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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 40 Research Studies DisplayedGonzalez CM, Walker SA, Rodriguez N
It can be done! A skills-based elective in implicit bias recognition and management for preclinical medical students.
This paper describes a skill-based elective designed to recognize and manage implicit bias for preclinical medical students. From 2017 to 2019, nine 1.5-hour sessions were delivered to 15 first-year medical students. A program evaluation based on focus groups with students and data from notes taken by the investigative team was conducted. Three themes were identified from the program evaluation: 1) Student engagement can be enhanced, 2) Instruction is empowering, and 3) Addressing bias in one’s own and witnessed encounters can be done.
AHRQ-funded; HS023199.
Citation: Gonzalez CM, Walker SA, Rodriguez N .
It can be done! A skills-based elective in implicit bias recognition and management for preclinical medical students.
Acad Med 2020 Dec;95(12S):S150-s55. doi: 10.1097/acm.0000000000003697..
Keywords: Education: Continuing Medical Education, Education: Academic
Branca A, Tellez D, Berkenbosch J
The new trainee effect in tracheal intubation procedural safety across PICUs in North America: a report from National Emergency Airway Registry for Children.
Researchers evaluated the effect of the timing of the PICU fellow academic cycle on tracheal intubation-associated events in a retrospective cohort study of 37 PICUs participating in the National Emergency Airway Registry for Children.. They found that the New Trainee Effect in tracheal intubation safety outcomes was not observed in various types of PICUs. There was a significant improvement in pediatric critical care medicine fellows' first attempt success and a significant decline in tracheal intubation-associated event rates, indicating substantial skills acquisition throughout pediatric critical care medicine fellowship.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Branca A, Tellez D, Berkenbosch J .
The new trainee effect in tracheal intubation procedural safety across PICUs in North America: a report from National Emergency Airway Registry for Children.
Pediatr Crit Care Med 2020 Dec;21(12):1042-50. doi: 10.1097/pcc.0000000000002480..
Keywords: Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Adverse Events, Patient Safety, Registries, Education: Continuing Medical Education, Training
Lim H, Raffel KE, Harrison JD
Decisions in the dark: an educational intervention to promote reflection and feedback on night float rotations.
An educational intervention was created for medical residents during night float rotations where they admit patients to the hospital. The intervention was designed to provide feedback on their diagnostic and management reasoning using feedback solicitation and chart review. Second- and third-year internal medicine residents on a 1-month night float rotation were recruited. Residents performed chart review of a subset of patients they admitted and completed reflection worksheets detailing patients’ clinical courses. Sixty-eight of 82 eligible residents participated in the intervention. The authors evaluated 248 reflection worksheets using content analysis. Major themes that emerged from chart review included residents’ identification of reasoning gaps and evaluation of resident-provider interactions.
AHRQ-funded; HS026383.
Citation: Lim H, Raffel KE, Harrison JD .
Decisions in the dark: an educational intervention to promote reflection and feedback on night float rotations.
J Gen Intern Med 2020 Nov;35(11):3363-67. doi: 10.1007/s11606-020-05913-z..
Keywords: Provider: Physician, Provider, Education: Continuing Medical Education, Decision Making
Brown 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
Prey JE, Polubriaginof F, Kuperman GJ
A global analysis of approaches to sharing clinical data with patients.
The authors investigated the current state of approaches for providing patients with access to their own clinical information. They found that efforts to improve patient access to data are active on a global-scale; however, there are many open questions about best practices and much can be learned by adopting an international perspective to guide future implementation efforts.
AHRQ-funded; HS021816.
Citation: Prey JE, Polubriaginof F, Kuperman GJ .
A global analysis of approaches to sharing clinical data with patients.
Stud Health Technol Inform 2015;216:907.
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Keywords: Education: Continuing Medical Education, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement
Starmer AJ, Destino L, Yoon CS
Intern and resident workflow patterns on pediatric inpatient units: a multicenter time-motion study.
The researchers sought to quantify the proportion of time spent by residents in direct care, indirect care activities, and education across 9 pediatric institutions. They found that across all sites and levels of training, trainees spent more time in interprofessional communication (34.7 percent), and at the computer (20.5 percent), and less time in contact with patients and families (12.0 percent) and in educational activities (4.7 percent).
AHRQ-funded; HS019456.
Citation: Starmer AJ, Destino L, Yoon CS .
Intern and resident workflow patterns on pediatric inpatient units: a multicenter time-motion study.
JAMA Pediatr 2015 Dec;169(12):1175-7. doi: 10.1001/jamapediatrics.2015.2471..
Keywords: Children/Adolescents, Education: Continuing Medical Education, Inpatient Care, Provider, Training, Workflow
Lewiss RE, Chan W, Sheng AY
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
A group of radiologists, physicists, and emergency physicians convened at the 2015 Academic Emergency Medicine consensus conference to discuss and prioritize a research agenda related to education, assessment, and competency in ordering and interpreting diagnostic imaging. In this article, the authors review the supporting reliability and validity evidence and make specific recommendations for future research on the education, competency, and assessment of learning diagnostic imaging.
AHRQ-funded; HS023498.
Citation: Lewiss RE, Chan W, Sheng AY .
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
Acad Emerg Med 2015 Dec;22(12):1447-54. doi: 10.1111/acem.12833.
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Keywords: Imaging, Education: Continuing Medical Education, Emergency Department, Emergency Medical Services (EMS), Healthcare Utilization, Health Services Research (HSR)
Mohan V, Scholl G, Gold JA
Intelligent simulation model to facilitate EHR training.
The authors proposed Six Principles that are EHR-agnostic and provide the framework for the development of an intelligent simulation model that can optimize EHR training by replicating real-world clinical conditions and appropriate cognitive loads.
AHRQ-funded; HS021637.
Citation: Mohan V, Scholl G, Gold JA .
Intelligent simulation model to facilitate EHR training.
AMIA Annu Symp Proc 2015 Nov 5;2015:925-32.
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Keywords: Education: Continuing Medical Education, Health Information Technology (HIT), Patient Safety, Training, Electronic Health Records (EHRs)
Wolfe H, Maltese MR, Niles DE
Blood pressure directed booster trainings improve intensive care unit provider retention of excellent cardiopulmonary resuscitation skills.
The authors incorporated arterial blood pressure (ABP) tracings into Booster Trainings, hypothesizing that ABP-directed CPR Booster Trainings would improve intensive care unit (ICU) provider 3-month retention of excellent CPR skills without need for interval retraining. They found that the ABP-directed CPR booster trainings improved ICU provider 3-month retention of excellent CPR skills without the need for interval retraining.
AHRQ-funded; HS022469; HS022464.
Citation: Wolfe H, Maltese MR, Niles DE .
Blood pressure directed booster trainings improve intensive care unit provider retention of excellent cardiopulmonary resuscitation skills.
Pediatr Emerg Care 2015 Nov;31(11):743-7. doi: 10.1097/pec.0000000000000394.
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Keywords: Blood Pressure, Education: Continuing Medical Education, Intensive Care Unit (ICU), Patient Safety, Training
Carayon P, Weinger MB, Brown R
How do residents spend their time in the intensive care unit?
The researchers described the work of residents and the distribution of their time in 6 intensive care units (ICUs) of 2 medical centers (MCs). The found that residents spent most time performing direct patient care and care coordination activities. The distribution of activities, which varied across MCs and across ICUs, highlights the need to consider the local context on residents' work in ICUs.
AHRQ-funded; HS015274.
Citation: Carayon P, Weinger MB, Brown R .
How do residents spend their time in the intensive care unit?
Am J Med Sci 2015 Nov;350(5):403-8. doi: 10.1097/maj.0000000000000520.
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Keywords: Education: Continuing Medical Education, Intensive Care Unit (ICU), Provider, Training
Lindman BR, Tong CW, Carlson DE
National Institutes of Health career development awards for cardiovascular physician-scientists: recent trends and strategies for success.
The authors report on recent success rates for obtaining NIH K awards, provide strategies for preparing a successful application and navigating the early career period for aspiring cardiovascular investigators, and offer cardiovascular division leadership perspectives regarding K awards in the current era. Their objective is to offer practical advice that will equip trainees considering an investigator path for success.
AHRQ-funded; HS023000.
Citation: Lindman BR, Tong CW, Carlson DE .
National Institutes of Health career development awards for cardiovascular physician-scientists: recent trends and strategies for success.
J Am Coll Cardiol 2015 Oct 20;66(16):1816-27. doi: 10.1016/j.jacc.2015.08.858..
Keywords: Education: Continuing Medical Education, Provider, Training
Gance-Cleveland B, Aldrich H, Dandreaux D
A virtual childhood obesity collaborative: satisfaction with online continuing education.
This descriptive study evaluated school-based health center (SBHC) providers’ satisfaction with Web based continuing education as part of a virtual childhood obesity intervention. Participation in the first two learning sessions was higher than the last two. Provider satisfaction of training modules by question type and content area was quite high. Many providers also reported plans to make changes in their practice after completing the training.
AHRQ-funded; HS018646.
Citation: Gance-Cleveland B, Aldrich H, Dandreaux D .
A virtual childhood obesity collaborative: satisfaction with online continuing education.
J Pediatr Health Care 2015 Sep-Oct;29(5):413-23. doi: 10.1016/j.pedhc.2015.01.006..
Keywords: Education: Continuing Medical Education, Obesity, Children/Adolescents, Prevention, Web-Based
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
Arora VM, Prochaska MT, Farnan JM
Patient perceptions of whom is most involved in their care with successive duty hour limits.
The researchers aimed to assess if patients’ perceptions of who is most involved in their care changed with residency duty hours. They found that after successive residency duty hours limits, hospitalized patients were more likely to report the attending physician and less likely to report the resident or intern as most involved in their hospital care.
AHRQ-funded; HS010597; HS016967.
Citation: Arora VM, Prochaska MT, Farnan JM .
Patient perceptions of whom is most involved in their care with successive duty hour limits.
J Gen Intern Med 2015 Sep;30(9):1275-8. doi: 10.1007/s11606-015-3239-0..
Keywords: Education: Continuing Medical Education, Inpatient Care, Provider, Clinician-Patient Communication, Workforce
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