implemented monitoring technology that will be used for patient critical alarms. The system was tested using a simulation with existing hospital technology to transmit an unambiguously critical alarm that appeared to originate from an actual patient to the nurse’s mobile device, with discreet observers measuring responses.
AHRQ-funded; HS026620.
Citation: Luo B, McLoone M, Rasooly IR .
Analysis: protocol for a new method to measure physiologic monitor alarm responsiveness.
Biomed Instrum Technol 2020 Nov/Dec;54(6):389-96. doi: 10.2345/0899-8205-54.6.389..
Keywords: Children/Adolescents, Hospitals, Simulation, Quality Improvement, Quality of Care, Patient Safety, Health Information Technology (HIT)
Dadiz R, Riccio J, Brown K
Qualitative analysis of latent safety threats uncovered by in situ simulation-based operations testing before moving into a single-family-room neonatal intensive care unit.
This study’s objective was to identify 1) latent safety threats (LSTs) in a new neonatal intensive care unit (NICU) through simulation-based pre-occupancy operations testing, and 2) LSTs that remained unresolved 1-year post-occupancy. This qualitative study included 111 healthcare professionals who participated in patient care simulations and debriefings in a new NICU. Debriefing transcripts were analyzed to characterize LSTs. Three-hundred threats with four major themes affecting staff function and patient safety emerged: relay of information, workplace design, patient care processes, and patient family and staff focus. One-year post occupancy 29 (9%) LSTs were still unresolved.
AHRQ-funded; R18 HS023460.
Citation: Dadiz R, Riccio J, Brown K .
Qualitative analysis of latent safety threats uncovered by in situ simulation-based operations testing before moving into a single-family-room neonatal intensive care unit.
J Perinatol 2020 Sep;40(Suppl 1):29-35. doi: 10.1038/s41372-020-0749-3..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Patient Safety, Simulation
Rozenfeld RA, Nannicelli AP, Brown AR
Verbal communication during airway management and emergent endotracheal intubation: observations of team behavior among multi-institutional pediatric intensive care unit in situ simulations.
The objective of this study was to assess health-care teams' verbal communication, an observable teamwork behavior, during simulations involving pediatric emergency airway management and intubation. The investigators found that no uniform statement was identified to declare an airway emergency among the care teams. Preintubation medication dosages were not consistently included in intubation medication orders, and frequently, there were multiple requests to obtain medications.
AHRQ-funded; HS017909.
Citation: Rozenfeld RA, Nannicelli AP, Brown AR .
Verbal communication during airway management and emergent endotracheal intubation: observations of team behavior among multi-institutional pediatric intensive care unit in situ simulations.
J Patient Saf 2020 Sep;16(3):e114-e19. doi: 10.1097/pts.0000000000000272..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Teams, Communication, Simulation
Nuamah JK, Adapa K, Mazur L
Electronic health records (EHR) simulation-based training: a scoping review protocol.
This article describes a literature review that will be conducted on the evidence for electronic health record (EHR)-based training interventions to facilitate improved EHR use for healthcare providers. Three databases will be searched for published articles and ProQuest and Google Scholar will be searched to identify unpublished articles from inception to January 29, 2020. Two reviewers will independently screen titles and abstracts using inclusion and exclusion criteria. Based on the extracted data, research evidence will be synthesized.
AHRQ-funded; HS025597.
Citation: Nuamah JK, Adapa K, Mazur L .
Electronic health records (EHR) simulation-based training: a scoping review protocol.
BMJ Open 2020 Aug 11;10(8):e036884. doi: 10.1136/bmjopen-2020-036884..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies, Simulation
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
Daly Guris RJ, Doshi A, Boyer DL
Just-in-time simulation to guide workflow design for coronavirus disease 2019 difficult airway management.
This paper describes the development and enactment of a number of simulation exercises, increasing in complexity for clinicians to practice intubation of critically ill children while wearing personal protective equipment due to coronavirus disease. The simulations ended up aiding in a real-life situation that then occurred less than 12 hours later that validated potential failure points and effectiveness of rapidly generated guidance. From this simulation a COVID-19 airway bundle template was created.
AHRQ-funded; HS026939; HS024511.
Citation: Daly Guris RJ, Doshi A, Boyer DL .
Just-in-time simulation to guide workflow design for coronavirus disease 2019 difficult airway management.
Pediatr Crit Care Med 2020 Aug;21(8):e485-e90. doi: 10.1097/pcc.0000000000002435..
Keywords: Children/Adolescents, COVID-19, Respiratory Conditions, Workflow, Simulation, Training
Panchal AR, Finnegan G, Way DP
Assessment of paramedic performance on difficult airway simulation.
The purpose of this study was to assess paramedic comprehensive airway management practices during a difficult airway simulation through which paramedics were obligated to consider alternatives to endotracheal intubation (ETI). The investigators concluded that in a difficult airway management scenario designed for low ETI success rates, even experienced paramedics were challenged with comprehensive airway management. This was exemplified by difficulties with the use of backup airway devices.
AHRQ-funded; HS021456.
Citation: Panchal AR, Finnegan G, Way DP .
Assessment of paramedic performance on difficult airway simulation.
Prehosp Emerg Care 2020 May-Jun;24(3):411-20. doi: 10.3109/10903127.2015.1102993..
Keywords: Simulation, Emergency Medical Services (EMS), Training, Quality of Care, Care Management, Provider Performance
Elison DM, McConnaughey S, Freeman RV
Focused cardiac ultrasound training in medical students: using an independent, simulator-based curriculum to objectively measure skill acquisition and learning curve.
Using simulators built and validated at the University of Washington (UW), the study sought to test whether medical students could learn the basic skills of focused cardiac ultrasound (FoCUS) from an individually paced, simulator-based curriculum, how skills improved, and the rate at which these skills were acquired. The study described the learning curve and technical skill acquisition in FoCUS. The investigators concluded that the simulator-based curriculum improved medical student's skills in an objective and quantifiable manner.
AHRQ-funded.
Citation: Elison DM, McConnaughey S, Freeman RV .
Focused cardiac ultrasound training in medical students: using an independent, simulator-based curriculum to objectively measure skill acquisition and learning curve.
Echocardiography 2020 Apr;37(4):491-96. doi: 10.1111/echo.14641..
Keywords: Education: Curriculum, Simulation
McCarthy DM, Powell RE, Cameron KA
Simulation-based mastery learning compared to standard education for discussing diagnostic uncertainty with patients in the emergency department: a randomized controlled trial.
The purpose of this study was to evaluate the effectiveness of the Uncertainty Communication Education Module (UCEM) in improving physician communications. Patients' understanding of the care they received has implications for care quality, safety, and patient satisfaction, especially when they are discharged without a definitive diagnosis. Developing a patient-centered diagnostic uncertainty communication strategy will improve safety of acute care discharges. This trial has been designed to have a low-resource, scalable intervention that would allow for widespread dissemination and uptake.
AHRQ-funded; HS025651.
Citation: McCarthy DM, Powell RE, Cameron KA .
Simulation-based mastery learning compared to standard education for discussing diagnostic uncertainty with patients in the emergency department: a randomized controlled trial.
BMC Med Educ 2020 Feb 19;20(1):49. doi: 10.1186/s12909-020-1926-y..
Keywords: Education: Continuing Medical Education, Clinician-Patient Communication, Communication, Emergency Department, Simulation, 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
Fernandez R, Rosenman ED, Olenick J
Simulation-based team leadership training improves team leadership during actual trauma resuscitations: a randomized controlled trial.
This study’s objective was to assess the clinical impact of simulation-based leadership training on team leadership and patient care during trauma resuscitations. A total of 79 second- and third-year residents at the Harborview Medical Center (a level 1 trauma center) were randomized and 360 resuscitations were analyzed. Participant-led actual trauma resuscitations were video recorded and then coded for leadership behaviors and patient care. Then the residents were randomized to a 4-hour simulation-based leadership training (intervention) or standard orientation (control) condition. The leadership behaviors were then scored pre- and post-training. There was a significant difference in post-training leadership behaviors between the intervention and control conditions.
AHRQ-funded; HS022458.
Citation: Fernandez R, Rosenman ED, Olenick J .
Simulation-based team leadership training improves team leadership during actual trauma resuscitations: a randomized controlled trial.
Crit Care Med 2020 Jan;48(1):73-82. doi: 10.1097/ccm.0000000000004077..
Keywords: Teams, Trauma, Simulation, Training, Provider