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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
26 to 50 of 159 Research Studies DisplayedBrown W, Santhosh L, Brady AK
A call for collaboration and consensus on training for endotracheal intubation in the medical intensive care unit.
This article presents a review of endotracheal intubation (EI) training for healthcare professionals in pulmonary and critical care medicine (PCCM). Although the ACGME mandates that trainees in PCCM achieve competence, only 60% of US PCCM trainees feel they are proficient in EI upon graduation. This article includes a review of EI training literature; the recommendations of a national group of PCCM, anesthesiology, emergency medicine, and pediatric experts; and a call for further research, collaboration, and consensus guidelines.
Citation: Brown W, Santhosh L, Brady AK .
A call for collaboration and consensus on training for endotracheal intubation in the medical intensive care unit.
Crit Care 2020 Oct 22;24(1):621. doi: 10.1186/s13054-020-03317-3..
Keywords: Training, Education: Continuing Medical Education, Critical Care, Intensive Care Unit (ICU), Guidelines
Glass M, Rana S, Coghlan R
Global palliative care education in the time of COVID-19.
This paper describes the Global Palliative Education Collaborative (GPEC), which is a training partnership between Harvard, University of California San Francisco, and Tulane medical schools in the U.S., and international palliative care (PC) programs in Uganda and India. U.S.-based fellowships are offered by GPEC to learn about resource-limited PC provision, gain perspectives on global challenges to caring for patients at the end of life, and cultivate resiliency. They also offer a novel educational project that the GPEC faculty and fellows are participating in called the Resilient Inspirational Storytelling Empathy Project. Palliative care has become even more important during the COVID-19 pandemic.
AHRQ-funded; HS026383.
Citation: Glass M, Rana S, Coghlan R .
Global palliative care education in the time of COVID-19.
J Pain Symptom Manage 2020 Oct;60(4):e14-e19. doi: 10.1016/j.jpainsymman.2020.07.018..
Keywords: Palliative Care, COVID-19, Education: Continuing Medical Education, Training
Zittleman L, Curcija K, Sutter C
Building capacity for medication assisted treatment in rural primary care Practices: the IT MATTTRs practice team training.
In response to rural communities and practice concerns related to opioid use disorder (OUD), the Implementing Technology and Medication Assisted Treatment Team Training in Rural Colorado study (IT MATTTRs) developed a training intervention for full primary care practice (PCP) teams in MAT for OUD. This evaluation reports on training implementation, participant satisfaction, and impact on perceived ability to deliver MAT.
AHRQ-funded; HS025065.
Citation: Zittleman L, Curcija K, Sutter C .
Building capacity for medication assisted treatment in rural primary care Practices: the IT MATTTRs practice team training.
J Prim Care Community Health 2020 Jan-Dec;11:2150132720953723. doi: 10.1177/2150132720953723..
Keywords: Medication, Primary Care, Opioids, Substance Abuse, Rural Health, Training, Education: Continuing Medical Education
Huth K, Amar-Dolan L, Perez JM
Visiting Jack: mixed methods evaluation of a virtual home visit curriculum with a child with medical complexity.
This study’s objective was to evaluate the impact of participation in a virtual home visit curriculum on pediatric residents’ confidence, knowledge, and application of knowledge in caring for children with medical complexity (CMC) in the home and community. This prospective pre-post intervention study was conducted in 2019 with first-year pediatric residents using quantitative and qualitative methods. The intervention used was an online video-based curriculum followed by an in-person seminar. Twenty-four residents participated. All reported increased confidence in all aspects of complex care presented in the curriculum. Half of them (12) participated in a follow-up interview or focus group. Four themes identified were: 1) recognizing prior attitudes towards complexity; 2) new mental framework for mental care at home; 3) drivers of behavior change; and 4) commitment to change practice.
AHRQ-funded; HS000063.
Citation: Huth K, Amar-Dolan L, Perez JM .
Visiting Jack: mixed methods evaluation of a virtual home visit curriculum with a child with medical complexity.
Acad Pediatr 2020 Sep-Oct;20(7):1020-28. doi: 10.1016/j.acap.2020.05.001..
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Chronic Conditions, Education: Continuing Medical Education
Khorfan R, Yuce TK, Love R
Cumulative effect of flexible duty-hour policies on resident outcomes: long-term follow-up results from the FIRST trial.
The authors investigated the long-term effect of flexible duty-hour policies on resident outcomes. They found that cumulative time under flexible duty-hour policies had no detrimental effects on duty-hour violations or resident well-being. After multiple years of flexibility, residents continue to report a high rate of satisfaction and positive effects on continuity of care.
Citation: Khorfan R, Yuce TK, Love R .
Cumulative effect of flexible duty-hour policies on resident outcomes: long-term follow-up results from the FIRST trial.
Ann Surg 2020 May;271(5):791-98. doi: 10.1097/sla.0000000000003802..
Keywords: Education: Continuing Medical Education, Patient Safety, Provider: Physician, Provider, Surgery
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
Ellis RJ, Holmstrom AL, Hewitt DB
A comprehensive national survey on thoughts of leaving residency, alternative career paths, and reasons for staying in general surgery training.
This survey examined reasons why general surgery residents might decide to leave their residency. The survey was administered with the 2018 American Board of Surgery In-Training Examination. Among 7,409 residents surveyed, 12.6% considered leaving residency over the last year. Almost half were considering other specialties if they were dissatisfied being a surgeon. Women were also more likely to consider leaving medicine. Common reasons for remaining in residency included the feeling of too large an investment to leave (65.3%) and career satisfaction (55%).
AHRQ-funded; HS000078; HS023011.
Citation: Ellis RJ, Holmstrom AL, Hewitt DB .
A comprehensive national survey on thoughts of leaving residency, alternative career paths, and reasons for staying in general surgery training.
Am J Surg 2020 Feb;219(2):227-32. doi: 10.1016/j.amjsurg.2019.10.040..
Keywords: Education: Continuing Medical Education, Surgery
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
Michelson KA, Nigrovic LE, Nagler J
Research interest in pediatric emergency medicine fellows.
The authors sought to determine the prevalence and determinants of interest in research careers among pediatric emergency medicine (PEM) fellows. They performed an electronically distributed national survey of current PEM fellows, assessing demographics, barriers to successful research, and beliefs about research using 4-point ordinal scales. The authors found that most fellows expect to devote a minority of their career to clinical research. Enthusiasm about research was strongly correlated with career research interest.
AHRQ-funded; HS000063.
Citation: Michelson KA, Nigrovic LE, Nagler J .
Research interest in pediatric emergency medicine fellows.
Pediatr Emerg Care 2020 Feb;36(2):e38-e42. doi: 10.1097/pec.0000000000001085..
Keywords: Emergency Department, Children/Adolescents, Health Services Research (HSR), Provider: Physician, Provider, Education: Continuing Medical Education
Salzman DH, Rising KL, Cameron KA
Setting a minimum passing standard for the uncertainty communication checklist through patient and physician engagement.
Historically, medically trained experts have served as judges to establish a minimum passing standard (MPS) for mastery learning. As mastery learning expands from procedure-based skills to patient-centered domains, such as communication, there is an opportunity to incorporate patients as judges in setting the MPS. In this study, the investigators described their process of incorporating patients as judges to set the minimum passing standard (MPS) and compared the MPS set by patients and emergency medicine residency program directors (PDs).
AHRQ-funded; HS025651.
Citation: Salzman DH, Rising KL, Cameron KA .
Setting a minimum passing standard for the uncertainty communication checklist through patient and physician engagement.
J Grad Med Educ 2020 Feb;12(1):58-65. doi: 10.4300/jgme-d-19-00483.1..
Keywords: Clinician-Patient Communication, Communication, Patient and Family Engagement, Patient Safety, Education: Continuing Medical Education, Training, Provider Performance
McDaniel CE, Rooholamini SN, Desai AD
A qualitative evaluation of a clinical faculty mentorship program using a realist evaluation approach.
The objectives of this study were to test and refine a program theory for an institutional mentorship program for junior clinically-focused faculty and to understand the facilitators and barriers of sustained participation. The authors identified 4 contextual themes, 3 mechanisms, and 3 outcomes, which they organized into a programmatic theory representing the program's impact on participants. They found that a mentorship program that provided junior faculty with opportunities to connect, share ideas and strategies, and self-reflect led to improvement in meaningful outcomes for clinically focused faculty. They concluded that their program theory provided a basis for institutions seeking to build a mentorship program targeted towards this increasing proportion of junior faculty.
AHRQ-funded; HS024299.
Citation: McDaniel CE, Rooholamini SN, Desai AD .
A qualitative evaluation of a clinical faculty mentorship program using a realist evaluation approach.
Acad Pediatr 2020 Jan-Feb;20(1):104-12. doi: 10.1016/j.acap.2019.08.008..
Keywords: Education: Continuing Medical Education, Education: Academic
Chan B, Lyles C, Kaplan C
A comparison of electronic patient-portal use among patients with resident and attending primary care providers.
In this study, the authors investigated differences in overall and patterns of portal use for patients with resident and attending primary care providers (PCPs). They concluded that given the lower patient-portal use among residents' patients, residency programs should develop curricula to bolster trainee competence in using the patient-portal for communication and to enhance the patient-physician relationship.
AHRQ-funded; HS022981; HS022408.
Citation: Chan B, Lyles C, Kaplan C .
A comparison of electronic patient-portal use among patients with resident and attending primary care providers.
J Gen Intern Med 2018 Dec;33(12):2085-91. doi: 10.1007/s11606-018-4637-x..
Keywords: Clinician-Patient Communication, Education: Continuing Medical Education, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Provider, Provider: Physician
Elkhadragy N, Corelli RL, Russ AL
Faculty perceptions of a tobacco cessation train-the-trainer workshop and experiences with implementation: a qualitative follow-up study.
Researchers conducted a long-term, qualitative follow-up study of faculty participants in the Rx for Change: Clinician-Assisted Tobacco Cessation workshop. All study participants reported implementing components of Rx for Change at their institution. The researchers’ analysis yielded eight major themes pertaining to faculty perceptions and experiences with implementation. They found that participation in the train-the-trainer workshop increased self-reported confidence for teaching tobacco cessation, and faculty valued access to useful, updated tools for teaching. Furthermore, the newly-acquired counseling skills were deemed helpful for treating patients' tobacco use and dependence in clinical practice.
AHRQ- funded; HS022119.
Citation: Elkhadragy N, Corelli RL, Russ AL .
Faculty perceptions of a tobacco cessation train-the-trainer workshop and experiences with implementation: a qualitative follow-up study.
Res Social Adm Pharm 2019 Dec;15(12):1436-45. doi: 10.1016/j.sapharm.2019.01.005..
Keywords: Tobacco Use: Smoking Cessation, Tobacco Use, Education: Continuing Medical Education
Yang AD, Quinn CM, Hewitt DB
National evaluation of needlestick events and reporting among surgical residents.
Needlestick injuries pose significant health hazards; however, the nationwide frequency of needlesticks and reporting practices among surgical residents are unknown. The objectives of this study were to examine the rate and circumstances of self-reported needlestick events in US surgery residents, assess factors associated with needlestick injuries, evaluate reporting practices, and identify reporting barriers.
AHRQ-funded; HS000078.
Citation: Yang AD, Quinn CM, Hewitt DB .
National evaluation of needlestick events and reporting among surgical residents.
J Am Coll Surg 2019 Dec;229(6):609-20. doi: 10.1016/j.jamcollsurg.2019.09.001..
Keywords: Education: Continuing Medical Education, Surgery, Injuries and Wounds, Provider
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
Symer MM, Sedrakyan A, Yeo HL
Case sequence analysis of the robotic colorectal resection learning curve.
This study examined trends in the increasing rate of resection surgery for colorectal cancer using robots. It has a major learning curve so investigators wanted to see if complication rates went down as the technology become more common. The cohort included adults undergoing colorectal section from 2008 through 2016 from data in the New York Statewide Planning and Research Cooperative database. The number of procedures started at 76 cases in 2010 and increased to 702 cases in 2015. Findings were that major complications (myocardial infarction, pulmonary embolism, shock, and death) did not decrease but iatrogenic complications were reduced. The odds of prolonged length of stay also decreased over time.
AHRQ-funded; HS000066.
Citation: Symer MM, Sedrakyan A, Yeo HL .
Case sequence analysis of the robotic colorectal resection learning curve.
Dis Colon Rectum 2019 Sep;62(9):1071-78. doi: 10.1097/dcr.0000000000001437..
Keywords: Cancer: Colorectal Cancer, Cancer, Surgery, Education: Continuing Medical Education, Outcomes
Cook JM, Newman E, Simiola V
Trauma training: competencies, initiatives, and resources.
Traumatic stress is currently not a required component of the standard curricula in graduate-level education in clinical and counseling psychology. However, due to the high prevalence of trauma and its potentially deleterious physical and mental health effects in the general and clinical populations, it is imperative that psychology graduate students and practitioners understand the relevance of trauma in their clients' lives and its impact in clinical research. This paper discusses competencies, initiatives and resources related to trauma training.
AHRQ-funded; HS021602.
Citation: Cook JM, Newman E, Simiola V .
Trauma training: competencies, initiatives, and resources.
Psychotherapy 2019 Sep;56(3):409-21. doi: 10.1037/pst0000233..
Keywords: Education: Continuing Medical Education, Behavioral Health, Provider, Stress, Training, Trauma
Hande K, Christenbery T, Phillippi J
Appreciative advising pilot study: an innovative approach to advising doctor of nursing practice students.
The purpose of this pilot study was to determine the feasibility of a doctor of nursing practice (DNP) appreciative advising model to advise students through the rigors of DNP education and improve student and faculty satisfaction. Faculty were provided with comprehensive guidebooks and received orientation on the model; qualitative responses were analyzed using content analysis. Results showed that the student and faculty participants reported satisfaction with the model and commented that the model allowed for early identification of needs and was helpful and worthwhile. These results suggest that the model may hold promise as a solution to assist students in adjusting to DNP education.
AHRQ-funded; HS024733.
Citation: Hande K, Christenbery T, Phillippi J .
Appreciative advising pilot study: an innovative approach to advising doctor of nursing practice students.
Nurse Educ 2019 Jul/Aug;44(4):187-91. doi: 10.1097/nne.0000000000000593..
Keywords: Provider: Nurse, Nursing, Education: Academic, 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
Gonzalez CM, Deno ML, Kintzer E
A qualitative study of New York medical student views on implicit bias instruction: implications for curriculum development.
The purpose of this study was to explore student perceptions of challenges and opportunities when participating in implicit bias instruction. The authors indicated that their analysis suggested a range of attitudes toward implicit bias instruction and identified contextual factors that may have influenced these attitudes. The themes were (1) resistance; (2) shame; (3) the negative role of the hidden curriculum; and (4) structural barriers to student engagement.
AHRQ-funded; HS023199.
Citation: Gonzalez CM, Deno ML, Kintzer E .
A qualitative study of New York medical student views on implicit bias instruction: implications for curriculum development.
J Gen Intern Med 2019 May;34(5):692-98. doi: 10.1007/s11606-019-04891-1..
Keywords: Education: Curriculum, Education: Continuing Medical Education, Education: Academic
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
DeWaters AL, Loria H, Mayo H
The impact of block ambulatory scheduling on internal medicine residencies: a systematic review.
Over the past decade, nearly half of internal medicine residencies have implemented block clinic scheduling; however, the effects on residency-related outcomes are unknown. The authors systematically reviewed the impact of block versus traditional ambulatory scheduling on residency-related outcomes, including (1) resident satisfaction, (2) resident-perceived conflict between inpatient and outpatient responsibilities, (3) ambulatory training time, (4) continuity of care, (5) patient satisfaction, and (6) patient health outcomes.
AHRQ-funded; HS022418.
Citation: DeWaters AL, Loria H, Mayo H .
The impact of block ambulatory scheduling on internal medicine residencies: a systematic review.
J Gen Intern Med 2019 May;34(5):731-39. doi: 10.1007/s11606-019-04887-x..
Keywords: Patient-Centered Outcomes Research, Education: Continuing Medical Education