National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Burnout (1)
- Cardiovascular Conditions (4)
- Care Management (1)
- Children/Adolescents (5)
- Clinician-Patient Communication (1)
- Communication (4)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- COVID-19 (3)
- Critical Care (7)
- Education: Academic (1)
- Education: Continuing Medical Education (18)
- Education: Curriculum (3)
- Electronic Health Records (EHRs) (2)
- Emergency Department (7)
- Emergency Medical Services (EMS) (3)
- Emergency Preparedness (3)
- Evidence-Based Practice (2)
- Guidelines (2)
- Healthcare Delivery (3)
- Health Information Technology (HIT) (6)
- Health Promotion (1)
- Health Services Research (HSR) (2)
- Heart Disease and Health (2)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (3)
- Implementation (1)
- Infectious Diseases (1)
- Intensive Care Unit (ICU) (6)
- Labor and Delivery (1)
- Maternal Care (2)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (4)
- Orthopedics (3)
- Outcomes (1)
- Patient Safety (10)
- Pregnancy (1)
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- Provider: Physician (5)
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- Registries (1)
- Research Methodologies (1)
- Respiratory Conditions (1)
- Rural Health (1)
- Screening (2)
- Shared Decision Making (3)
- (-) Simulation (49)
- Sleep Problems (2)
- Surgery (11)
- Surveys on Patient Safety Culture (1)
- Teams (9)
- TeamSTEPPS (2)
- Telehealth (2)
- Training (27)
- Trauma (1)
- Women (3)
- 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
26 to 49 of 49 Research Studies DisplayedFernandez 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
Barker LT, Bond WF, Vincent AL
A novel in situ simulation framework for introduction of a new technology: the 3-Act-3-Debrief model.
Researchers studied a simulation-based introduction to new technologies in order to address specific factors that influence adoption. They found that a novel 3-stage simulation-debriefing structure positively targeted factors influencing the adoption of new healthcare technologies.
AHRQ-funded; HS024027.
Citation: Barker LT, Bond WF, Vincent AL .
A novel in situ simulation framework for introduction of a new technology: the 3-Act-3-Debrief model.
Adv Simul 2020 Sep 25;5:25. doi: 10.1186/s41077-020-00145-x..
Keywords: Telehealth, Health Information Technology (HIT), Implementation, Simulation
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
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
Rosenman ED, Vrablik MC, Brolliar SM
Targeted simulation-based leadership training for trauma team leaders.
Effective team leadership is linked to better teamwork, which in turn is believed to improve patient care. Simulation-based training provides a mechanism to develop effective leadership behaviors. Traditionally, healthcare curricula have included leadership as a small component of broader teamwork training, with very few examples of leadership-focused curricula. The objective of this work was to describe a novel simulation-based team leadership curriculum that easily adapts to individual learners.
AHRQ-funded; HS022458.
Citation: Rosenman ED, Vrablik MC, Brolliar SM .
Targeted simulation-based leadership training for trauma team leaders.
West J Emerg Med 2019 May;20(3):520-26. doi: 10.5811/westjem.2019.2.41405..
Keywords: TeamSTEPPS, Teams, Simulation, Training, Emergency Department, Education: Continuing Medical Education, Quality Improvement, Quality of Care
Farra S, Hodgson E, Miller ET
Effects of virtual reality simulation on worker emergency evacuation of neonates.
This study compared differences in learning outcomes among newborn intensive care unit (NICU) workers who underwent emergency evacuation training either with virtual reality simulation (VRS) or web-based clinical updates (CU). The workers were evaluated based on knowledge gained, confidence with evacuation, and performance in a live evacuation exercise. Workers were randomly assigned to VRS or CU. The groups did not statistically differ based on Cognitive Assessment scores or self-evaluations. However, the VRS group performed statistically better than the CU group in the live exercise. This study points to the effectiveness of virtual reality training.
AHRQ-funded; HS023149.
Citation: Farra S, Hodgson E, Miller ET .
Effects of virtual reality simulation on worker emergency evacuation of neonates.
Disaster Med Public Health Prep 2019 Apr;13(2):301-08. doi: 10.1017/dmp.2018.58..
Keywords: Emergency Preparedness, Newborns/Infants, Intensive Care Unit (ICU), Simulation, Training, Education: Continuing Medical Education
Bond WF, Barker LT, Cooley KL
A simple low-cost method to integrate telehealth interprofessional team members during in situ simulation.
This article describes the integration of remote telehealth electronic intensive care unit (eICU) personnel into in situ simulations with rural emergency department (ED) care teams and the technical challenges of creating shared awareness of the patient's condition and the care team's progress among the care team, the eICU, and those running the simulation. The purpose of the simulations was to introduce telehealth technology and new processes of engaging the eICU via telehealth during sepsis care in rural EDs; development of the scenarios included experts in sepsis, telehealth, and emergency medicine. A shared in situ simulation clinical actions observational checklist was created using an off-the-shelf survey software program. The checklist was completed during the simulations by an onsite observer, and shared with the eICU team via teleconferencing software to and cue eICU nurse engagement. Staff from the two EDs were engaged and an eICU nurse participated in debriefing via the telehealth video system.
AHRQ-funded; HS024027.
Citation: Bond WF, Barker LT, Cooley KL .
A simple low-cost method to integrate telehealth interprofessional team members during in situ simulation.
Simul Healthc 2019 Apr;14(2):129-36. doi: 10.1097/sih.0000000000000357..
Keywords: Critical Care, Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Rural Health, Simulation, Teams, Telehealth
Kahwati LC, Sorensen AV, Teixeira-Poit S
AHRQ Author: Mistry KB
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
The purpose of this study was to describe the Safety Program for Perinatal Care (SPPC) implementation experience and evaluate the short-term impact on labor and delivery (L&D) unit patient safety culture, processes, and adverse events. SPPC implementation by L&D units were supported sing a program toolkit, trainings, and technical assistance. Researchers then evaluated the program using a pre-post, mixed-methods design. Changes in safety and quality were measured using the Modified Adverse Outcome Index (MAOI) and other perinatal care indicators. Findings showed that SPPC had a favorable impact on unit patient safety culture and processes, but mixed short-term impact on maternal and neonatal adverse events.
AHRQ-authored; AHRQ-funded; 2902010000241.
Citation: Kahwati LC, Sorensen AV, Teixeira-Poit S .
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
Jt Comm J Qual Patient Saf 2019 Apr;45(4):231-40. doi: 10.1016/j.jcjq.2018.11.002..
Keywords: Adverse Events, Communication, Comprehensive Unit-based Safety Program (CUSP), Labor and Delivery, Maternal Care, Newborns/Infants, Outcomes, Patient Safety, Pregnancy, Simulation, Surveys on Patient Safety Culture, Teams, TeamSTEPPS, Training, Women
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
Cicero MX, Whitfill T, Walsh B
Correlation between paramedic disaster triage accuracy in screen-based simulations and immersive simulations.
This study examined the effectiveness of adding a screen-based simulation (SBS) to immersive simulation of a disaster for triage education of paramedics and emergency medical technicians (EMTs). A randomized controlled trial (RCT) was conducted with emergency medical personnel who had completed an immersive simulation of a school shooting, interacted with an SBS for 13 weeks, and completed the immersive simulation again. The participants were divided into groups: one who had gone through the Seconds to Survival (60S) disaster triage SBS and the other who had not. There was a significant increase in triage accuracy with immersive simulation, but SBS did not correlate with performance in the immersive simlation.
AHRQ-funded; HS022837.
Citation: Cicero MX, Whitfill T, Walsh B .
Correlation between paramedic disaster triage accuracy in screen-based simulations and immersive simulations.
Prehosp Emerg Care 2019 Jan-Feb;23(1):83-89. doi: 10.1080/10903127.2018.1475530..
Keywords: Emergency Preparedness, Emergency Medical Services (EMS), Simulation, Training, Education: Continuing Medical Education
Murray DJ, Boyle WA, Beyatte MB
Decision-making skills improve with critical care training: using simulation to measure progress.
Health care professionals are expected to acquire decision-making skills during their training, but few methods are available to assess progress in acquiring these essential skills. The purpose of this study was to determine whether a simulation methodology could be used to assess whether decision-making skills improve during critical care training. The investigators indicate that their findings provide evidence to support the validity of a simulation-based method to assess progress in decision-making skills.
AHRQ-funded; HS022265.
Citation: Murray DJ, Boyle WA, Beyatte MB .
Decision-making skills improve with critical care training: using simulation to measure progress.
J Crit Care 2018 Oct;47:133-38. doi: 10.1016/j.jcrc.2018.06.021..
Keywords: Critical Care, Education: Continuing Medical Education, Shared Decision Making, Simulation, Teams, Training
Barsuk JH, Cohen ER, Williams MV
Simulation-based mastery learning for thoracentesis skills improves patient outcomes: a randomized trial.
Physicians-in-training often perform bedside thoracenteses in academic medical centers, and complications are more common among less experienced clinicians. Simulation-based mastery learning (SBML) is one potential solution to this problem. This study evaluated the effects of a randomized trial of thoracentesis SBML on patient complications: iatrogenic pneumothorax, hemothorax, and reexpansion pulmonary edema.
AHRQ-funded; HS021202.
Citation: Barsuk JH, Cohen ER, Williams MV .
Simulation-based mastery learning for thoracentesis skills improves patient outcomes: a randomized trial.
Acad Med 2018 May;93(5):729-35. doi: 10.1097/acm.0000000000001965..
Keywords: Education: Continuing Medical Education, Patient Safety, Provider, Provider: Physician, Simulation, Training
Rosenman ED, Dixon AJ, Webb JM
A simulation-based approach to measuring team situational awareness in emergency medicine: a multicenter, observational study.
This study’s goal was to develop and evaluate a novel approach to the measurement of team situational awareness (TSA) in interprofessional emergency medicine (EM) teams. EM teams, consisting of resident physicians, nurses, and medical students, were recruited from the University of Washington and Wayne State University; each team completed a simulated emergency resuscitation scenario, then completed three measures: a TSA measure, a team perception of shared understanding measure, and a team leader effectiveness measure. The simulations were recorded and coded independently for team performance by using a previously validated measure. Relationships between the TSA measure and other variables were explored. The authors conclude that simulations can provide a platform for TSA research and that their study provides a feasible method for simulation-based assessment of TSA.
AHRQ-funded; HS020295; HS022458.
Citation: Rosenman ED, Dixon AJ, Webb JM .
A simulation-based approach to measuring team situational awareness in emergency medicine: a multicenter, observational study.
Acad Emerg Med 2018 Feb;25(2):196-204. doi: 10.1111/acem.13257..
Keywords: Shared Decision Making, Emergency Department, Simulation, Teams
Rosenman ED, Fernandez R, Wong AH
Changing systems through effective teams: a role for simulation.
The objectives of this research were to explore the antecedents and processes that support team effectiveness, to summarize the role of simulation in the development and understanding team effectiveness, and to identify research targets that further the improvement of team-based training and assessment; the ultimate goal was the improvement of healthcare systems. The authors explore the foundations of team effectiveness, with a focus on team affect and team cognition. They also discuss advanced team processes that build on these foundations. The role of simulation‐based training in targeting these constructs and identifying resources from the team science literature is highlighted. The collaboration between educators and researchers from emergency medicine and the team sciences is emphasized, as is the importance of using a translational science approach to evaluate simulation‐based team training and elucidate the relationship between training and systems‐level outcomes.
AHRQ-funded; HS024820.
Citation: Rosenman ED, Fernandez R, Wong AH .
Changing systems through effective teams: a role for simulation.
Acad Emerg Med 2018 Feb;25(2):128-43. doi: 10.1111/acem.13260.
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Keywords: Emergency Department, Healthcare Delivery, Simulation, Teams
Bond WF, Hui J, Fernandez R
The 2017 Academic Emergency Medicine Consensus Conference: Catalyzing System Change Through Healthcare Simulation: Systems, Competency, and Outcomes.
The Academic Emergency Medicine (AEM) Consensus Conference "Catalyzing System Change Through Healthcare Simulation: Systems, Competency, and Outcome" was conceived to foster discussion among experts in EM, engineering, and social sciences, focusing on key barriers and opportunities in simulation-based research. This executive summary describes the overall rationale for the conference, conference planning, and consensus-building approaches and outlines the focus of the eight breakout sessions.
AHRQ-funded; HS024820.
Citation: Bond WF, Hui J, Fernandez R .
The 2017 Academic Emergency Medicine Consensus Conference: Catalyzing System Change Through Healthcare Simulation: Systems, Competency, and Outcomes.
Acad Emerg Med 2018 Feb;25(2):109-15. doi: 10.1111/acem.13302..
Keywords: Emergency Department, Healthcare Delivery, Health Services Research (HSR), Simulation
Laker LF, Torabi E, France DJ
Understanding emergency care delivery through computer simulation modeling.
This article is a product of a breakout session from the 2017 Academic Emergency Medicine conference entitled “Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes.” This article explores the role that computer simulation modeling can and should play in developing emergency room care delivery systems. The four approaches to computer simulation modeling were described and each of their benefits and risks. An introduction to available software modeling platforms and how to determine the best one for the readers situation is also included.
AHRQ-funded; HS021749.
Citation: Laker LF, Torabi E, France DJ .
Understanding emergency care delivery through computer simulation modeling.
Acad Emerg Med 2018 Feb;25(2):116-27. doi: 10.1111/acem.13272..
Keywords: Emergency Department, Healthcare Delivery, Simulation, Health Services Research (HSR)
Wang D
Use contexts and usage patterns of interactive case simulation tools by HIV healthcare providers in a statewide online clinical education program.
The researcher analyzed four interactive case simulation tools (ICSTs) from a statewide online clinical education program. Results have shown that ICSTs are increasingly used by HIV healthcare providers. Smart phone has become the primary usage platform for specific ICSTs. Usage patterns depend on particular ICST modules, usage stages, and use contexts.
AHRQ-funded; HS022057.
Citation: Wang D .
Use contexts and usage patterns of interactive case simulation tools by HIV healthcare providers in a statewide online clinical education program.
Stud Health Technol Inform 2017;245:1242.
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Keywords: Education: Continuing Medical Education, Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Provider, Simulation, 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
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
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
Wang D, Le XH, Luque AE
Identifying effective approaches for dissemination of clinical evidence--correlation analyses on promotional activities and usage of a guideline-driven interactive case simulation tool in a statewide HIV-HCV-STD clinical education program.
The investigators analyzed correlations between promotional activities and usage of a guideline-driven interactive case simulation tool (ICST) for insomnia screening and treatment in a statewide HIV-HCV-STD clinical education program. They found that promotional activities were strongly correlated with the number of audience as well as the intensity of use of the target resource, with strong correlations identified between the sending of email newsletters and the intensity of resource use by promotion recipients, by new users, and through the most convenient access channel associated with the promotion.
AHRQ-funded; HS022057.
Citation: Wang D, Le XH, Luque AE .
Identifying effective approaches for dissemination of clinical evidence--correlation analyses on promotional activities and usage of a guideline-driven interactive case simulation tool in a statewide HIV-HCV-STD clinical education program.
Stud Health Technol Inform 2015;216:515-9.
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Keywords: Human Immunodeficiency Virus (HIV), Education: Continuing Medical Education, Simulation, Guidelines, Evidence-Based Practice, Health Promotion, Screening, Sleep Problems, Training
Wehbe-Janek H, Pliego J, Sheather S
System-based interprofessional simulation-based training program increases awareness and use of rapid response teams.
The objective of this study was to develop and implement an interprofessional simulation-based training program for rapid response and cardiac arrest emergencies with emphasis on early recognition and effective communication. The researchers concluded that their study demonstrated that rapid response team underuse due to system barriers may be overcome by this type of program targeting specific needs of the institution.
AHRQ-funded; HS016634
Citation: Wehbe-Janek H, Pliego J, Sheather S .
System-based interprofessional simulation-based training program increases awareness and use of rapid response teams.
Jt Comm J Qual Patient Saf. 2014 Jun;40(6):279-87..
Keywords: Critical Care, Cardiovascular Conditions, Simulation, Training, Communication
Le XH, Luque AE, Wang D
Assessing the usage of a guideline-driven interactive case simulation tool for insomnia screening and treatment in an HIV clinical education program.
The researchers report the preliminary results from a study to assess the usage of a guideline-driven insomnia screening and treatment case simulation tool. Using system usage diagrams as an instrument, they quantified visit frequency and length of stay for different types of system resources. Preliminary results have shown that both recommendations and interactive decision diagrams were frequently used, with the former having a longer length of stay but fewer visits.
AHRQ-funded; HS022057.
Citation: Le XH, Luque AE, Wang D .
Assessing the usage of a guideline-driven interactive case simulation tool for insomnia screening and treatment in an HIV clinical education program.
Stud Health Technol Inform 2013;192:323-7..
Keywords: Education: Continuing Medical Education, Guidelines, Human Immunodeficiency Virus (HIV), Screening, Simulation, Sleep Problems