National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Behavioral Health (2)
- Burnout (2)
- Cancer (2)
- Cardiovascular Conditions (1)
- Care Management (1)
- Children/Adolescents (2)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (1)
- Communication (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Critical Care (1)
- Cultural Competence (1)
- Decision Making (6)
- Depression (1)
- Diagnostic Safety and Quality (1)
- Digestive Disease and Health (1)
- Education: Academic (2)
- (-) Education: Continuing Medical Education (37)
- Education: Curriculum (1)
- Electronic Health Records (EHRs) (1)
- Emergency Medical Services (EMS) (2)
- Evidence-Based Practice (1)
- Health Literacy (2)
- Health Services Research (HSR) (2)
- Hospitals (2)
- Infectious Diseases (1)
- Injuries and Wounds (1)
- Inpatient Care (1)
- Labor and Delivery (1)
- Learning Health Systems (1)
- Newborns/Infants (1)
- Nursing (1)
- Palliative Care (3)
- Patient-Centered Healthcare (1)
- Patient Safety (5)
- Practice Patterns (2)
- Pregnancy (1)
- Prevention (2)
- Primary Care (1)
- Provider (11)
- Provider: Clinician (1)
- Provider: Nurse (1)
- Provider: Physician (7)
- Provider Performance (4)
- Quality Improvement (1)
- Quality of Care (2)
- Research Methodologies (2)
- Risk (1)
- Simulation (2)
- Social Media (1)
- Stress (2)
- Surgery (11)
- Teams (1)
- TeamSTEPPS (1)
- Tools & Toolkits (2)
- Training (14)
- Workforce (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 37 Research Studies DisplayedDversdal RK, Gold JA, Richards MH
A 5-day intensive curriculum for interns utilizing simulation and active-learning techniques: addressing domains important across internal medicine practice.
In this paper, the authors describe their 5-day intensive, simulation and active learning-based curriculum for internal medicine interns to address perceived gaps in cognitive, affective and psychomotor domains. Intern confidence and self-perceived competence was assessed via survey before and after the curriculum, along with qualitative data.
AHRQ-funded; HS021367.
Citation: Dversdal RK, Gold JA, Richards MH .
A 5-day intensive curriculum for interns utilizing simulation and active-learning techniques: addressing domains important across internal medicine practice.
BMC Res Notes 2018 Dec 21;11(1):916. doi: 10.1186/s13104-018-4011-4.
.
.
Keywords: Education: Continuing Medical Education
Symer MM, Abelson JS, Wong NZ
Impact of medical school experience on attrition from general surgery residency.
This article describes a national prospective cohort study in which general surgery interns who entered training in the 2007-2008 academic year were asked questions about their medical school experience and reasons for pursuing general surgery residency. The purpose was to discover if inadequate preparation in medical school was responsible for high attrition rates in general surgery residency. Intern responses were linked with American Board of Surgery residency completion data. The results indicate that increased quality, not quantity, of surgery clerkships is associated with improved completion rates of residency. Relationships with positive yet demanding role models were also associated with a lower rate of attrition.
AHRQ-funded; HS000066.
Citation: Symer MM, Abelson JS, Wong NZ .
Impact of medical school experience on attrition from general surgery residency.
J Surg Res 2018 Dec;232:7-14. doi: 10.1016/j.jss.2018.06.002..
Keywords: Education: Continuing Medical Education, Surgery
Leeds IL, Rosenblum AJ, Wise PE
Eye of the beholder: risk calculators and barriers to adoption in surgical trainees.
This study examined barriers to surgical trainees in using risk calculator tools before surgery. A total of 124 surgical residents responded to a survey and most still favored more traditional methods for risk calculation including direct verbal communication, sketch diagrams, and brochures. Only about half or less were familiar with more contemporary tools such as best-worst case scenario framing, case-specific risk calculators, and all-procedure calculators.
AHRQ-funded; HS024736.
Citation: Leeds IL, Rosenblum AJ, Wise PE .
Eye of the beholder: risk calculators and barriers to adoption in surgical trainees.
Surgery 2018 Nov;164(5):1117-23. doi: 10.1016/j.surg.2018.07.002..
Keywords: Clinical Decision Support (CDS), Decision Making, Education: Continuing Medical Education, Risk, Surgery
Gonzalez CM, Garba RJ, Liguori A
How to make or break implicit bias instruction: implications for curriculum development.
The purpose of this study was to analyze faculty experiences regarding facilitating discussions as part of the institution's curriculum on racial and ethnic implicit bias recognition and management. The investigators conducted 21 in-depth interviews with faculty who had experience teaching in implicit bias instruction or were interested in facilitating discussions related to implicit bias and the Implicit Association Test. Grounded theory methodology was used to analyze interview transcripts.
AHRQ-funded; HS023199.
Citation: Gonzalez CM, Garba RJ, Liguori A .
How to make or break implicit bias instruction: implications for curriculum development.
Sessions):S74-s81. doi: 10.1097/acm.0000000000002386..
Keywords: 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, Decision Making, Simulation, Teams, Training
Chopra V, Harrod M, Winter S
Focused ethnography of diagnosis in academic medical centers.
J Hosp Med 2018 Oct;13(10):668-72. doi: 10.12788/jhm.2966.
This ethnographic study focused on the progress of teaching diagnosis to trainees in academic teaching hospitals. Trainees at 2 academic medical centers were observed to understand the barriers and facilitators to diagnosis. A total of 4 teaching teams between January and May 2016 were observed. Four key themes were identified and can be used to inform future interventions.
This ethnographic study focused on the progress of teaching diagnosis to trainees in academic teaching hospitals. Trainees at 2 academic medical centers were observed to understand the barriers and facilitators to diagnosis. A total of 4 teaching teams between January and May 2016 were observed. Four key themes were identified and can be used to inform future interventions.
AHRQ-funded; HS024385; HS022835.
Citation: Chopra V, Harrod M, Winter S .
Focused ethnography of diagnosis in academic medical centers.
J Hosp Med 2018 Oct;13(10):668-72. doi: 10.12788/jhm.2966..
Keywords: Education: Continuing Medical Education, Education: Academic, Diagnostic Safety and Quality, Cultural Competence
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
Cofer KD, Hollis RH, Goss L
Burnout is associated with emotional intelligence but not traditional job performance measurements in surgical residents.
The purpose of this study was to evaluate whether burnout was associated with emotional intelligence and job performance in surgical residents. The investigators found that burnout was present in surgery residents and was associated with emotional intelligence. There was no association of burnout with United States Medical Licensing Examination scores, American Board of Surgery In-Training Exam percentile, or surgical milestones. The investigators suggested that traditional methods of assessing resident performance may not be capturing burnout and strategies to reduce burnout should consider targeting emotional intelligence.
AHRQ-funded; HS023009.
Citation: Cofer KD, Hollis RH, Goss L .
Burnout is associated with emotional intelligence but not traditional job performance measurements in surgical residents.
J Surg Educ 2018 Sep - Oct;75(5):1171-79. doi: 10.1016/j.jsurg.2018.01.021..
Keywords: Burnout, Education: Continuing Medical Education, Provider, Provider: Physician, Provider Performance
Blay E, Engelhardt KE, Hewitt DB
Evaluation of reasons why surgical residents exceeded 2011 duty hour requirements when offered flexibility: a FIRST Trial analysis.
This study’s objective was to examine the reasons why residents exceeded a 24-hour call during their daily shift. Residents in the flexible arm of the Flexibility in Duty Hour Requirement for Surgical Trainees (FIRST) trial were surveyed anonymously. All clinical general surgery residents taking the 2017 American Board of Surgery In-Training Examination were included in the survey. There was a very high response rate (99.2%) which included 1838 of 1852 general surgery residents in the FIRST trial. Of those who responded, 21.7% indicated their programs expected them to stay longer. A large majority (78.1%) indicated they wanted to stay longer with only 7.4% reporting coercion from attending surgeons, and 9.3% reporting coercion from senior residents.
AHRQ-funded; HS000078.
Citation: Blay E, Engelhardt KE, Hewitt DB .
Evaluation of reasons why surgical residents exceeded 2011 duty hour requirements when offered flexibility: a FIRST Trial analysis.
JAMA Surg 2018 Sep;153(9):860-62. doi: 10.1001/jamasurg.2018.1047.
.
.
Keywords: Surgery, Provider: Physician, Education: Continuing Medical Education, Provider
Johnson AM, Spaete JP, Jowell PS
Top ten tips palliative care clinicians should know about interventional symptom management options when caring for patients with gastrointestinal malignancies.
In this article, the researchers brought together a team of interventional gastroenterologists and palliative care experts to collate practical pearls for the types of endoscopic interventions used for symptom management in patients with GI malignancies.
AHRQ-funded; HS023681.
Citation: Johnson AM, Spaete JP, Jowell PS .
Top ten tips palliative care clinicians should know about interventional symptom management options when caring for patients with gastrointestinal malignancies.
J Palliat Med 2018 Sep;21(9):1339-43. doi: 10.1089/jpm.2018.0251..
Keywords: Palliative Care, Education: Continuing Medical Education, Cancer
Morgan JR, Barlam TF, Drainoni ML
A qualitative study of the real-world experiences of infectious diseases fellows regarding antibiotic stewardship.
A qualitative study was performed to explore infectious disease (ID) fellows' experiences and perspectives regarding their antibiotic stewardship training and their role as future antibiotic stewards. The investigators concluded that ID fellowship training was not successfully conveying the public health importance of antibiotic stewardship or the role of ID physicians as leaders of antibiotic stewardship programs. They noted that fellows were more focused on concrete tasks related to stewardship.
AHRQ-funded; HS022242.
Citation: Morgan JR, Barlam TF, Drainoni ML .
A qualitative study of the real-world experiences of infectious diseases fellows regarding antibiotic stewardship.
Open Forum Infect Dis 2018 Sep;5(9):ofy102. doi: 10.1093/ofid/ofy102..
Keywords: Antibiotics, Antimicrobial Stewardship, Education: Continuing Medical Education, Infectious Diseases
Kanters AE, Shubeck SP, Sandhu G
Justifying our decisions about surgical technique: evidence from coaching conversations.
The objective of this qualitative study was to determine the extent to which practicing surgeons participating in a coaching program justify their technical decisions based on their experience or based on evidence. The investigators found that practicing surgeons often justify their surgical decisions with anecdotal evidence and "lessons learned," rather than deferring to surgical literature. The authors suggest that this either represents a lack of evidence or poor uptake of existing data.
AHRQ-funded; HS023597; HS000053.
Citation: Kanters AE, Shubeck SP, Sandhu G .
Justifying our decisions about surgical technique: evidence from coaching conversations.
.
Keywords: Decision Making, Education: Continuing Medical Education, Provider, Practice Patterns, Surgery
Simpkin AL, Khan A, West DC
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
This study examined how stress from uncertainty is related to resilience among medical residents and whether those attributes are related to depression and burnout. The investigators surveyed 86 residents in pediatric residency programs from 4 urban freestanding children’s hospitals in North America in 2015. They used the Physicians’ Reaction to Uncertainty Scale to measure stress from uncertainty, the 14-item Resilience Scale to measure uncertainty, the Harvard National Depression Scale for depression, and the Maslach Burnout Inventory for burnout. There was a response rate of 58.1%. Five residents met depression criteria, and 15 residents met the burnout criteria. Depressed and burned out residents both had higher mean levels of stress compared to residents who neither depressed nor burned out.
AHRQ-funded; HS022986.
Citation: Simpkin AL, Khan A, West DC .
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
Acad Pediatr 2018 Aug;18(6):698-704. doi: 10.1016/j.acap.2018.03.002..
Keywords: Burnout, Stress, Depression, Provider: Physician, Behavioral Health, Provider, Education: Continuing Medical Education, Hospitals
Symer MM, Abelson JS, Gade L
Association between American Board of Surgery in-training examination score and attrition from general surgery residency.
In this study, to identify residents at risk of attrition, the investigators analyzed American Board of Surgery In-Training Exam scores based on average rank and change in score. The investigators found that lower American Board of Surgery In-Training Exam scores were associated with attrition, but this difference was small, and some residents completed training with very low scores. A large drop in American Board of Surgery In-Training Exam scores from one year to the next appeared to be associated with attrition.
AHRQ-funded; HS000066.
Citation: Symer MM, Abelson JS, Gade L .
Association between American Board of Surgery in-training examination score and attrition from general surgery residency.
Surgery 2018 Aug;164(2):206-11. doi: 10.1016/j.surg.2018.03.016..
Keywords: Education: Continuing Medical Education, Surgery
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: Decision Making, Palliative Care, Cancer, Surgery, Education: Continuing Medical Education, Training
Le Parc JM, Bischof JJ, King AM JM, Bischof JJ, King AM
A randomized comparison of in-hospital rescuer positions for endotracheal intubation in a difficult airway.
The objective of the study was to compare in-hospital emergency medicine (EM) trainees' performance on endotracheal intubation (ETI) delivered from both the seated and standing positions. The study concluded that the position of the in-hospital provider, whether seated or standing, had no effect on the provider's ETI performance. Since environmental circumstances sometimes necessitate alternative positioning for effective ETI administration, the findings suggest that there may be value in training residents to perform ETI from both positions.
AHRQ-funded; HS021456.
Citation: Le Parc JM, Bischof JJ, King AM JM, Bischof JJ, King AM .
A randomized comparison of in-hospital rescuer positions for endotracheal intubation in a difficult airway.
West J Emerg Med 2018 Jul;19(4):660-67. doi: 10.5811/westjem.2018.4.37227..
Keywords: Education: Continuing Medical Education, Emergency Medical Services (EMS), Patient Safety, Provider Performance
Yeo HL, Abelson JS, Symer MM
Association of time to attrition in surgical residency with individual resident and programmatic factors.
Attrition in general surgery residency remains high, and attrition that occurs in the later years is the most worrisome. Although several studies have retrospectively investigated the timing of attrition, no study to date has prospectively evaluated a national cohort of residents to understand which residents are at risk for attrition and at what point during residency. The purpose of this study was to prospectively evaluate individual resident and programmatic factors associated with the timing of attrition during general surgery residency.
AHRQ-funded; HS000066.
Citation: Yeo HL, Abelson JS, Symer MM .
Association of time to attrition in surgical residency with individual resident and programmatic factors.
JAMA Surg 2018 Jun;153(6):511-17. doi: 10.1001/jamasurg.2017.6202.
.
.
Keywords: Education: Continuing Medical Education, Provider, Provider: Physician, Surgery
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: 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
Greenberg CC, Ghousseini HN, Pavuluri Quamme SR
A statewide surgical coaching program provides opportunity for continuous professional development.
Researchers sought to develop and evaluate a video-based coaching program for board-eligible/certified surgeons. They found that, overall, participants were satisfied with their experience and found the coaching program valuable. Future research to evaluate the impact of coaching on practice change and patient outcomes is recommended.
AHRQ-funded; HS022403.
Citation: Greenberg CC, Ghousseini HN, Pavuluri Quamme SR .
A statewide surgical coaching program provides opportunity for continuous professional development.
Ann Surg 2018 May;267(5):868-73. doi: 10.1097/sla.0000000000002341..
Keywords: Education: Continuing Medical Education, Health Services Research (HSR), Patient Safety, Provider, Provider: Physician, Quality of Care, Surgery