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- Adverse Events (2)
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- (-) Education: Continuing Medical Education (24)
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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 24 of 24 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
Broder-Fingert S, Ferrone CF, Giauque A
Residents' knowledge and comfort with caring for children with autism spectrum disorder.
The authors evaluated a cohort of pediatric residents’ knowledge of and comfort with caring for children with autism spectrum disorder (ASD). Their data suggest that more education is needed to increase resident competence in caring for individuals with ASD. Residents reported very low rates of direct communication with patients with ASD and no residents had used pictures to communicate with these patients. The authors found it concerning that few residents had found resources to help these patients with their communication needs. At the same time, comfort with using pictures to communicate was scored higher than other domains.
AHRQ-funded; HS000063.
Citation: Broder-Fingert S, Ferrone CF, Giauque A .
Residents' knowledge and comfort with caring for children with autism spectrum disorder.
Clin Pediatr 2014 Dec;53(14):1390-2. doi: 10.1177/0009922814526982.
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Keywords: Autism, Children/Adolescents, Education: Continuing Medical Education, Children/Adolescents, Clinician-Patient Communication
Smith CS, Hill W, Francovich C
Diagnostic reasoning across the medical education continuum.
The researchers aimed to study linguistic and non-linguistic elements of diagnostic reasoning across the continuum of medical education. They identified three major findings: (1) The "apprentice effect" in novices (high stress and low narrative competence); (2) logistic concept growth in intermediates; and (3) a cognitive state transition (between analytical and intuitive approaches) in experts.
AHRQ-funded; HS018063.
Citation: Smith CS, Hill W, Francovich C .
Diagnostic reasoning across the medical education continuum.
Healthcare 2014 Jul 15;2(3):253-71. doi: 10.3390/healthcare2030253.
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Keywords: Education: Continuing Medical Education, Education: Continuing Medical Education, Patient Safety, Training
Cook JM, Newman E
A consensus statement on trauma mental health: the New Haven Competency Conference process and major findings.
The purpose of this article was to state the need for a comprehensive model of trauma-focused, empirically informed competencies for psychiatrists, and describe the work resulting from the New Haven Competencies consensus conference. The 60 participating experts outlined 5 broad foundational and functional competencies in the areas of trauma-focused and trauma-informed scientific knowledge, psychosocial assessment, psychosocial interventions, professionalism, and relational and systems. Eight cross-cutting competencies were voted into the resulting consensus statement.
AHRQ-funded; HS021602.
Citation: Cook JM, Newman E .
A consensus statement on trauma mental health: the New Haven Competency Conference process and major findings.
Psychol Trauma 2014 Jul;6(4):300-07. doi: 10.1037/a0036747..
Keywords: Trauma, Behavioral Health, Evidence-Based Practice, Education: Continuing Medical Education, Training
Shelton J, Kummerow K, Phillips S
Patient safety in the era of the 80-hour workweek.
The purpose of this paper was to evaluate the effect of duty-hour regulations (DHR) on patient safety. The researchers found no differences in the patient safety indicator (PSI) rates over time for hemorrhage or hematoma, physiologic or metabolic derangement, accidental puncture or laceration, or wound dehiscence. Teaching hospitals had higher rates than non-teaching hospitals both preintervention and postintervention for all the PSIs except wound dehiscence.
AHRQ-funded; HS013833.
Citation: Shelton J, Kummerow K, Phillips S .
Patient safety in the era of the 80-hour workweek.
J Surg Educ 2014 Jul-Aug;71(4):551-9. doi: 10.1016/j.jsurg.2013.12.011.
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Keywords: Adverse Events, Education: Continuing Medical Education, Patient Safety, Quality Indicators (QIs), Provider
Arora VM, Berhie S, Horwitz LI
Using standardized videos to validate a measure of handoff quality: the handoff mini-clinical examination exercise.
The researchers report the results of the development of a shorter Handoff Mini-Clinical Examination Exercise (CEX), along with the formal establishment of its construct validity, namely its ability to distinguish between levels of performance in 3 domains of handoff quality. They were able to demonstrate evidence that the Handoff Mini-CEX can draw reliable and valid conclusions regarding handoff performance by physicians in U.S. hospitals.
AHRQ-funded; HS018278
Citation: Arora VM, Berhie S, Horwitz LI .
Using standardized videos to validate a measure of handoff quality: the handoff mini-clinical examination exercise.
J Hospital Med. 2014 Jul;9(7):441-6. doi: 10.1002/jhm.2185.
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Keywords: Provider Performance, Quality Measures, Quality Improvement, Quality of Care, Education: Continuing Medical Education, Patient Safety
Stahl JE, Balasubramanian HJ, Gao X
Balancing clinical experience in outpatient residency training.
In order to balance the range of clinical experiences to which medical residents are exposed during their training, the authors set out to develop a framework for systematically optimizing patient reassignment at the beginning of the academic year. Their approach was based on a computer algorithm that they designed to sort patient panels by weighting factors of interest such as age, gender, and complexity.
AHRQ-funded; HS018795.
Citation: Stahl JE, Balasubramanian HJ, Gao X .
Balancing clinical experience in outpatient residency training.
Med Decis Making. 2014 May;34(4):464-72. doi: 10.1177/0272989X14524304..
Keywords: Education: Continuing Medical Education, Health Information Technology (HIT), Patient Safety
Boyer DL, Nishisaki A
Evaluating patient outcomes in medical education research: mission impossible?*.
This editorial examines evaluation of the impact of pediatric supplemental crisis resource management (CRM) training among first- and second-year residents. The author suggests that increasing CRM training and using debriefing for skill retention may link this training to patient outcomes.
AHRQ-funded; HS022464
Citation: Boyer DL, Nishisaki A .
Evaluating patient outcomes in medical education research: mission impossible?*.
Pediatr Crit Care Med. 2014 May;15(4):382-4. doi: 10.1097/pcc.0000000000000116..
Keywords: Education: Continuing Medical Education, Outcomes, Children/Adolescents, Training
Ness GL, Sheehan AH, Snyder ME
Graduating student pharmacists' perspectives on e-professionalism and social media: qualitative findings.
The researchers conducted a cross-sectional survey of 212 graduating student pharmacists to characterize their views of professionalism on popular social media sites. The themes identified in the analysis were separation of personal and professional lives, how accountability for actions should vary by severity, and the extent of representation of the students’ character on social media.
AHRQ-funded; HS022119.
Citation: Ness GL, Sheehan AH, Snyder ME .
Graduating student pharmacists' perspectives on e-professionalism and social media: qualitative findings.
J Am Pharm Assoc 2014 Mar-Apr;54(2):138-43. doi: 10.1331/JAPhA.2014.13188..
Keywords: Education: Academic, Education: Continuing Medical Education, Provider: Pharmacist, Social Media
Pershing S, Fuchs VR
Restructuring medical education to meet current and future health care needs.
The authors ask whether the duration, sequencing, and requirements of medical education are appropriate to meet current and future challenges to medical care. They conclude that a much more agile system that prepares physicians to practice in a changing environment is needed. This will require change at both the macro regulatory level (e.g., accreditation bodies and specialty boards) as well as the micro level of individual programs taking initiative in innovation.
AHRQ-funded; HS000028.
Citation: Pershing S, Fuchs VR .
Restructuring medical education to meet current and future health care needs.
Acad Med 2013 Dec;88(12):1798-801. doi: 10.1097/acm.0000000000000020..
Keywords: Education: Academic, Education: Continuing Medical Education, Education: Curriculum
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