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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 30 Research Studies DisplayedHu 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
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
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
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
St Hilaire MA, Anderson C, Anwar J
Brief (<4 hour) sleep episodes are insufficient for restoring performance in first-year resident physicians working overnight extended-duration work shifts.
This study examines the impact of reinstating extended duration (24-28) work shifts (EDWS) for postgraduate year 1 resident physicians. The performance of residents was studied for 23 male residents between 2002-2004 during a three-week on-call rotation schedule at the Medical and Intensive Care Units at Brigham and Women’s Hospital in Boston. If the sleep episodes were four hours or less then the odds of >1 attentional failure was 2.72 times higher during post-call compared to matched sessions during non-EDWS.
AHRQ-funded; HS012032.
Citation: St Hilaire MA, Anderson C, Anwar J .
Brief (<4 hour) sleep episodes are insufficient for restoring performance in first-year resident physicians working overnight extended-duration work shifts.
Sleep 2019 May;42(5):pii: zsz041. doi: 10.1093/sleep/zsz041..
Keywords: Adverse Events, Education: Continuing Medical Education, Medical Errors, Patient Safety, Provider, Provider: Physician, Quality of Care, Sleep Problems, Training
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
Sheehan FH, McConnaughey S, Freeman R
Formative assessment of performance in diagnostic ultrasound using simulation and quantitative and objective metrics.
The authors of this article describe how they developed simulator-based tools for assessing provider competence in transthoracic echocardiography (TTE) and vascular duplex scanning. Psychomotor skill in TTE image acquisition was calculated using the deviation angle of an acquired image from the anatomically correct view, and this skill metric applied for formative assessment to evaluate curricula and provide feedback to learners. Psychomotor skill in vascular ultrasound was measured in terms of dexterity and image plane location. The skill metric in the TTE simulator enabled immediate feedback, as well as formative assessment of curriculum efficacy and a comparison of curriculum outcomes. The vascular duplex ultrasound simulator also provided feedback. The authors conclude that skill in acquiring diagnostic ultrasound images of organs and vessels can be measured using simulation in an objective, quantitative, and standardized manner. Simulator-based metrics might also be applied to summative assessment.
AHRQ-funded; HS024219.
Citation: Sheehan FH, McConnaughey S, Freeman R .
Formative assessment of performance in diagnostic ultrasound using simulation and quantitative and objective metrics.
Mil Med 2019 Mar 1;184(Supplement_1):386-91. doi: 10.1093/milmed/usy388.
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Keywords: Diagnostic Safety and Quality, Education: Continuing Medical Education, Imaging, Provider Performance, Training
Cross WF, West JC, Pisani AR
A randomized controlled trial of suicide prevention training for primary care providers: a study protocol.
This paper summarizes the protocol for an ongoing study used to determine the most effective way to train primary care providers in suicide prevention. The effectiveness of training using simulation is being studies using two conditions: 1) a control group that receives online training via brief videos and; 2) the same online training plus two standardized patient (SP) interactions that can be either face-to-face, or telehealth.
AHRQ-funded; HS024224.
Citation: Cross WF, West JC, Pisani AR .
A randomized controlled trial of suicide prevention training for primary care providers: a study protocol.
BMC Med Educ 2019 Feb 14;19(1):58. doi: 10.1186/s12909-019-1482-5..
Keywords: Education: Continuing Medical Education, Behavioral Health, Prevention, Primary Care, Training
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
Rubio DM, Mayowski CA, Norman MK
A multi-pronged approach to diversifying the workforce.
This paper describes a multi-pronged, collaborative approach to enhance the diversity of trainees and scholars at the University of Pittsburgh Institute for Clinical Research Education. It describes the Career Education and Enhancement for Health Care Research Diversity (CEED) program, designed for postdoctoral fellows and junior faculty and the CEED II program designed for medical students.
AHRQ-funded; HS023185.
Citation: Rubio DM, Mayowski CA, Norman MK .
A multi-pronged approach to diversifying the workforce.
Int J Environ Res Public Health 2018 Oct 11;15(10). doi: 10.3390/ijerph15102219..
Keywords: Education: Continuing Medical Education, Research Methodologies, Training
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
Gilmartin H, Saint S, Rogers M
Pilot randomised controlled trial to improve hand hygiene through mindful moments.
The purpose of this study was to evaluate the effectiveness of a brief mindfulness intervention on hand hygiene performance and mindful attention for inpatient physician teams. The investigators found that the intervention improved hand hygiene in attending physicians and residents, but not in medical students. The intervention was well-received, increased mindfulness practice, and appeared to be a feasible way to introduce mindfulness in the clinical setting.
AHRQ-funded; HS024385.
Citation: Gilmartin H, Saint S, Rogers M .
Pilot randomised controlled trial to improve hand hygiene through mindful moments.
BMJ Qual Saf 2018 Oct;27(10):799-806. doi: 10.1136/bmjqs-2017-007359..
Keywords: Education: Continuing Medical Education, Inpatient Care, Patient Safety, Prevention, Training
Burgess JF, Menachemi N, Maciejewski ML
Update on the health services research doctoral core competencies.
The purpose of this study was to present revised core competencies for doctoral programs in health services research (HSR), modalities to deliver these competencies, and suggested methods for assessing mastery of these competencies. The study concluded that core competencies in HSR are a continually evolving work in progress because new research questions arise, new methods are developed, and the trans-disciplinary nature of the field leads to new multidisciplinary and team building needs.
AHRQ-funded.
Citation: Burgess JF, Menachemi N, Maciejewski ML .
Update on the health services research doctoral core competencies.
Health Serv Res 2018 Oct;53(Suppl 2):3985-4003. doi: 10.1111/1475-6773.12851..
Keywords: Education: Academic, Education: Continuing Medical Education, Health Services Research (HSR), Training
Lewis Gilbert A, McCord AL, Ouyang F
Characteristics associated with confidential consultation for adolescents in primary care.
This study examines how provider report of confidential consultation in the electronic health record is associated with adolescent characteristics, health risk factors, and provider training. The study found that provider training is needed to reinforce the importance of confidential consultation for all adolescents.
AHRQ-funded; HS022681.
Citation: Lewis Gilbert A, McCord AL, Ouyang F .
Characteristics associated with confidential consultation for adolescents in primary care.
J Pediatr 2018 Aug;199:79-84.e1. doi: 10.1016/j.jpeds.2018.02.044..
Keywords: Children/Adolescents, Education: Continuing Medical Education, Electronic Health Records (EHRs), Primary Care, Training
Forrest CB, Chesley FD, Tregear ML
AHRQ Author: Chesley FD, Mistry KB
Development of the learning health system researcher core competencies.
The purpose of this study was to develop core competencies for learning health system (LHS) researchers to guide the development of training programs. The investigators found that the iterative development process yielded seven competency domains: (1) systems science; (2) research questions and standards of scientific evidence; (3) research methods; (4) informatics; (5) ethics of research and implementation in health systems; (6) improvement and implementation science; and (7) engagement, leadership, and research management.
AHRQ-authored; AHRQ-funded; 290201200017I.
Citation: Forrest CB, Chesley FD, Tregear ML .
Development of the learning health system researcher core competencies.
Health Serv Res 2018 Aug;53(4):2615-32. doi: 10.1111/1475-6773.12751..
Keywords: Education: Continuing Medical Education, Learning Health Systems, Training
Adrian M, Lyon AR, Nicodimos S
Enhanced "train and hope" for scalable, cost-effective professional development in youth suicide prevention.
This study examined the impact of a 6-hr continuing education training, and the effect of a post-training reminder system, on mental health practitioners' knowledge, attitudes, and behavior surrounding suicide assessment and intervention. All practitioners, involved in the study, demonstrated increase in suicide assessment knowledge and attitudes for engaging in suicide risk assessments from pre- to posttest, and gains were maintained at the 3-month follow-up. The use of e-mail reminders was not associated with any additional changes.
AHRQ-funded; HS022982.
Citation: Adrian M, Lyon AR, Nicodimos S .
Enhanced "train and hope" for scalable, cost-effective professional development in youth suicide prevention.
Crisis 2018 Jul;39(4):235-46. doi: 10.1027/0227-5910/a000489..
Keywords: Education: Continuing Medical Education, Behavioral Health, Patient-Centered Healthcare, Prevention, Training
Bateni SB, Canter RJ, Meyers FJ
Palliative care training and decision-making for patients with advanced cancer: a comparison of surgeons and medical physicians.
Surgical decision-making in patients with advanced cancer requires careful thought and deliberation to balance the high risks with the potential palliative benefits. In this study, the investigators sought to compare surgical decision-making and palliative care training among surgeons and medical physicians who commonly treat advanced cancer patients. The investigators concluded that substantial deficiencies in palliative care training persised among surgeons and were associated with more aggressive recommendations for treatment for the selected scenarios presented in patients with advanced cancer.
AHRQ-funded; HS022236.
Citation: Bateni SB, Canter RJ, Meyers FJ .
Palliative care training and decision-making for patients with advanced cancer: a comparison of surgeons and medical physicians.
Surgery 2018 Jul;164(1):77-85. doi: 10.1016/j.surg.2018.01.021..
Keywords: Shared Decision Making, Palliative Care, Cancer, Surgery, Education: Continuing Medical Education, Training
Shoemaker SJ, Brach C, Edwards A
AHRQ Author: Brach C
Opportunities to improve informed consent with AHRQ training modules.
Patients often do not understand the risks, benefits, and alternatives of undergoing specific interventions, even after signing a consent form. This paper describes a mixed-methods pilot test of two Agency for Healthcare Research and Quality (AHRQ) informed consent training modules that was implemented in four hospitals. The study concluded that many opportunities exist for hospitals to improve their informed consent practices.
AHRQ-authored; AHRQ-funded; 290201000031I.
Citation: Shoemaker SJ, Brach C, Edwards A .
Opportunities to improve informed consent with AHRQ training modules.
Jt Comm J Qual Patient Saf 2018 Jun;44(6):343-52. doi: 10.1016/j.jcjq.2017.11.010..
Keywords: Shared Decision Making, Education: Continuing Medical Education, Health Literacy, Hospitals, Clinician-Patient Communication, 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
McArdle J, Sorensen A, Fowler CI
Strategies to improve management of shoulder dystocia under the AHRQ Safety Program for Perinatal Care.
The purpose of this study using TeamSTEPPS was to assess the implementation of safety strategies to improve management of births complicated by shoulder dystocia in labor and delivery units. Results suggested that successful management of shoulder dystocia requires a rapid, standardized, and coordinated response. The Safety Program for Perinatal Care strategies to increase safety of shoulder dystocia management are scalable, replicable, and adaptable to unit needs and circumstances.
AHRQ-funded; 2902010000241.
Citation: McArdle J, Sorensen A, Fowler CI .
Strategies to improve management of shoulder dystocia under the AHRQ Safety Program for Perinatal Care.
J Obstet Gynecol Neonatal Nurs 2018 Mar;47(2):191-201. doi: 10.1016/j.jogn.2017.11.014.
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Keywords: Labor and Delivery, Newborns/Infants, Pregnancy, Adverse Events, TeamSTEPPS, Injuries and Wounds, Care Management, Education: Continuing Medical Education, Training, Tools & Toolkits, Patient Safety, Nursing, Communication, Quality of Care
Stefanidis D
Developing a robust suturing assessment: validity evidence for the intracorporeal suturing assessment tool.
The purpose of this study was to validate a novel Intracorporeal Suturing Assessment Tool (ISAT) by comparing it with existing measures that have been reported to have validity evidence. The study found that the ISAT accurately assessed laparoscopic suturing skill related to other instruments. Unlike the generic Global Operative Assessment of Laparoscopic Skills (GOALS), ISAT includes specific information that can provide feedback on trainee suturing ability and targeted performance improvements.
AHRQ-funded; HS022080.
Citation: Stefanidis D .
Developing a robust suturing assessment: validity evidence for the intracorporeal suturing assessment tool.
Surgery 2018 Mar;163(3):560-64. doi: 10.1016/j.surg.2017.10.029..
Keywords: Education: Continuing Medical Education, Tools & Toolkits, Training