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- Adverse Events (2)
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- Cardiovascular Conditions (1)
- Caregiving (1)
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- Comparative Effectiveness (1)
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- Depression (1)
- Diagnostic Safety and Quality (1)
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- Simulation (9)
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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 25 Research Studies DisplayedCosta DK
The team, the team, the team: what critical care research can learn from football teams.
This article compares critical care ICUs to football teams and discusses how ICU teams can learn from the science of football teams. The author suggests that ICU teams should discuss team composition and their roles, and have individual and team training on team dynamics. She also suggests applying processes from football like huddles and time-outs that may be useful.
AHRQ-funded; HS024552.
Citation: Costa DK .
The team, the team, the team: what critical care research can learn from football teams.
Ann Am Thorac Soc 2019 Dec;16(12):1492-94. doi: 10.1513/AnnalsATS.201903-202IP.
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Keywords: Teams, Critical Care, Intensive Care Unit (ICU), Training
Adams DR, Williams NJ, Becker-Haimes EM
Therapist financial strain and turnover: interactions with system-level implementation of evidence-based practices.
In this study, the investigators prospectively examined the relationship between therapist financial strain and turnover in 247 therapists in 28 community mental health agencies. The investigators expected greater therapist financial strain to predict higher turnover and participation in a system-funded evidence-based practice (EBP) training initiative to alleviate this effect. They found that, controlling for covariates, financial strain predicted therapist turnover but not for therapists who participated in an EBP training initiative.
AHRQ-funded; HS000084.
Citation: Adams DR, Williams NJ, Becker-Haimes EM .
Therapist financial strain and turnover: interactions with system-level implementation of evidence-based practices.
Adm Policy Ment Health 2019 Nov;46(6):713-23. doi: 10.1007/s10488-019-00949-8..
Keywords: Healthcare Costs, Evidence-Based Practice, Behavioral Health, Provider, Provider: Clinician, Training, Workforce
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
Ivlev I, Vander Ley KJ, Wiedrick J
Training patients to review scientific reports for the Patient-Centered Outcomes Research Institute: an observational study.
This observational study aimed to evaluate the effect of new training for patient peer reviewers of scientific reports for the Patient-Centered Outcomes Research Institute (PCORI). A new online training in peer review was used to help change reviewers’ knowledge and skills and change self-efficacy and attitudes. Reviewers improved their answers to the knowledge questions. Median numbers of answers improved after the training, particularly in questions targeting the specifics of PCORI peer review. It modestly increased reviewers’ confidence in completing a high-quality peer review. Their excitement about providing a review slightly increased. All reviewers were satisfied with the training.
AHRQ-funded; HS026370.
Citation: Ivlev I, Vander Ley KJ, Wiedrick J .
Training patients to review scientific reports for the Patient-Centered Outcomes Research Institute: an observational study.
BMJ Open 2019 Sep;9(9):e028732. doi: 10.1136/bmjopen-2018-028732..
Keywords: Patient-Centered Outcomes Research, Evidence-Based Practice, Research Methodologies, Patient and Family Engagement, Education: Patient and Caregiver, Training
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
Wang D
A comparison of in-person and online training in a statewide clinical education program for dissemination of HIV, HCV and STD clinical evidence.
This study compared in-person and online training for dissemination of clinical evidence of HIV, HCV, and STD. The study used 250 clinicians completing four training courses in dual formats over a three-month period. Online training was the preferred format by clinicians.
AHRQ-funded; HS022057.
Citation: Wang D .
A comparison of in-person and online training in a statewide clinical education program for dissemination of HIV, HCV and STD clinical evidence.
Stud Health Technol Inform 2019 Aug 21;264:2003-04. doi: 10.3233/shti190756..
Keywords: Human Immunodeficiency Virus (HIV), Hepatitis, Sexual Health, Evidence-Based Practice, Training, Patient-Centered Outcomes Research
Burnett-Zeigler I, Hong S, Waldron EM
A mindfulness-based intervention for low-income African American women with depressive symptoms delivered by an experienced instructor versus a novice instructor.
The authors piloted a streamlined mindfulness teacher training protocol for Federally Qualified Health Center (FQHC) staff. They also examined the distribution and variability of psychologic outcomes for participants in groups led by an experienced instructor compared to a FQHC staff instructor who received the streamlined training. They concluded that preliminary data indicate that health care staff who receive streamlined training to deliver mindfulness-based interventions have comparable outcomes as experienced instructors.
AHRQ-funded; HS023011.
Citation: Burnett-Zeigler I, Hong S, Waldron EM .
A mindfulness-based intervention for low-income African American women with depressive symptoms delivered by an experienced instructor versus a novice instructor.
J Altern Complement Med 2019 Jul;25(7):699-708. doi: 10.1089/acm.2018.0393..
Keywords: Behavioral Health, Comparative Effectiveness, Depression, Low-Income, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Vulnerable Populations, Training, Women
Burgdorf J, Roth DL, Riffin C
Factors associated with receipt of training among caregivers of older adults.
Emerging evidence suggests that support of family caregivers, including education and training, can improve health outcomes for caregivers and care recipients. In this paper, the authors examine whether caregiver characteristics are associated with receipt of training. The investigators found that 93% of older adults’ family caregivers did not report receiving role-related training.
AHRQ-funded; HS000029.
Citation: Burgdorf J, Roth DL, Riffin C .
Factors associated with receipt of training among caregivers of older adults.
JAMA Intern Med 2019 Jun;179(6):833-35. doi: 10.1001/jamainternmed.2018.8694.
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Keywords: Caregiving, Training, Education: Patient and Caregiver, Home Healthcare, Quality of Life, Elderly
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
Kahwati LC, Sorensen AV, Teixeira-Poit S
AHRQ Author: Mistry KB
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
The purpose of this study was to describe the Safety Program for Perinatal Care (SPPC) implementation experience and evaluate the short-term impact on labor and delivery (L&D) unit patient safety culture, processes, and adverse events. SPPC implementation by L&D units were supported sing a program toolkit, trainings, and technical assistance. Researchers then evaluated the program using a pre-post, mixed-methods design. Changes in safety and quality were measured using the Modified Adverse Outcome Index (MAOI) and other perinatal care indicators. Findings showed that SPPC had a favorable impact on unit patient safety culture and processes, but mixed short-term impact on maternal and neonatal adverse events.
AHRQ-authored; AHRQ-funded; 2902010000241.
Citation: Kahwati LC, Sorensen AV, Teixeira-Poit S .
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
Jt Comm J Qual Patient Saf 2019 Apr;45(4):231-40. doi: 10.1016/j.jcjq.2018.11.002..
Keywords: Adverse Events, Communication, Comprehensive Unit-based Safety Program (CUSP), Labor and Delivery, Maternal Care, Newborns/Infants, Outcomes, Patient Safety, Pregnancy, Simulation, Surveys on Patient Safety Culture, Teams, TeamSTEPPS, Training, Women
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
Sherman M, Leland F, Ross B
Simopoly: improving simulation center operations through a tabletop simulation exercise.
In this article, the authors described a novel simulation, Simopoly, designed to provide the opportunity to think creatively about simulation center staff development, retention, and promotion in the context of daily operations and management.
AHRQ-funded; HS020295; HS022458.
Citation: Sherman M, Leland F, Ross B .
Simopoly: improving simulation center operations through a tabletop simulation exercise.
Simul Healthc 2014 Oct;9(5):304-11. doi: 10.1097/sih.0000000000000051.
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Keywords: Provider, Quality Improvement, Training
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
Wehbe-Janek H, Pliego J, Sheather S
System-based interprofessional simulation-based training program increases awareness and use of rapid response teams.
The objective of this study was to develop and implement an interprofessional simulation-based training program for rapid response and cardiac arrest emergencies with emphasis on early recognition and effective communication. The researchers concluded that their study demonstrated that rapid response team underuse due to system barriers may be overcome by this type of program targeting specific needs of the institution.
AHRQ-funded; HS016634
Citation: Wehbe-Janek H, Pliego J, Sheather S .
System-based interprofessional simulation-based training program increases awareness and use of rapid response teams.
Jt Comm J Qual Patient Saf. 2014 Jun;40(6):279-87..
Keywords: Critical Care, Cardiovascular Conditions, Simulation, Training, Communication
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